In Central Florida the words "home care" and "home health" get used interchangeably, but they describe separately regulated services with very different rules about what a caregiver may do and who pays for it.
By Orlando Senior Advisor Care Team · August 6, 2026
Almost every family we talk with in Orange, Seminole, Osceola and Lake counties starts the same way: "We want to keep Mom at home, so we're looking at home care." Then they call five companies and get five very different answers about hours, tasks and cost. The confusion is not the family's fault. In Florida, several distinct kinds of provider are allowed to send someone to your parent's front door, and the Agency for Health Care Administration (AHCA) oversees them under different categories.
Broadly, there are three you will run into around Orlando. A licensed home health agency employs or contracts clinical staff — nurses, physical and occupational therapists, speech therapists, home health aides — and can deliver skilled care ordered by a physician. A registered homemaker and companion services provider handles non-medical support: light housekeeping, laundry, meal preparation, errands, grocery shopping, companionship and supervision. A nurse registry does not employ caregivers at all; it refers independent contractors to you, and you become the party contracting with that caregiver.
That last distinction matters more than most families realize, and we come back to it below.
This is the single most common surprise. In Florida, a homemaker and companion registration does not authorize hands-on personal care. A companion can remind your father to take his pills; they cannot administer them. They can be present while he showers and hand him a towel; they generally cannot bathe him, transfer him from bed to wheelchair, or provide incontinence care. Those hands-on tasks fall to a home health aide or CNA working through a licensed home health agency, or to a caregiver referred by a nurse registry.
If a company quotes you a low hourly rate for "personal care" and turns out to hold only a homemaker and companion registration, that is a red flag worth a direct question. Ask which AHCA credential the company holds, in those words, and then confirm it yourself — AHCA publishes license and registration lookup tools online, and a legitimate provider will not hesitate to give you the number.
Medicare covers home health, not home care. To qualify, a physician must certify that your parent needs intermittent skilled nursing or therapy and is essentially homebound, and the services must come from a Medicare-certified agency. When those conditions are met, Medicare pays for the visits — but it pays for episodes of skilled care, typically a few visits a week for a defined period. It does not pay for someone to sit with your mother all afternoon, and it does not pay for housekeeping or companionship as a standalone service.
Non-medical home care in Central Florida is usually paid privately, through a long-term care insurance policy, through VA benefits including Aid and Attendance for eligible wartime veterans and surviving spouses (the Orlando VA Medical Center at Lake Nona is the local point of contact), or through Florida's Statewide Medicaid Managed Care Long-Term Care program for those who qualify clinically and financially. Those funding paths run on completely different timelines. A Medicare home health episode can begin within days of a hospital discharge at AdventHealth or Orlando Health. Medicaid long-term care enrollment involves a CARES assessment and, frequently, a wait.
Families are often best served by using both at once: the Medicare-covered therapist who comes twice a week after a hip replacement, plus privately paid help on the other five days.
A home health agency employs its aides, which means the agency carries workers' compensation and liability coverage, runs background screening, supervises the caregiver, and — critically — sends a replacement when your regular aide calls out sick. You pay more per hour for that infrastructure.
A nurse registry refers independent contractors. The rate is often lower and you may get more continuity with one caregiver. But the contractual relationship is between you and that individual, and you should ask plainly: who covers a no-show at 7 a.m. on a Tuesday, who carries insurance, and what happens if the caregiver is injured in the home. Neither model is wrong. They allocate risk differently, and a family with a spouse at home who can cover a gap is in a very different position than an adult child managing care from another state.
Before you compare rates, get these answered in writing: What AHCA license or registration do you hold, and what is the number? Are your caregivers your employees, or independent contractors referred to me? Exactly which hands-on tasks are your staff permitted to perform? What is your minimum shift, and does that change on weekends or holidays? And who do I call after hours, and what is your documented process when a scheduled caregiver does not arrive?
If you are starting from zero, the Senior Resource Alliance — the Area Agency on Aging serving Orange, Seminole, Osceola and Brevard counties — is a free, unbiased first call, as is Florida's statewide Elder Helpline at 1-800-963-5337. Neither will sell you anything, and both can tell you which publicly funded programs your parent might already be eligible for before you start paying out of pocket.
A free call with zero sales pressure. Whether you're new to Central Florida or new to senior care, we answer to your family — not to the communities we recommend.
Or call (689) 400-3031