Home Health vs Home Care in Arizona: What's the Difference?

The Core Distinction

Home health and home care sound interchangeable. In Arizona, they are legally and practically different services with different regulation, different payers, and different eligibility rules.

Home health care is clinical. A licensed registered nurse or therapist provides wound care, IV infusions, medication administration, physical or occupational therapy, and clinical monitoring. Home health agencies in Arizona must be licensed by the Arizona Department of Health Services (ADHS) under Article 12 regulations. Medicare covers home health when ordered by a physician and the patient is "homebound" — meaning leaving home requires considerable effort.

Home care (also called non-medical home care, custodial care, or personal care) is everything else: bathing assistance, dressing, meal preparation, companionship, light housekeeping, grocery shopping, and help with mobility. Arizona does not license or regulate non-medical home care agencies at all. Anyone can open and operate one with no state oversight, no mandatory background checks, and no insurance requirements.

Side-by-Side Comparison

What ALTCS Covers Under Each Category

If your parent is enrolled in ALTCS, their managed care organization (MCO) can authorize both home health and home care services as part of the individualized care plan. The distinction matters because they are billed and managed differently.

ALTCS-covered skilled home health includes intermittent nursing visits, physical therapy, occupational therapy, speech therapy, and home health aide services when linked to a clinical care plan. The MCO contracts with licensed home health agencies to provide these services.

ALTCS-covered non-medical home care falls under several service categories:

• Attendant care — hands-on assistance with activities of daily living (ADLs) like bathing, dressing, toileting, transferring, and grooming
• Homemaker services — meal preparation, cleaning, laundry, and shopping when the member cannot perform these tasks independently
• Personal care services — a broader category that AHCCCS defines to include both ADL assistance and instrumental ADL support (medication reminders, appointment scheduling)

The number of authorized hours depends on the PAS assessment and the case manager's evaluation of what the member needs to remain safely at home. There is no fixed hours-per-score table, so a diagnosis or PAS score alone does not guarantee 20, 30, or 40+ hours.

When You Need Both

Most families keeping an aging parent at home end up using both service types, often simultaneously:

• After a hospital discharge, your parent may need skilled home health for wound care or physical therapy (covered by Medicare for up to 60-day episodes, renewable) while also needing non-medical home care for daily bathing and meal prep (covered by ALTCS or paid privately).
• For a parent with diabetes and mobility limitations, a home health nurse visits weekly to manage insulin adjustments and foot wound care, while a home care aide comes daily to help with bathing and meal preparation.
• For a parent with dementia, home health involvement is typically limited to periodic clinical assessments, medication reviews, or therapy. The bulk of daily care — supervision, redirection, personal hygiene, safety monitoring — is non-medical home care.

The key practical difference: Medicare home health is episodic and intermittent (a few visits per week for a defined period), not daily custodial coverage. Families who expect Medicare to cover 8 hours of daily care are consistently disappointed. Medicare pays for the nurse to come dress a wound three times a week; it does not pay someone to sit with your parent all day.

How to Vet a Non-Medical Home Care Agency in Arizona

Because Arizona does not regulate non-medical home care, the quality gap between agencies is enormous. Before hiring, verify:

1. Fingerprint clearance cards. Ask whether every caregiver holds a current Level 1 Fingerprint Clearance Card. There is no legal requirement, but any agency that does not screen employees this way is cutting corners on the most basic safety measure.
2. APS Registry checks. Since January 2025, licensed care facilities must verify the Adult Protective Services registry. Non-medical agencies have no legal obligation to do so, but responsible ones do.
3. Insurance. Ask for proof of general liability insurance and workers' compensation coverage. If a caregiver is injured in your parent's home and the agency carries no workers' comp, the family may be liable.
4. AZNHA membership. The Arizona In-Home Care Association is a voluntary self-regulatory body that requires member agencies to meet credentialing standards including insurance, background checks, and training minimums. Membership is not a guarantee of quality, but it is a minimum bar.

For licensed home health agencies, ADHS maintains a public database of licensed providers including inspection reports and deficiency findings. Check it before selecting a home health provider.

For a complete walkthrough of hiring caregivers, setting up ALTCS-funded attendant care, and choosing between the Agency with Choice and Self-Directed Attendant Care models, the Arizona Home Care, Waivers & Support Guide covers every step.

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