Guide
Home health, home care or a nursing home: how to tell which you need
These terms get used as if they mean the same thing. They do not, and the difference decides who pays.
The short answer
Home health is skilled nursing or therapy at home, ordered by a provider and often paid by Medicare or Medicaid. Home care is non-medical help with bathing, meals and daily life, usually paid by Medicaid long-term programs, insurance or the family. A nursing home provides round-the-clock care and supervision in a licensed facility. Many people use home health and home care together.
Quick comparison
| Home health | Home care | Nursing home | |
|---|---|---|---|
| What it is | Skilled care at home | Help with daily life at home | Round-the-clock care in a facility |
| Who gives it | RNs, LPNs, therapists, aides | CNAs, aides, companions, direct service workers | Nurses and aides on staff |
| Who orders it | A health care provider | You or a care plan | Often a doctor, with assessment |
| Who usually pays | Medicare, Medicaid | Medicaid long-term programs, insurance, private funds | Medicaid, private funds, short-term Medicare |
A simple way to decide
- Is there a wound, a new medication routine or a recent hospital stay? Start with home health.
- Is the trouble bathing, dressing, cooking, loneliness or a tired caregiver? Start with home care.
- Does the person need awake supervision around the clock, and is there no way to staff it at home? Talk through a facility honestly.
Cost at a glance
CareScout's Florida 2024 survey lists a nursing home semi-private room at $124,100 a year and a private room at $138,700. Full-time non-medical care at home runs in the $70,000s, while round-the-clock care at home can exceed the cost of a facility.
Medicaid can help keep someone home
Florida's Long-Term Care program is built for people who would otherwise need a nursing home but want to be at home. Nursing home residents who have been there at least 60 straight days can get priority enrollment to move back. See how it works.
Questions families ask
What is domiciliary care?
It means care delivered in your home. In Florida you will usually see it called home care or home and community-based services.
Is assisted living cheaper?
CareScout's 2024 Florida figure was $63,885 a year, but costs vary and care levels differ. Compare what is included.