Home care and home health care
Home care is non-medical help at home with personal care, household chores, transportation and safety, while home health care is part-time skilled nursing and therapy ordered by a health care provider.[1][2] Medicare covers home health for eligible homebound people but does not pay for custodial home care when that is the only care needed.[2]
Home care versus home health
| Non-medical home care | Medicare home health | |
|---|---|---|
| Services | Bathing, dressing, grooming, toileting, eating, chores, money management, transportation[1] | Part-time skilled nursing, physical/occupational/speech therapy, medical social services, part-time aide care alongside skilled care[2] |
| Who orders it | The family or individual | A doctor or other provider who has seen the patient in person[2] |
| Medicare | Not covered when it is the only care needed[2] | $0 for covered services if homebound and eligible[2] |
| Limits | As purchased | Generally up to 8 hours a day combined, maximum 28 hours a week[2] |
Cost of home care
| Area | Hourly | Monthly (44 hrs/week) | Annual |
|---|---|---|---|
| United States | $35 | $6,673 | $80,080 |
| California | $40 | $7,627 | $91,520 |
| San Diego-Chula Vista-Carlsbad area | $40 | $7,627 | $91,520 |
Source: CareScout Cost of Care Survey 2025, which now combines homemaker and home health aide services as “non-medical caregiver” and assumes 44 hours per week.[3][4][6]
How common is care at home
LongTermCare.gov estimates that 65% of people use some care at home, for an average of two years, and 42% use paid care at home.[7] NIA notes that in many cases long-term care at home is provided by unpaid family members, friends and neighbors, supplemented by paid caregivers.[8]
Home care rules in California
Under the Home Care Services Consumer Protection Act, since January 2016 California has required Home Care Organizations to be licensed and maintains a public online registry of background-checked Home Care Aides, both administered by the CDSS Home Care Services Branch.[5] Aides can be looked up in the Home Care Aide Registry.[9] In San Diego County, the County’s Aging & Independence Services provides home and personal care assistance to people who receive Supplemental Security Income or have low incomes.[10]
Frequently asked questions
Does Medicare pay for home care?
Medicare pays for home health services, such as part-time skilled nursing and therapy, for eligible homebound people. It does not pay for 24-hour care or for custodial personal care when that is the only care needed.[2]
How much does home care cost per hour?
The 2025 national median for a non-medical caregiver was $35 per hour; the California and San Diego-area medians were $40 per hour.[3][4][6]
Do home care agencies need a license in California?
Yes. Since January 2016, California has required Home Care Organizations to be licensed and aides to be listed on a public registry after a background check.[5]
See also
References
Web pages accessed September 28, 2026 unless noted. See sources and methodology.
- ^ "Aging in Place: Growing Older at Home". National Institute on Aging (NIH).
- ^ "Home health services (coverage page)". Medicare.gov, Centers for Medicare & Medicaid Services.
- ^ "Cost of Care Survey 2025: national median costs". CareScout (formerly the Genworth Cost of Care Survey). Survey fielded July–November 2025.
- ^ "Cost of Care Survey 2025: Median Cost Data Tables (PDF, dated 03/02/26)". CareScout. 2025 data.
- ^ "Home Care Services". California Department of Social Services.
- ^ "Cost of Care Survey 2025 calculator: San Diego-Chula Vista-Carlsbad area". CareScout. 2025 data for the San Diego metropolitan area.
- ^ "How Much Care Will You Need?". LongTermCare.gov, Administration for Community Living. Page last modified 02/18/2020.
- ^ "What Is Long-Term Care?". National Institute on Aging (NIH).
- ^ "California Home Care Aide Registry". California Department of Social Services. Search tool.
- ^ "About Aging & Independence Services". County of San Diego Health and Human Services Agency.