How to Find, Understand, and Pay for Home Care Services Near Me

Home care services are a broad category of support provided to people in their own homes. They exist to help individuals who need assistance with daily living, recovery from illness or surgery, or ongoing management of a disability or chronic condition.

There are two main types: home health care and personal care.

Home health care is medical in nature. It involves skilled clinical services like nursing care, physical therapy, occupational therapy, or speech therapy delivered at home by licensed professionals. It is typically prescribed by a doctor and tied to a specific medical need or recovery goal.

Personal care covers help with daily living activities like bathing, dressing, grooming, meal preparation, and light housekeeping. It is less about treating a condition and more about supporting a person’s ability to maintain independence and function at home. Because every person’s situation is different, personal care is typically built around their unique needs rather than a fixed set of tasks.

Many people need both types of support, while others may need only one. Understanding the difference helps you figure out what to look for and how to pay for it.

Home care covers a wide range of services across two main categories: home health care and personal care. Here is an overview of what each includes.

Home health care services are medical in nature, typically ordered by a doctor and delivered by licensed professionals.

A registered nurse or licensed practical nurse can visit your home to manage medications, monitor chronic conditions, provide wound care, or coordinate with your doctor. Nursing visits can range from a few times per week to daily, depending on medical need.

These therapies help people recover function after an illness, injury, or surgery. Physical therapy focuses on mobility and strength. Occupational therapy helps people relearn or adapt daily tasks. Speech therapy addresses communication and swallowing difficulties. All three can be provided at home when traveling to a clinic is difficult.

Want to better understand the differences between physical, occupational, and speech therapy? Watch this short overview from The Ohio State University Wexner Medical Center.

Home health aides assist with bathing, dressing, toileting, grooming, and mobility, and may also help with light medical tasks under the supervision of a licensed nurse. They are often the most consistent presence in a person’s day-to-day care.

Personal care services are non-medical. They support daily living and independence at home without requiring a doctor’s order or a licensed clinician.

Personal care aides help with the same daily living tasks as home health aides, including bathing, dressing, grooming, and meal preparation, but work outside of a clinical or medical framework. They are well suited for people who need regular hands-on support but do not have skilled medical needs.

Companion care provides social interaction and supervision for people who should not be alone for extended periods. Homemaker services cover tasks like cooking, grocery shopping, laundry, and light housekeeping. Respite care, which gives family caregivers a temporary break from their responsibilities, often falls into this category as well.

Some home care programs include or coordinate meal delivery services, which help ensure people who have difficulty cooking are still getting proper nutrition. Non-medical transportation assists people in getting to medical appointments, therapy sessions, or other community activities.

Home care sometimes involves arranging for durable medical equipment like wheelchairs, walkers, hospital beds, or oxygen equipment to be delivered and set up in the home. Your doctor or care manager typically initiates this process through a referral.

There is no single answer to this, but there are some common signs that home care may be worth looking into.

• Everyday tasks that used to be easy are becoming difficult or unsafe
• A person is recovering from surgery or a serious illness and needs skilled support at home before they are ready to be fully independent
• A disability or chronic condition requires consistent help with personal care or daily activities
• A family member is providing care informally and needs support or relief to continue managing a loved one’s care without burning out

If any of these situations sound familiar, talking to a doctor or care manager is a good first step. They can assess what level of care is appropriate and point you toward the right programs.

Looking for self-directed care options? Get program information based on the state where you live.

Cost is one of the first questions people have, and understandably so. Here is a straightforward look at the main options.

Medicare covers home health care services, but only under specific conditions. You must be considered homebound, meaning leaving home requires considerable effort. A doctor must certify that you need skilled care, such as nursing or therapy. Services must be provided by a Medicare-certified home health agency. Medicare does not cover non-medical personal care or homemaker services when that is the only care needed.

Medicaid covers a broader range of home care services than Medicare, including personal care and long-term support for people with disabilities or chronic conditions. Coverage and eligibility rules vary by state, but Medicaid is often the primary payer for people who need ongoing home care and meet the financial and medical eligibility requirements. Both Medicare and Medicaid are government programs, but they work differently, and understanding which one applies to your situation is an important first step.

For services not covered by insurance, people pay privately. Affordability of home care can vary widely depending on location, the type of care needed, and how many hours per week are involved. Some families use long-term care insurance policies to offset these expenses.

If you or someone you care for is eligible for Medicaid, there is a home care option worth knowing about that does not involve a home care agency at all.

It is called self-directed care, and it works differently from traditional home care. Instead of an agency assigning a worker to your home, you choose who provides your support. That person can be someone you already know, a family member, a close friend, or a trusted neighbor. You set the schedule. Your care is built around your life and your preferences. Participants in self-directed programs become the employer of their caregiver, and a financial management services company handles the administrative side, including payroll, taxes, and enrollment paperwork.

Self-directed care is available through Medicaid in most states to older adults, people with physical disabilities, people with intellectual or developmental disabilities, and individuals with chronic conditions who qualify for Medicaid-funded home and community-based services. The program name and structure vary depending on where you live, but the core model is consistent: you are in control of who helps you and how.

For many people, this option is a better fit than traditional agency care. You are not assigned a stranger. You are not working around an agency’s schedule. The person providing your care is someone who already knows you and what you need. The benefits of this model go beyond convenience. People in self-directed programs consistently report greater satisfaction, more stability in their care, and a stronger sense of control over their daily lives.

Ask your Medicaid case manager or care coordinator whether self-directed care is available in your state and program. If you are not yet on Medicaid, that is the first step, and it is worth exploring whether you qualify.

• Step 1: Talk to Your Doctor or a Hospital Discharge Planner: This is the best starting point for most people. A doctor or discharge planner can assess your needs, refer you to appropriate services, and tell you what your insurance will cover.
• Step 2: Contact Your Medicaid Office or Managed Care Plan: If you are on Medicaid, reach out to your state Medicaid office or managed care plan to ask about covered home care services and whether self-direction is an option in your area. Your local Area Agency on Aging is another useful resource for older adults navigating home care options.
• Step 3: Research Private Pay Options if Needed: If you are paying out of pocket, look for licensed and accredited home health agencies. Ask about caregiver screening practices, training requirements, and how they handle scheduling and supervision. Get clear answers on hourly rates and what services are included before you commit.
• Step 4: Create a Personalized Care Plan: Once you have identified your needs and your provider, put it in writing. Personalized care plans outline who is providing what support, when, how often, and what the goals are. A good plan keeps everyone on the same page and helps you track whether the care is working.

Need help understanding how to compare your options? Use our guide to find affordable home care providers near you.

If anything in this article made you wonder whether self-directed care could be an option for you or a loved one, you are in the right place. Self-direction is available to people with disabilities, chronic conditions, and older adults who qualify for Medicaid-funded home and community-based services. The program names and structures vary by state, but the core idea is the same everywhere: you choose who helps you, and your care fits your life. Take our short questionnaire to find out what your next steps look like.

Public Partnerships LLC (PPL) is a financial management services company dedicated entirely to supporting self-directed care. PPL operates in approximately 50 programs across the United States and has supported more than 700,000 participant and caregiver relationships. When you enroll in a self-direction program with PPL, we handle the administrative side, including payroll, taxes, and enrollment paperwork, so you can focus on your care. It is all we do, and we have been doing it for decades.