Key takeaways
- Companion care is non-medical: companionship, everyday assistance and social engagement.
- Home health care is skilled care such as nursing and therapy, ordered by a doctor or other provider.
- Medicare's home health benefit requires a person to be homebound and need part-time or intermittent skilled services.
- Medicare.gov states it does not pay for homemaker services or custodial care when that is the only care needed.
- Many families use both: medical care from a home health agency and companion care for everyday life.
What is companion care?
Companion care is non-medical support that helps older adults live well at home. It centers on companionship, conversation and shared activities, plus everyday help such as errands, light housekeeping, meal preparation and accompaniment to appointments or outings.
What is home health care?
Home health care is skilled medical care delivered at home by licensed professionals. According to Medicare.gov, “Home health services”, covered services can include part-time or intermittent skilled nursing care (such as wound care, injections, or IV or nutrition therapy), physical, occupational and speech-language therapy, and medical social services. A doctor or other provider must order the care.
Companion care vs. home health care at a glance
| Companion care | Home health care | |
|---|---|---|
| Purpose | Connection, wellbeing and help with daily life | Treating or recovering from an illness, injury or condition |
| Typical services | Companionship, errands, light housekeeping, meals, outings | Skilled nursing, therapy, medical social services |
| Who provides it | Trained companions and caregivers | Licensed nurses and therapists through a home health agency |
| Needs a doctor's order? | No | Yes |
| Typical length | Ongoing, as long as it helps | Usually for a defined period tied to a care plan |
| Medicare coverage | Generally not covered when it is the only care needed | Covered for eligible, homebound beneficiaries |
Does Medicare pay for companion care?
Generally no. Medicare.gov lists what Medicare does not pay for under its home health benefit, including 24-hour-a-day care at home, home meal delivery, homemaker services such as shopping and cleaning that are unrelated to the care plan, and custodial or personal care that helps with daily living activities when it is the only care a person needs. Families often pay privately, and some long-term care insurance policies may help, so review your policy details.
Who qualifies for Medicare home health care?
Medicare.gov says a person must need part-time or intermittent skilled services and be homebound, and a doctor or other provider must see them in person and confirm they need home health care. Being homebound means leaving home is not recommended because of a condition, or the person is normally unable to leave home and leaving takes a lot of effort.
Can you use companion care and home health care together?
Yes, and many families do. A home health nurse or therapist might visit for a few weeks after a hospital stay, while a companion helps with meals, errands and company in between. The two work best when everyone knows who is doing what.
Which one does my loved one need?
If the main needs are medical, such as wound care, injections or therapy, speak with their doctor about home health care. If the main needs are company, routine and help with everyday tasks, companion care is often the right fit. If you are unsure, start with their doctor and a conversation with us, and we can talk through what we offer.
Learn more about our everyday assistance and companionship services.
This guide is general information, not medical, legal or financial advice. Please consult qualified professionals about your family's situation.