Understanding the basics of home care 101 is important when looking for the right care to assist someone as they grow older. Many families are confused as to what home care is, what it covers and does not cover, and how it works.

Home Care

This page will explain what home care is and the services that it covers for families needing extra help. Take your time and read through all the services so you know what exactly you are looking for care.

Here’s what you’ll learn in Home Care 101.
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What is Home Care?

Simply put, home care is when someone comes into a home and provides a nurse, home health aide, or homemaker to assist the person(s) living there with medical or non-medical services.

There are three types of home care.

1. Private home care (also known as non-medical home care)

2. Visiting nurses associations (VNA)

3. Skilled home care

Medicare Nurse/Visiting Nurses Association (VNA)

homehealthcare2Visiting nurses associations (VNA) are non-profit companies that provide care for a limited duration of time. A VNA is used when a senior is being discharged from a hospital or a post-acute rehab facility and needs assistance in their home while they are still recovering. They include nurses, therapists and home health aides.

One of the biggest misconceptions about VNA service is that it is unlimited hours services that run indefinitely. Medicare pays for these services but is not an unlimited amount of care indefinitely.

Usually a senior will receive a few days of care a week for two to four hours. The nurse will address medical issues (IVs, medications, wound care). Therapists will assist with continuing treatment for mobility, and home health aides assist with dressing, sponge baths, and other non-medical needs.

Often it is suggested by the hospital or rehab facility to supplement VNA nurses with private home care services. They also offer home health aides too, but they will be limited to a small amount of hours per week to care for the person.

Private Home Care (aka private care, non-medical care, private duty care)

privatehomecarePrivate home care companies provide home health aides, certified nursing assistance (CNA) and homemakers. Private home care offers a range of services that help with preventing injury, providing nutrition, and supervision for someone that needs assistance with their activities of daily living (ADLs).

These aides are available for a senior at a moments notice. They can help with bathing, toileting, dressing, meal preparation, chores, fall prevention, supervision, and transportation to name a few.

Many families use private home care in conjunction with VNA services because of the limited hours a VNA nurse is at the home, and they continue services with a private home care company after the VNA has left.

Private care is paid directly by the family that is receiving the services. Insurance does not cover this cost as it is not a medical need and is unlikely to reimburse for services.

There are other alternatives for payment that drastically reduce the out of pocket cost, which include; long-term care insurance, and Veterans aid and attendance.

Private duty home care companies can provide care under two different business models, one as a referral agency, the other as an employment model.

Referral Agencies vs. Employment Agencies


A referral agency provides caregivers under a model that is becoming less common. The company hires qualified companions, CNAs, and home health aides and adds them to the ‘pool’ of caregivers they can refer to families needing care.

These caregivers should be background checked, reference checked and qualified to provide care, but the difference payments. When a customer calls and agrees to the service under a referral model, they pay a fee to the agency for referring them a qualified caregiver. That caregiver becomes an employee of the family that is hiring them. The family is expected to pay the workers compensation, taxes, insurances, social security, and hourly pay to the caregiver – the family is the employer.


With this type of business, the caregiver is an employee of the home care company that sends them out to customers home. The hourly cost is higher than with a referral model, but the customer does not have to worry about the taxes, insurances, liabilities, and other responsibilities that come from having an employee in their home. Instead, there is only one payment made on a weekly or monthly schedule to the home care company.

This is becoming a more popular was for home care agencies to operate and is more popular with customers as it is simpler to understand and there is only one payment that needs to be made, which is to the company they are hiring to care for their loved one.

Ask all possibly companies you are looking to hire if which model they are under and ensure that they are insuring their employees by asking for proof of workers compensation insurance and general liability insurance.

Skilled Home Care

The last segment of home care is the skilled home care. You hire a company to provide a nurse that can help with open wounds, IVs, and medication management. The skilled care is paid for through private insurances but is usually not covered by Medicare. These companies provide their services under a model that provides you the skilled care you need without having to go to a hospital or outpatient facility.

Wrapping It Up

Now that you have read our article about home care 101, you now understand the differences between the various types of home care.

Home care 101 is meant to be a brief overview of what home care is and the services it can provide. If you are looking for a more in-depth understanding of home care services, go to our guide on private home care services, where you will find a wealth of detailed information.