Two kinds of care that come to the house
Hospice or home health: what is the difference?
Home health and hospice both send nurses to the house, which is why they get confused. Home health is short-term skilled care to recover from an illness or surgery or to manage a condition, for people who are homebound. Hospice is comfort care for someone with a life expectancy of six months or less who has chosen not to pursue a cure. Medicare pays for both, but not for both at the same time for the same illness.
Medically reviewed by Oscar Chien, MD, Medical Director, October 19, 2026
On this page (9 sections)
- How is hospice different from home health?
- Who qualifies for home health, and who for hospice?
- Can you have hospice and home health at the same time?
- When does someone move from home health to hospice?
- Who visits, and how often?
- Who pays?
- How do you start either one?
- Common questions about hospice and home health
- Read more
How is hospice different from home health?
The two differ in their goal, who qualifies, the homebound rule, who visits, how long they last and what they cover. Both come to wherever the person lives, and neither provides a caregiver who stays.
| Home health | Hospice | |
|---|---|---|
| Goal | Recover from an illness, injury or surgery, or keep a condition stable at home | Comfort, dignity and support for the person and family in the last months of life |
| Who qualifies | A doctor certifies you are homebound and need intermittent skilled nursing or therapy (42 CFR 409.42) | A hospice doctor and your doctor certify a life expectancy of six months or less if the illness runs its usual course, and you choose comfort care (42 CFR 418.22) |
| Homebound rule | Yes. Leaving home must take considerable effort and be infrequent | No. You can go out as you are able |
| Who visits | A nurse and, as ordered, a physical, occupational or speech therapist, an aide and a social worker, on a visit schedule | A nurse, a hospice aide, a social worker, a chaplain and the hospice doctor, on a plan of care, plus a nurse by phone 24 hours a day |
| How long | In 30-day payment periods for as long as the skilled need lasts and you remain homebound | In benefit periods, two of 90 days and then 60-day periods, for as long as you remain eligible |
| What is covered | Skilled nursing, therapy, aide visits tied to skilled care, medical social services, some supplies. Not medicines, not equipment rental | The team's visits, medicines for symptoms, equipment, supplies, short inpatient stays, respite, and grief support for the family |
| Who pays | Medicare Part A or Part B, with no copay for the visits | Medicare Part A hospice benefit; most people pay nothing for the hospice care itself |
| Can you have both | Not for the same illness as hospice | Home health can continue for a condition unrelated to the terminal illness, arranged with the hospice |
General information from Medicare's rules. Whether a particular person qualifies for either benefit is decided by a doctor's certification, and we check it before care starts.
Who qualifies for home health, and who for hospice?
Home health is for a person who is homebound and needs skilled care part-time: a nurse to manage a new medicine or a wound, a therapist after a fall or a stroke. A doctor orders it after a face-to-face visit, and it continues while the skilled need lasts. The aim is to get better or to stay stable.
Hospice is for a person whose illness is expected to end their life within six months if it runs its usual course, and who has chosen comfort care over treatment meant to cure. There is no homebound rule. The aim is comfort and support for the person and the family. Read is it time for hospice.
Can you have hospice and home health at the same time?
Not for the same illness. Once you elect hospice, the hospice is responsible for all care related to the terminal illness, so a home health agency cannot bill Medicare for that illness at the same time. If home health was already in place, it usually ends when hospice begins, and the hospice team takes over the nursing and aide visits.
For a condition unrelated to the terminal illness, home health can continue under regular Medicare. The hospice and the home health agency coordinate so that nobody is visiting for the same thing twice. Tell the hospice about any home health you have when you call.
When does someone move from home health to hospice?
Often when the home health nurse or the doctor sees that the person is no longer recovering: more hospital visits, more weight loss, less time out of bed, and the treatments are harder to bear than the illness. That is the moment to ask the doctor whether hospice would fit. The home health agency can make the referral, and the hospice checks eligibility within a day. Read signs it may be time.
Who visits, and how often?
Home health visits are set by the orders: a nurse once or twice a week, a therapist two or three times a week, for a few weeks at a time. Hospice visits follow the plan of care and change as needs change: the nurse weekly or more, the aide several times a week for bathing, the social worker and chaplain as needed, and a nurse by phone at any hour. Neither one provides a caregiver who stays in the home. Read what hospice provides.
Who pays?
Medicare pays for both. Home health is paid under Part A or Part B with no copay for the visits; medicines and equipment are billed separately under your usual coverage. Hospice is paid under Part A as a bundle: the team, the medicines for symptoms, the equipment and the supplies, with most people paying nothing for the hospice care itself. Neither pays for room and board or for a private caregiver. Read does Medicare cover hospice.
How do you start either one?
Both start with a doctor's order and a certification. For home health, the doctor orders it after a face-to-face visit and names the agency. For hospice, anyone can call the hospice, which arranges the certification with the doctor. Our nurse answers (877) 258-7129 at any hour and can tell you within the call which one fits, or whether neither does yet.
Common questions about hospice and home health
Is home health the same as hospice?
No. Home health is skilled care to recover or stay stable, for people who are homebound. Hospice is comfort care for the last months of life, with no homebound rule. Both come to the home; neither provides a caregiver who stays.
Do I have to be homebound for hospice?
No. The homebound rule applies to home health, not hospice. A person on hospice can go out as they are able.
Does home health or hospice send a caregiver?
Neither. Both send visits from a nurse and an aide on a schedule. Care between visits is done by family, a hired caregiver, or facility staff.
Can home health turn into hospice?
Yes. When the person is no longer recovering, the home health nurse or the doctor can refer to hospice, and hospice starts after the certification. The home health episode ends when hospice begins.
Read more
Hospice vs palliative care, what hospice provides, 24-hour care and paying for care.
About this page
- Written by
- Beta Hospice care team
- Medically reviewed by
- Oscar Chien, MD, Medical Director
- Last reviewed
- October 19, 2026
- Next review
- April 19, 2027
How we write and review this site
Sources
- Medicare.gov: Home health services (opens in a new tab)
- 42 CFR 409.42: Beneficiary qualifications for coverage of home health services (opens in a new tab)
- Medicare.gov: Hospice care coverage (opens in a new tab)
- 42 CFR 418.22: Certification of terminal illness (opens in a new tab)
These sources support the general information on this page. For one personās care and coverage, talk with the hospice team.
You do not have to decide alone.
Call (877) 258-7129 any time, or leave your number and someone from Beta's hospice team will call you. No decision is needed to call. Most families start with a question.
Only a hospice doctor, together with the personās own doctor, can confirm hospice eligibility. A website cannot.
- A nurse answers 24 hours a day, 7 days a week
- You can stop hospice at any time
- You have the right to choose your hospice