What is non-medical home care?
Non-medical home care is help with the activities of daily living — bathing, dressing, eating, toileting, moving around — and the household tasks that go with them. It's given by a non-medical caregiver, usually a personal care aide or companion, not a nurse.
In-home non-medical senior care is the most common form of home care in the U.S. It's what most people mean by home care. Medical care at home — wound care, injections, therapy — is home health, and it's covered differently. See home health vs. home care and our overview, what is in-home care.
| Non-medical home care | Home health care | |
|---|---|---|
| Who | Personal care aides, companions, homemakers | Nurses, therapists, home health aides |
| What | Bathing, dressing, meals, housekeeping, company | Wound care, medications, therapy, monitoring |
| Ordered by | The family or a Medicaid care plan | A doctor |
| Medicare | No | Yes, part-time, for homebound patients |
| Medicaid | Yes, as personal care | Yes |
Personal care services
Personal care services are hands-on help with the body: bathing, grooming, dressing, toileting, continence care, eating, and moving from bed to chair. Personal in-home care — personal care assistance at home — is the heart of non-medical care and the part families find hardest to give themselves.
Personal care for elderly at home is often what makes the difference between staying at home and moving to a facility. Personal care for elderly parents, personal care services for elderly and personal care services for seniors are the same services, usually booked in morning and evening visits. At-home personal care can be two hours a day or live-in, and personal care at home can grow as needs grow; see part-time care and live-in caregivers.
Medicaid defines personal care as help with activities of daily living and instrumental activities like laundry and meal preparation. Personal care for seniors and younger adults with disabilities is one of the most widely offered Medicaid home care benefits.
Personal care aides, attendants and assistants
The worker has many titles: personal care aide, personal care attendant (PCA), personal care assistant, personal caregiver, personal caretaker or personal carer. A personal care provider might also be called a home care personal assistant, a personal assistant for elderly clients or a personal assistant for seniors. An elderly assistant or elderly helper does the same job with a friendlier title.
The U.S. Bureau of Labor Statistics describes personal care aides as focused on nonmedical support such as companionship, cleaning and cooking, while home health aides may also check vital signs and give medication under a nurse's direction, depending on state rules. See what a home health aide does.
An in-home personal care assistant can work for an agency or directly for the family. Personal carers can also be hired privately. A private personal care assistant or private personal carer hired directly costs less per hour, but you become the employer. See private pay home care.
Companion care and home companions
Companion care is supervision and company: conversation, walks, meals together, reminders, rides and making sure someone is safe. Home companions and elderly companions suit people who can mostly care for themselves but shouldn't be alone — early memory loss, frailty or loneliness.
Federal labor rules define companionship services as fellowship and protection, with hands-on care limited to 20 percent of a worker's hours. That's a pay-rule definition, not a care rule, but it shows the line: companionship is mostly presence, personal care is mostly hands-on.
If you're searching companion care near me, home companion care near me, companion agencies near me or companion care agencies near me, use our home care near me guide to find licensed agencies, and ask whether their companions can also give personal care if needs grow.
Homemaker services
Homemaker services cover the house rather than the person: meal preparation, laundry, light cleaning, shopping and errands. Homemaker services for seniors are often the first help families arrange, because they're easy to accept.
A homemaker agency may offer homemaker help alone or bundle it with personal care. CareScout now reports homemaker and home health aide rates as one category because the prices have converged. For homemaker services near me, Area Agencies on Aging often fund some homemaker hours for older adults — ask when you call.
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Domiciliary care: the British term for home care
"Domiciliary care" is what home care is called in the UK. Domiciliary care services, a domiciliary care agency and a domiciliary care provider are, in American terms, a home care agency giving non-medical care. If you're searching domiciliary care near me for a relative in the U.S., look for a licensed home care or personal care agency instead.
What non-medical caregivers can and can't do
Exact rules depend on your state's licensing and nurse-delegation laws. As a general guide:
| Usually allowed | Usually not allowed without nurse training or delegation |
|---|---|
| Bathing, dressing, grooming, toileting | Injections, IVs, sterile dressings |
| Help moving and transferring | Catheter or feeding-tube care |
| Medication reminders | Setting up, measuring or changing medications |
| Meals, laundry, housekeeping | Assessing symptoms or changing a care plan |
| Company, supervision, errands | Anything a doctor's order says needs a nurse |
The Department of Labor lists invasive or sterile procedures such as catheter care and tube feeding as medically related services that typically require training by medical personnel. If your relative needs those, you need a home health agency or in-home nursing care alongside personal care.
Choosing a personal care agency
A personal care agency, personal home care agency or personal care assistant agency employs, screens and schedules aides. When you compare personal care agencies near me, ask:
- Are you licensed in this state for personal care?
- Are aides employees, and are they bonded and insured?
- How are aides screened and trained?
- Will the same aide come each time?
- Who covers a missed shift?
- Do you accept Medicaid, the VA or long-term care insurance?
Our full checklist for choosing a home care agency goes further, and local home care agencies compared looks at independents versus franchises like Home Helpers and Right at Home.
Finding personal care near me
Personal care near me searches — personal care services near me, personal care aides near me, personal caregivers near me or a personal care provider near me — all start with the same step: find who serves your county and who accepts your way of paying.
County pages list local options — Suffolk County, New York, San Diego County, Orange County, Florida, Wayne County, Michigan and Essex County, New Jersey. If you need personal home care near me paid by Medicaid, the state program decides which providers you can use — see your state page.
If you're posting a "personal caregiver needed" ad yourself, run a background check and put duties and pay in writing.
What non-medical home care costs
CareScout's 2025 Cost of Care Survey put the national median for a non-medical in-home caregiver at $35 an hour, or $80,080 a year at 44 hours a week. Homemaker, companion and personal home care services usually cost about the same per hour from an agency.
Hiring privately usually costs less per hour, but you take on payroll taxes and backup care. See the cost of in-home care for local budgeting.
Medicaid personal care services
Medicare doesn't pay for personal care when that's the only care needed, according to Medicare.gov. Medicaid does. Personal care is an optional Medicaid benefit, and states offer it through the state plan, home and community-based services waivers, self-directed services under section 1915(j), and Community First Choice under section 1915(k).
The programs have many names — personal care services, attendant care, PCA programs. Examples include Massachusetts's PCA program, Michigan's Home Help, Washington's Medicaid Personal Care and Wisconsin's Personal Care Services. See Medicaid home care and your state's caregiver program.
| State | Programs that can pay a family caregiver | |
|---|---|---|
| Alabama | Personal Choices, E&D Waiver, ACT Waiver, SAIL Waiver | Alabama program → |
| Alaska | Personal Care Services (PCS), Community First Choice (CFC), Children's waivers (CCMC & IDD) | Alaska program → |
| Arizona | ALTCS self-directed care, Agency with Choice, Parents as Paid Caregivers (PPCG) | Arizona program → |
| Arkansas | IndependentChoices, ARChoices in Homecare | Arkansas program → |
| California | IHSS (In-Home Supportive Services) | California program → |
| Colorado | CDASS, IHSS, Family CNA program | Colorado program → |
| Connecticut | Adult Family Living (AFL), Community First Choice (CFC), PCA Waiver, CT Home Care Program (CHCPE) | Connecticut program → |
| Delaware | DSHP-Plus self-directed care | Delaware program → |
| District of Columbia | EPD Waiver — Services My Way | District of Columbia program → |
| Florida | SMMC-LTC Participant Directed Option, CDC+, Family Home Health Aide (children) | Florida program → |
| Georgia | Structured Family Caregiving (SFC), CCSP / SOURCE, NOW & COMP Waivers, GAPP (children) | Georgia program → |
| Hawaii | QUEST Integration self-direction | Hawaii program → |
| Idaho | A&D Waiver self-directed care, Personal Care Services (PCS), Certified Family Home | Idaho program → |
| Illinois | Community Care Program (CCP), Home Services Program (HSP), MFTD Waiver (children) | Illinois program → |
| Indiana | Structured Family Caregiving (SFC), Attendant Care (PathWays & H&W Waivers) | Indiana program → |
| Iowa | Consumer Choices Option (CCO), CDAC (agency-delivered) | Iowa program → |
| Kansas | Frail Elderly Waiver, Physical Disability Waiver, Brain Injury Waiver, Technology Assisted Waiver (children) | Kansas program → |
| Kentucky | Participant Directed Services (PDS), HCB Waiver, Michelle P. Waiver | Kentucky program → |
| Louisiana | Community Choices Waiver, Monitored In-Home Caregiving (MIHC), Children's Choice Waiver | Louisiana program → |
| Maine | Consumer Directed Attendant Services (Section 12), Home & Community Benefits (Section 19), Family Home Health Aide (children, 2026) | Maine program → |
| Maryland | Community First Choice (CFC), CPAS, Community Options Waiver, DDA Waivers (children) | Maryland program → |
| Massachusetts | PCA Program, Adult Foster Care (AFC), Frail Elder Waiver | Massachusetts program → |
| Michigan | Home Help Program, MI Choice Waiver | Michigan program → |
| Minnesota | CFSS, CDCS, Elderly Waiver | Minnesota program → |
| Mississippi | Elderly & Disabled Waiver (agency only), Independent Living Waiver | Mississippi program → |
| Missouri | Consumer Directed Services (CDS), Structured Family Caregiving Waiver | Missouri program → |
| Montana | Big Sky Waiver (self-directed), Community First Choice & PCS | Montana program → |
| Nebraska | Personal Assistance Services (PAS), Aged & Disabled Waiver | Nebraska program → |
| Nevada | Personal Care Services (self-directed), Structured Family Caregiving Waiver | Nevada program → |
| New Hampshire | Choices for Independence (CFI) Waiver, PCAS, In-Home Supports Waiver (children) | New Hampshire program → |
| New Jersey | Personal Preference Program (PPP) | New Jersey program → |
| New Mexico | Turquoise Care Self-Directed Community Benefit, Mi Via Waiver | New Mexico program → |
| New York | CDPAP | New York program → |
| North Carolina | CAP/DA (consumer-directed), Coordinated Caregiving, CAP/C (children) | North Carolina program → |
| North Dakota | HCBS Waiver — Family Personal Care, Qualified Service Provider (QSP), Family Paid Caregiver Pilot (children) | North Dakota program → |
| Ohio | PASSPORT Waiver, Structured Family Caregiving, Next Generation MyCare, Ohio Home Care Waiver | Ohio program → |
| Oklahoma | ADvantage Waiver — CD-PASS | Oklahoma program → |
| Oregon | Independent Choices Program (ICP), Spousal Pay Program, Consumer-Employed Provider program | Oregon program → |
| Pennsylvania | Community HealthChoices (CHC), Services My Way, OBRA Waiver | Pennsylvania program → |
| Rhode Island | Personal Choice Program, Independent Provider Program | Rhode Island program → |
| South Carolina | Community Choices Waiver (self-directed), Medically Complex Children Waiver | South Carolina program → |
| South Dakota | Structured Family Caregiving (HOPE Waiver) | South Dakota program → |
| Tennessee | TennCare CHOICES consumer direction, ECF CHOICES, Katie Beckett (children) | Tennessee program → |
| Texas | Consumer Directed Services (CDS), STAR+PLUS HCBS, CLASS & MDCP Waivers | Texas program → |
| Utah | DSPD Caregiver Compensation, New Choices Waiver, Aging Waiver | Utah program → |
| Vermont | Choices for Care (self-directed), Flexible Choices | Vermont program → |
| Virginia | CCC Plus Waiver consumer direction, LRI option (spouses & parents) | Virginia program → |
| Washington | Community First Choice (CFC), Medicaid Personal Care (MPC), Individual Provider (via CDWA) | Washington program → |
| West Virginia | Aged & Disabled Waiver — Personal Options | West Virginia program → |
| Wisconsin | IRIS, Family Care, Personal Care Services (PCS), CLTS Waiver (children) | Wisconsin program → |
| Wyoming | Community Choices Waiver (participant-directed) | Wyoming program → |
A personal care assistant for a family member — paid by Medicaid
Most Medicaid personal care programs let the person receiving care choose their own personal care assistant. For a family member, that assistant can be you. You're hired, you log hours, and the program pays you. This is how a personal care assistant for family member care gets paid in New York's CDPAP, California's IHSS and consumer-directed care programs nationwide.
Read how to get paid to care for a family member, or check eligibility in two minutes.
Where to go next
Frequently asked questions
What is non-medical home care?
Help with daily living rather than medical treatment: personal care like bathing and dressing, companionship and supervision, and homemaker services like meals and laundry.
What is the difference between personal care and companion care?
Personal care is hands-on help with the body, such as bathing and toileting. Companion care is mostly supervision and company, with little hands-on help.
Can a non-medical caregiver give medications?
Usually they can remind someone to take medication but not measure, set up or change it. Rules vary by state, and some states let nurses delegate certain tasks.
Does Medicare pay for non-medical home care?
No. Medicare does not cover personal care or homemaker services when that is the only care someone needs.
Does Medicaid pay for personal care services?
Yes. States offer Medicaid personal care through the state plan, home and community-based waivers or Community First Choice, for people who qualify on income, assets and care needs.
Can a family member be a paid personal care assistant?
In most states, yes. Self-directed Medicaid programs let the person receiving care hire a relative as their personal care assistant.
What is domiciliary care?
It is the British term for home care. In the U.S. the equivalent is a licensed home care or personal care agency.
Sources: CareScout 2025 Cost of Care Survey (press release) · Medicare.gov: home health services · Medicaid.gov: mandatory and optional Medicaid benefits · Medicaid.gov: self-directed personal assistance services, 1915(j) · U.S. DOL Fact Sheet #79A: companionship services · BLS Occupational Outlook: home health and personal care aides. Program rules and rates change — always confirm with the program. Reviewed September 30, 2026.