A Henry County Family’s Guide to Understanding Who Pays for Care at Home
“My mom has Medicare. Won’t Medicare pay for someone to stay with her at home?”
It is one of the most common questions families ask when an older adult begins needing help. The confusion is understandable: Medicare, Medicaid, Medicare Advantage, home health, personal care, and private-pay home care all sound related, yet they solve very different problems.
For families in Henry County, understanding those differences before a hospitalization, fall, or sudden decline can make care planning far less stressful. Henry County had an estimated 264,922 residents in 2025, and 13.9% were age 65 or older. As our community grows and ages, more families will face the question of how to keep a parent or loved one safe at home.
The Simplest Way to Think About the Three Options
Although every situation is different, this framework helps:
- Medicare home health is primarily skilled, medically necessary care delivered at home for people who meet Medicare’s coverage requirements.
- Georgia Medicaid can help qualifying individuals obtain health care and, through certain long-term services and supports programs, assistance that helps them remain in the community.
- Private-pay home care is purchased directly by the individual or family and can provide flexible, ongoing assistance based on the person’s needs rather than Medicare or Medicaid eligibility.
| Question | Medicare Home Health | Georgia Medicaid | Private-Pay Home Care | |
|---|---|---|---|---|
| Main purpose | Skilled, medically necessary care at home | Coverage/services for eligible individuals, including some long-term supports | Flexible assistance chosen by the client/family | |
| Income limits? | No income test for Medicare eligibility | Yes, depending on the Medicaid program | No government income test | |
| Long-term custodial/personal care? | Generally not when it is the only care needed | May be available through qualifying programs | Yes, based on needs and budget | |
| Examples | Skilled nursing, PT, OT, speech therapy; limited aide care when requirements are met | Personal care, case management, meals, respite and other services may be available through qualifying programs | Bathing, dressing, mobility, meals, companionship, transportation, respite and supervision |
1. Medicare Home Health: Think Skilled Care, Not Long-Term Care
Medicare can be extremely valuable when a person needs medically necessary skilled care at home. Medicare Part A and Part B can cover qualifying home health services, and Medicare lists covered home health care at $0 for eligible beneficiaries under Original Medicare.
But Medicare home health is not the same thing as having a caregiver in the home for as many hours as the family would like. Original Medicare does not cover long-term care, and Medicare generally does not cover custodial care when that is the only care a person needs. Custodial care includes everyday help such as bathing, dressing, eating, getting in and out of a bed or chair, moving around, and using the bathroom.
This distinction becomes important after a hospital or rehabilitation stay. A person may initially qualify for skilled nursing, physical therapy, occupational therapy, speech-language pathology, or other covered home health services. As the skilled need changes, however, the family may discover that Mom still needs help showering, Dad still cannot safely prepare meals, or someone still needs supervision because of weakness or fall risk.
That does not necessarily mean something went wrong with Medicare. It often means the person’s needs have shifted from a covered skilled-health need toward ongoing personal or custodial support.
Medicare also distinguishes short-term skilled rehabilitation from long-term care. For example, Medicare Part A may cover skilled nursing facility care for a limited period under qualifying conditions, but it does not generally pay for long-term custodial nursing-home care.
2. Medicaid: Potential Long-Term Support, but Eligibility Matters
Medicaid is different. It is a joint federal-state program, and eligibility depends on the specific Medicaid category or program. For Georgia families exploring long-term services and supports, income and resources are only part of the picture.
Georgia Medicaid explains that applicants for long-term services and supports must meet income and resource limits. Other factors can include functional status, medical needs, citizenship, Georgia residency, and—in waiver programs—the need to meet an institutional or nursing-facility level of care.
Programs such as Georgia’s Community Care Services Program (CCSP) and SOURCE are designed to help certain frail elderly or disabled Georgians who would otherwise qualify for a nursing-facility level of care receive services in the community. Depending on the program and approved plan, services can include personal care, case management, home-delivered meals, adult day health, alternative living services, and respite.
For 2026, Georgia lists the Community Care gross income limit at $2,982 per month for an individual and $5,964 per month for a couple, with resource limits of $2,000 for an individual and $3,000 for a couple. These figures should not be treated as a universal Medicaid test: eligibility rules differ by program, circumstances matter, and limits can change.
The practical takeaway is simple: having Medicaid—or believing someone may qualify for Medicaid—does not automatically guarantee a particular number of caregiver hours. Families should have the person’s specific eligibility and program benefits evaluated.
3. Private-Pay Home Care: Flexibility for Ongoing Needs
Private-pay home care fills a different role. Rather than qualifying because a skilled medical service is required or because a government program’s financial and functional criteria are met, the family purchases the amount and type of support that fits the situation.
That may mean a few hours of help with bathing and meal preparation, assistance several days each week, respite for a spouse who has become the primary caregiver, transportation to appointments, companionship, mobility assistance, or more extensive support when someone can no longer safely remain home alone.
Private-pay care can also work alongside other services. A person might receive Medicare-covered skilled home health visits while also using private-pay caregivers for longer periods of personal care and supervision. The two services can address different needs.
This is an important distinction for families: skilled home health and private-duty home care do not have to be viewed as competitors. In many cases, they are different pieces of the same aging-at-home plan.
Where BrightStar Care of Locust Grove & McDonough Fits
BrightStar Care of Locust Grove & McDonough does not bill Medicare for Medicare home health services. Our agency’s role is different: we are positioned to provide ongoing home-care support for families who need assistance beyond, alongside, or after short-term skilled recovery services.
Consider a common scenario. Mom returns home after a hospitalization and receives Medicare-covered therapy and skilled nursing visits. Those clinicians may be exactly what she needs medically. But they are not necessarily there for several hours each morning to help her get out of bed, shower, dress, prepare breakfast, move safely through the house, or give her daughter time to go to work.
That is the gap families often discover only after discharge.
Depending on the care plan, BrightStar Care can help with personal care, mobility assistance, meal preparation, companionship, respite, transportation, medication reminders, and other support designed to help a loved one remain safe and independent at home. We also provide skilled services when appropriate through our licensed clinical team, but those services are not billed as Medicare home health.
A Henry County Example
Imagine an older adult in McDonough who returns home after a hip fracture and rehabilitation stay. Medicare-covered services may support the skilled portion of recovery. But the family may still face a much more practical question: Who is helping at 7:00 a.m. when she needs to get out of bed and safely into the shower? Who prepares lunch? Who stays with her while her daughter works? Who helps reduce the risk of another fall?
Those everyday needs are where understanding the payer matters. Medicare may cover qualifying skilled care. Medicaid may offer longer-term supports for someone who meets the applicable eligibility requirements. Private-pay care gives families another path when they want or need flexible assistance at home.
Five Questions to Ask Before Assuming Something Is Covered
- What type of care does my loved one actually need: skilled medical care, personal care, supervision, or a combination?
- Is the need temporary and recovery-focused, or is it likely to continue for months or years?
- Does the person meet the eligibility requirements for the Medicare or Medicaid service we are considering?
- If insurance or a government program covers some care, who will provide the assistance needed during the remaining hours?
- What can our family realistically provide without creating caregiver burnout?
The Bottom Line
The words Medicare, Medicaid, and home care are often used interchangeably in everyday conversation, but they are not interchangeable.
Medicare can be an excellent resource for qualifying skilled home health and short-term rehabilitation needs. Georgia Medicaid may provide important long-term services and supports for people who satisfy specific financial, functional, and program requirements. Private-pay home care offers families the flexibility to arrange ongoing assistance according to their loved one’s needs.
The best time to understand those differences is before the family reaches a crisis.
If you are caring for an aging parent or loved one in McDonough, Locust Grove, Stockbridge, Hampton, Jackson, or the surrounding Henry County area and are unsure what type of home care you need, BrightStar Care of Locust Grove & McDonough can help you sort through the care needs and determine whether our services are an appropriate fit.
Schedule a Complimentary In-Home Assessment
Every family’s situation is different. A complimentary in-home assessment gives us an opportunity to learn what is happening in the home, understand the support your loved one needs, and develop a personalized plan for helping them remain safe and independent.
BrightStar Care of Locust Grove & McDonough — Guiding Georgia families through every step of aging at home.
Sources
- Medicare.gov — Home health care, skilled nursing facility care, nursing home coverage, and services not covered by Original Medicare.
- Georgia Department of Community Health / Georgia Medicaid — Long-Term Services and Supports and Waiver Programs (including CCSP and SOURCE).
- Georgia Medicaid — 2026 ABD-FM Income and Resource Limits.
- U.S. Census Bureau QuickFacts — Henry County, Georgia (2025 population estimate and age 65+ percentage).
Important note: Coverage and eligibility can vary by individual, program, and health plan. Medicare Advantage plans may offer supplemental benefits beyond Original Medicare. Families should verify current benefits and eligibility directly with Medicare, Georgia Medicaid, or their health plan.