Types of In-Home Care Explained
In-home care isn't one-size-fits-all. Understanding the differences helps you find the right fit—and avoid paying for services you don't need. For a deeper look at costs, see our costs and payment guide.
The Three Main Types
Most in-home care falls into three categories. The boundaries between them aren't always sharp, but understanding the general distinctions helps when you talk to agencies and providers.
Companion Care (Homemaker Services)
What it is: Social support and light assistance for people who are generally independent but shouldn't be alone for long periods.
Who provides it: Caregivers, companions, or homemakers—no medical license required.
Typical services:
- Conversation and companionship
- Meal preparation and light cooking
- Light housekeeping and laundry
- Grocery shopping and errands
- Medication reminders (not administration)
- Transportation to appointments
Best for: Early-stage cognitive changes, social isolation, respite for family caregivers. See signs it might be time to start.
Usually not covered by health insurance. See full cost breakdown.
Personal Care (Home Health Aides)
What it is: Hands-on assistance with activities of daily living (ADLs) for people who need physical help with basic tasks.
Who provides it: Home health aides (HHAs) or certified nursing assistants (CNAs).
Typical services:
- Bathing, showering, and sponge baths
- Dressing and grooming assistance
- Toileting and incontinence care
- Mobility assistance and transfers
- Feeding assistance
- All companion care services
Best for: Physical limitations, moderate dementia, post-surgery recovery.
May be partially covered after hospitalization. Learn about payment options.
Skilled Nursing Care
What it is: Medical care provided by licensed nurses for complex health conditions.
Who provides it: Registered Nurses (RNs) or Licensed Practical Nurses (LPNs).
Typical services:
- Wound care and dressing changes
- IV therapy and injections
- Medication management
- Catheter and ostomy care
- Vital sign monitoring
- Post-surgical care
Best for: Complex medical conditions, hospital discharge, chronic diseases.
May be covered by Medicare for limited periods. See Medicare coverage details.
Quick Comparison
| Feature | Companion | Personal | Skilled |
|---|---|---|---|
| Physical assistance | No | Yes | Yes |
| Medical care | No | No | Yes |
| License required | No | Often | Yes |
| Medicare coverage | No | Limited | Yes* |
| Typical hourly cost | $20–$30 | $25–$35 | $50–$100+ |
*Medicare skilled nursing coverage requires a doctor's order and is limited. Learn more about what's covered.
How Care Levels Often Progress
Many families start with companion care and gradually increase as needs evolve. Understanding this progression helps with long-term financial planning:
- Independence with check-ins — A few hours of companion care weekly
- Regular supervision — Daily companion care visits
- Light physical assistance — Mix of companion and personal care
- Significant daily help — Full personal care assistance
- Complex medical needs — Skilled nursing involvement
Not sure where your situation falls? Our assessment can help.
Not Sure What Level You Need?
Our guided assessment asks a few questions and recommends the type of care that typically fits your situation.
Take the AssessmentImportant Notes
- Terminology varies. Different states use different terms. Always ask what specific tasks are included.
- Mixing levels is common. Many families use a personal care aide for most hours and a skilled nurse for periodic check-ins.
- Training varies widely. Always ask about qualifications. See our questions to ask providers.