Choosing Home Care
Non-Medical Home Care vs. Home Health Care in Texas: What's the Difference?
The two names sound alike, but they are different services with different providers, rules and costs. Here is how to tell which one your family needs, or whether it is both.
By Lilly's Home Health Care Editorial TeamPublished 7 min read
Key takeaways
- Non-medical home care helps with everyday activities such as bathing, dressing, meals, housekeeping and getting around. Home health care is medical care, such as nursing or therapy.
- Medicare can cover limited, part-time home health care when specific conditions are met. It does not pay for personal or custodial care when that is the only care a person needs.
- Many families need both, sometimes at the same time. Start with what the help is for, not with the name of the service.
When you start looking for help for a parent, “home care” and “home health care” show up side by side and are often used as if they mean the same thing. They do not. Non-medical home care helps with the everyday tasks of living at home. Home health care is medical care delivered at home, such as nursing or therapy.
Which one you need depends on whether the help is about getting through the day or about treating a condition. Many families need one, then the other, or both at once. Below is how the two differ, who pays for each, and a simple way to sort out what your family actually needs.
What non-medical home care covers
Non-medical home care, which you will also see called personal care, companion care or custodial care, supports daily life. The National Institute on Aging (NIA) describes personal care as help with everyday activities, “also called ‘activities of daily living,’ such as bathing, dressing, grooming, using the toilet, eating, and moving around.” It describes chores such as housecleaning, grocery shopping and laundry as a separate kind of help many older adults need.
In practice, non-medical support often looks like:
- Help with bathing, dressing and grooming (personal care)
- Meal preparation, light housekeeping and laundry (household support)
- Rides to appointments and help with errands (transportation and errands)
- Conversation and company (companion care), or a break for a family caregiver (respite care)
- Reminders about medicine a doctor has already prescribed, which is different from giving medication
What it does not include is treatment. A non-medical caregiver is not a nurse and does not provide wound care, injections or therapy.
What home health care covers
The NIA says home health care services can help with “many aspects of health care, such as medications, wound care, medical equipment, and physical therapy,” and can include in-home nursing care to help a person recover from surgery, an accident or an illness.
Medicare's list of covered home health services includes part-time or intermittent skilled nursing care and, if certain conditions are met, physical, occupational and speech-language therapy. In short, home health care is clinical care delivered by professionals such as nurses and therapists.
The two side by side
| Topic | Non-medical home care | Home health care |
|---|---|---|
| What it is | Help with everyday activities and routines at home | Medical care at home, such as nursing or therapy |
| Typical tasks | Bathing and dressing help, meals, laundry, errands, rides, companionship | Skilled nursing care, wound care, physical, occupational or speech therapy |
| Who provides it | Caregivers, who are not nurses | Clinicians such as nurses and therapists |
| Who decides it is needed | You and your family, based on daily needs | A doctor or other health care provider. Medicare requires one to confirm the need |
| Typical schedule | Set with the agency, from short visits to longer or overnight support | Under Medicare, part-time or intermittent skilled care |
| How it is usually paid | Mostly out of pocket. Medicare does not pay for personal care when it is the only care needed | May be covered by Medicare if conditions are met. Other plans vary |
Who pays for each
Medicare is where most families get stuck, so it is worth being precise. Medicare's own website says it does not cover custodial or personal care, such as help with bathing, dressing or using the bathroom, when that is the only care you need. It also does not cover homemaker services, such as shopping and cleaning, that are unrelated to your care plan.
Medicare can cover home health care when conditions are met. A doctor or other health care provider must see you in person and confirm you need it, you must need part-time or intermittent skilled services, leaving home must not be recommended because of your condition, and a Medicare-certified home health agency must provide it. Help from a home health aide with things like bathing or grooming is covered only if you are also getting skilled nursing care.
Non-medical home care is generally paid for privately. Lilly's, for example, is a private-pay agency, and cost depends on the type of care, the schedule and the hours. The NIA notes that some long-term care insurance plans help pay for companion visits and respite care, and that Medicaid coverage of home health services varies by state. Because plans differ, ask your own plan directly rather than assuming either way.
How Texas fits in
In Texas, the Health and Human Services Commission (HHSC) licenses agencies that provide care in a person's home as Home and Community Support Services Agencies, or HCSSAs. HHSC licenses them by the kind of service they offer. Personal assistance services is one license category. Licensed home health services and licensed-and-certified home health services are others.
HHSC's training materials note that an agency may not offer specific health care services without first selecting the appropriate service category, and that an agency must be licensed in one of the certified categories to provide services through Medicare. That gives families a concrete question to ask any agency: which services are you licensed to provide?
How to tell which one your family needs
Start with what the help is for. These four questions usually settle it.
- Is the need about treatment? Wound care, injections, therapy, monitoring a condition or following specific medical orders are clinical needs. Talk to the doctor or care team about home health care.
- Is the need about getting through the day? Bathing, getting dressed, meals, laundry, rides to appointments and having company are everyday needs. Non-medical home care is built for these.
- Is someone coming home from the hospital? The discharge team can explain what clinical help your loved one needs at home. The NIA notes the hospital can help arrange home health help when nursing care is still needed at home for a short time.
- Is it both? That is common. A nurse or therapist may handle treatment while a non-medical caregiver helps with meals, laundry and getting to the next appointment. The two work side by side; neither replaces the other.
Where Lilly's fits
Lilly's Home Health Care provides non-medical support at home across North Texas: personal care, companion care, respite care, overnight and 24-hour support, non-medical help after a hospital stay or surgery, household support and transportation and errands. We are not a skilled nursing or therapy service, and our caregivers do not administer medication or provide medical treatment. If your loved one needs clinical care, that comes from home health professionals, and many families use non-medical help for the everyday side of life at the same time.
If you are not sure where to start, how care at home gets started explains what happens after you contact us, and the areas we serve lists the North Texas cities we support.
Questions to ask any agency before you decide
Sources
- Home health services (Medicare.gov; accessed October 11, 2026)
- Long-term care (Medicare.gov; accessed October 11, 2026)
- Services for Older Adults Living at Home (National Institute on Aging; accessed October 11, 2026)
- HCSSA Pre-Survey Training, Module 1: Service Categories (Texas Health and Human Services Commission; accessed October 11, 2026)
- Home and Community Support Services Agencies (HCSSA) (Texas Health and Human Services Commission; accessed October 11, 2026)
