Why the names cause confusion
Families in Greater St. Louis often hear “home health,” “home care” and “house calls” used as if they mean the same thing. They do not. Mixing them up can lead to calling the wrong place, waiting for a service that was never ordered or expecting help that is not part of the arrangement.
Below is a general explanation. Rules and definitions vary by plan and by agency, so use this as a starting point for questions, not as a promise about any one service.
Home health
Home health is skilled care delivered at home through an agency. It usually includes nurses and may include physical, occupational or speech therapists, or social workers.
- Who orders it: A physician or other authorized clinician orders it, and the agency sets up a plan of care.
- How long: It is usually intermittent and time-limited, tied to a recovery or a medical need.
- Who provides it: A licensed agency, and in many cases one certified to bill Medicare.
- Typical uses: After a hospital stay, after surgery, or when a new medical need makes recovery at home hard.
Plans often set conditions, such as a need for skilled care or difficulty leaving home. Ask the agency and your plan how the rules apply to you.
Home care
Home care is non-medical help with daily life. Caregivers may help with bathing, dressing, meals, light housekeeping, reminders and company.
- Who orders it: Usually the person or family chooses it. No clinical order is required for most private arrangements.
- How long: As much or as little as the family arranges.
- Who provides it: A home care agency or an independent caregiver.
- Who usually pays: In general, families pay privately. Some long-term care policies and certain state or community programs may help. Ask each one what applies.
Home care workers help with daily tasks but do not take the place of a clinician’s assessment or orders.
House calls
A house call is a clinician visit at home for medical care, such as primary care follow-up or wound care. The clinician examines the patient, makes clinical decisions and writes orders.
- Who orders it: The patient or family can ask for it. The clinician writes orders after the visit.
- How long: Visits continue at the schedule the clinician sets.
- Who provides it: Clinicians in a treating practice.
- Who pays: It depends on the practice, the plan and the care needed. Ask before the first visit.
Gateway arranges house calls in St. Louis with partner clinicians. We are not a home health agency and not a home care agency. We work with both.
Side by side
- Need skilled nursing or therapy at home after a hospital stay: ask about home health.
- Need help getting dressed, bathing or preparing meals: ask about home care.
- Need a clinician to examine you, adjust a plan or review medications without going to an office: ask about house calls.
- Have a wound that is not healing while an agency visits: consider house calls for wound care alongside home health.
How they can work together
Many people use more than one. A person recovering from surgery might have home health nurses during the week, a home care aide for daily tasks and a house call clinician to follow a wound.
The key is communication. Each group should know the others exist. Tell every provider who else visits, and ask that they share updates with your physician. Gateway’s page on wound care for home health patients shows how that coordination works when a wound is involved.
Questions to ask before you choose
- Who will be coming to my home, and what are they allowed to do?
- Who orders this service, and do I need a referral?
- Does my plan have rules about this service, such as homebound status?
- What will I be asked to pay, and who do I call with billing questions?
- How will you share updates with my physician and my family?
- What should I do if something changes between visits?
If you are unsure where to start, request care and tell us what is happening. We will help you work out whether a house call fits, or whether another service should come first.
When to get help right away
For a medical emergency, call 911. That includes chest pain, trouble breathing, sudden confusion or bleeding that will not stop. Home health, home care and house calls are not emergency services.
Common questions
Is a house call the same as a home health visit?
No. A home health visit comes from an agency under a plan of care for a limited time. A house call is a visit by a clinician who examines the patient and sets the medical plan. The two can be used together. See our comparison of home health and mobile wound care.
Do I have to be homebound for these services?
Not always. Homebound status is a rule that some plans apply to certain services, especially home health. House calls and home care may follow different rules. Our guide on what homebound means explains the term, and your plan can tell you how it applies.
Who pays for home care?
Usually the family pays privately. Some long-term care insurance policies and certain programs may contribute. Because this varies, ask the agency which payment options it works with and ask any program you use what it requires.
Can I get all three at once?
Yes, many people do. Each service has a different job, so they do not replace one another. Tell each provider about the others so they can share information and avoid duplication.
Who should I call first?
Start with your physician if you have a medical need and an existing relationship. If you want a clinician to come to you, or you are not sure which service fits, call Gateway at 314-325-0126 with your ZIP code. We will explain what we can arrange.
Related pages
General information to help you talk with your own clinician. It is not medical advice, and the treating clinician makes every clinical decision. For a medical emergency, call 911.
Updated October 2026