In short
"Home care" usually means a non-medical aide who helps with bathing, dressing, meals and companionship; "home health" is short-term skilled nursing or therapy ordered by a doctor. Medicare may pay for home health in some situations, but it does not pay for long-term personal care. For ongoing help at home, families usually pay privately or, for those who qualify, use a Medicaid program. Call (800) 614-8388 for help finding agencies.
Two different things called "home care"
| Home care (non-medical) | Home health (medical) | |
|---|---|---|
| Who provides it | A home-care aide or companion | A nurse, therapist or aide working under a doctor's plan of care |
| What they do | Bathing, dressing, meals, light housekeeping, errands, company | Wound care, medication management, physical or speech therapy, monitoring |
| Typical duration | Ongoing: hours a day or a few days a week | Short-term and intermittent, while you're recovering |
| Paid by | Private pay, usually billed by the hour; some long-term care insurance; limited Medicaid programs | Medicare may cover it when ordered and when you're homebound |
Who pays for what
Medicare generally does not pay for long-term care, including help with daily living at home. It can cover home health — skilled nursing or therapy — for a limited time when a doctor orders it and you meet the homebound and other rules. Ask the agency to explain the plan of care in writing.
Medicaid may pay for personal-care help at home for people who qualify financially and functionally. In Kansas that path runs through KanCare, including the Home and Community Based Services Frail Elderly (FE) waiver — which as of July 6, 2026 has a waitlist for new assessments, so apply early by contacting the Aging and Disability Resource Center at 1-855-200-2372. In Missouri, help runs through MO HealthNet for the Aged, Blind, and Disabled; eligibility is judged by income, assets and a nursing-facility level-of-care determination. Apply for Missouri coverage through the Family Support Division.
Veterans may qualify for help through VA programs; see our veterans benefits page. We explain these programs but we don't advise on shifting assets to qualify — for anything involving the house or savings, talk with the Area Agency on Aging and a licensed elder law attorney.
Not sure how many hours of help you need?
Tell us what a typical day looks like and we'll help you line up agencies to compare.
How to hire someone safely
- Use an agency, or be ready to be an employer. An agency handles background checks, taxes and insurance and covers shifts when an aide is sick. Hiring directly is cheaper but you become the employer — the paperwork and the liability are yours.
- Check the license. Home-care agencies are licensed by the state (KDADS in Kansas, DHSS in Missouri). Ask for the license number and look it up.
- Ask about supervision. Who checks the aide's work, and how often? A good agency has a care supervisor, not just a scheduler.
- Start small. A few hours a week to build trust beats a full-time arrangement you can't undo.
- Protect money and valuables. Keep medications and finances out of reach, and never hand over a bank card or passwords.
When home stops being safe
Home care has a ceiling. If someone needs help all night, is repeatedly falling, has dementia and wanders, or needs skilled nursing, staying home can become more dangerous and more expensive than a community. Watch for a pattern of falls, a stove left on, medications missed or doubled, unpaid bills, and weight loss. Any one of those is a reason to look again at the level of care — not necessarily to move, but to add help or consider assisted living. If there is an emergency, call 911.
Questions about care at home
Does Medicare pay for a caregiver to come to the house?
Medicare does not pay for long-term help with daily living such as bathing, dressing or meals. It can cover skilled home health — nursing or therapy — for a limited time when a doctor orders it and you meet the homebound rules. For ongoing personal care, families usually pay privately.
What if we can't afford full-time care?
Talk to the Area Agency on Aging (in Johnson County, 913-715-8861) — they can connect you with lower-cost programs, respite for family caregivers, and help applying for benefits. In Kansas the KanCare Frail Elderly waiver now has a waitlist, so start the process early.
How much does home care cost?
Non-medical home care is typically billed by the hour. Rates vary widely by agency and by region, and are higher for complex care or overnight shifts, so compare at least three agencies before you decide.
Can the same person help with medicine?
It depends on the state and the aide's training. Some aides can hand you pre-set medications or remind you; only a nurse can administer certain medications. Ask the agency exactly what its aides are allowed to do.
Sources
- Medicare.gov — Long-term care coverage
- KDADS — Frail Elderly (FE) HCBS waiver (eligibility, ADRC intake line 1-855-200-2372)
- Missouri DSS — Apply for MO HealthNet; MO HealthNet ABD eligibility manual