Home Care vs. Home Health Care: What's the Difference in Texas?
Families searching for help at home in Texas run into two nearly identical terms that mean very different things: home care and home health care. Choosing the wrong one wastes weeks — and knowing the difference tells you who will actually pay for it.
Here's the plain-English breakdown.
The One-Sentence Difference
Home care is non-medical help with daily living (bathing, meals, housekeeping, companionship) provided by trained caregivers. Home health care is skilled medical care (nursing, therapy) provided at home by licensed clinicians under a doctor's orders.
What Home Care Includes
Home care — also called personal care, attendant care, or non-medical home care — keeps daily life running safely:
- Bathing, dressing, grooming, and toileting assistance
- Transfers, walking support, and fall prevention
- Meal preparation and feeding assistance
- Medication reminders
- Light housekeeping, laundry, shopping, and errands
- Escort to appointments and companionship
- Respite so family caregivers can rest
Home care can run a few hours a week or every day, indefinitely — it's built for ongoing needs that come with aging, disability, or chronic conditions.
What Home Health Care Includes
Home health is ordered by a physician, delivered by licensed clinicians, and usually short-term after an illness, injury, or hospital stay:
- Skilled nursing: wound care, injections, IV therapy, catheter care, health monitoring
- Physical, occupational, and speech therapy
- Medical social services
- Home health aide visits — but only alongside the skilled care
When the doctor's treatment goals are met, home health ends. The everyday help doesn't — which is why many families use home health and home care together after a hospitalization.
Who Pays for What
This is where the distinction really matters:
Medicare pays for home health, not home care. If your loved one is homebound and needs intermittent skilled nursing or therapy, Medicare covers home health at 100% through a certified agency. But Medicare explicitly does not pay for personal or custodial care when that's the only care needed, nor for homemaker services or 24-hour care.
Medicaid pays for home care. Texas Medicaid covers non-medical home care through several programs — Primary Home Care (PHC), Community Attendant Services (CAS), STAR+PLUS, and Community First Choice — and the state's Family Care program covers people who don't qualify for Medicaid. In many of these, a family member can even be paid as the caregiver.
Private pay: without a program, non-medical home care in Texas runs around $30/hour on average (2025–26 cost-of-care surveys) — below the national median of about $35, but still roughly $2,600+/month at 20 hours a week. That price tag is exactly why the Medicaid programs above are worth applying for.
How Texas Licenses Each (and Why You Should Check)
Texas licenses both under the Home and Community Support Services Agency (HCSSA) system, in different categories: home care agencies hold a Personal Assistance Services license, while home health agencies hold a Licensed Home Health (and, to bill Medicare, Licensed & Certified Home Health) license. Before hiring any agency, ask for their HCSSA license — a hired-off-a-flyer "independent caregiver" arrangement leaves your family with no screening, no supervision, and no backup when someone gets sick.
Which Does Your Loved One Need?
- Recovering from surgery, new diagnosis, wound care, therapy ordered → home health (ask the doctor for a referral)
- Needs ongoing help bathing, cooking, staying safe day to day → home care
- Both are true → both, often at the same time
- Not sure → call us; this is the question we answer most
Talk to Rahma Home Care Agency
Rahma Home Care Agency provides licensed non-medical home care across Dallas, Fort Worth, Arlington, Plano, and surrounding North Texas communities — including care funded through Texas Medicaid programs and care provided by paid family caregivers.
Call (945) 286-4004 for a free consultation. We'll tell you honestly which kind of care fits — even if the answer is a doctor's referral rather than us.
Coverage rules current as of 2026. Official sources: medicare.gov and hhs.texas.gov.