The essentials in 30 seconds
Companion care is non-medical help at home focused on company, conversation, supervision and light everyday tasks such as errands, meals and transportation. It is different from personal care (hands-on help with bathing, dressing, the toilet, eating and moving around) and from home health care (skilled nursing and therapy ordered by a doctor). Companions come from home care agencies, from volunteer "friendly visitor" programs or as privately hired individuals.
- Write down exactly which tasks you need before you call anyone: that tells you whether companion care is enough.
- Ask every provider how they check backgrounds, train staff and handle emergencies, and get fees and services in writing.
- Original Medicare, Medicaid and private health insurance generally do not pay for companion services; some long-term care insurance policies and some state Medicaid waiver programs may help.
What companion care is and what a companion caregiver does
Companion care is the lightest level of in-home support. The companion's main job is to be there: to talk, share an activity, notice changes and help with the small tasks that keep a day running. Volunteer programs often offer short visits (the National Institute on Aging describes visits of under two hours), while agencies can schedule companions for a few hours a week up to many hours a day.
Typical companion tasks:
- Conversation, reading aloud, games, puzzles and hobbies
- Going for walks and accompanying the person to appointments, church, the senior center or social events
- Running errands: groceries, pharmacy pickups, the post office
- Preparing simple meals and sitting down to eat together
- Light housekeeping linked to the person: dishes, laundry, tidying
- Reminders for appointments and daily routines
- Checking in on safety and telling the family about changes in mood, appetite or the home
What companions usually do not do:
- Hands-on personal care such as bathing, dressing or help with the toilet (that is personal care)
- Medical tasks: wound care, injections, managing medicines, monitoring a health condition (that is home health care or nursing)
- Heavy housework, yard work or home repairs
The line between companion and personal care varies between agencies, so ask each one exactly what its companions are trained and allowed to do.
Companion care vs personal care vs home health care
| Companion care | Personal care | Home health care | |
|---|---|---|---|
| Main purpose | Company, supervision, errands, light tasks | Help with "activities of daily living": bathing, dressing, grooming, toilet, eating, moving around | Skilled nursing, physical, occupational or speech therapy |
| Who provides it | Agency companion, volunteer or private hire | Trained aide from an agency or a private hire | Medicare-certified agency staff, ordered by a doctor |
| Medical? | No | No, but hands-on | Yes |
| Typical length | A few hours a week to daily | From short daily visits to live-in | Part-time or intermittent, often after an illness or hospital stay |
| Original Medicare | Generally not covered | Not covered when it is the only care you need | Covered if you are homebound and meet the other conditions |
You can combine levels: a home health nurse visits twice a week after a hospital stay, while a companion covers weekday afternoons. If your list of needs includes bathing, getting out of bed or the toilet, look for personal care rather than companion care alone.
Signs that companion care may help
The National Institute on Aging links loneliness and social isolation in older adults with higher risks of high blood pressure, heart disease, depression, cognitive decline and dementia. Companion care is one way to add regular contact; it does not replace medical care or a doctor's assessment.
| What you notice | What it may point to | Next step |
|---|---|---|
| Lives alone and rarely sees anyone between family visits | Social isolation | Try a volunteer friendly visitor or a few companion hours a week |
| Stopped driving, no easy way to get out | Isolation through lack of transportation | Companion who drives, plus local senior transportation |
| Fridge almost empty, meals skipped | Trouble shopping or cooking alone | Companion for shopping and shared meals; ask about meal delivery |
| Withdrawn in conversations, mishears often | Possible hearing loss feeding isolation | Ask the doctor about a hearing check |
| Recent loss of a spouse, retirement or move | Major life change | Regular visits on a fixed schedule |
| Needs help to wash, dress or get up | More than companionship | Look into personal care or a home health assessment |
| Sad, hopeless or losing interest for weeks | Possible depression | Talk to the doctor first |
Other risk factors the NIA lists include loss of mobility, vision problems, cognitive challenges, financial struggles, caring for a sick relative and language barriers. If you are worried about loneliness, mention it to the person's doctor: it is a health topic, not just a social one.
How to choose a companion care agency or caregiver
| Option | Strengths | What to check |
|---|---|---|
| Home care agency | Employs, screens and trains staff, and can send a replacement when your usual companion is away | Licensing in your state, how carers are matched, minimum hours, cancellation notice |
| Independent caregiver | You choose the person directly; continuity with one person | You do the background check, references, scheduling and backup cover yourself |
| Volunteer friendly visitor | Free; short, regular visits | Waiting lists and limits on what volunteers can do |
-
01
List the needs
Write down tasks, days and hours, and anything the person enjoys. Include who to call in an emergency and any health conditions the companion should know about.
-
02
Gather names
Ask the doctor, friends and neighbors, the local senior center or your Area Agency on Aging. The Eldercare Locator (800-677-1116, run by the federal Administration for Community Living) connects you to local services.
-
03
Check the record
Ask for references and call them. Check for complaints with the state or local agencies that regulate health and home care services, and with the Better Business Bureau.
-
04
Ask the hard questions
Use the list below at every interview, and compare answers side by side.
-
05
Meet first
Arrange a first visit while a family member is present, and ask the older adult how it felt.
-
06
Put it in writing
Get a written agreement or care plan listing tasks, schedule, fees, what is included and excluded, and the notice needed to change or stop the service.
-
07
Review after a month
Ask the person, the companion and the family what is working and adjust the plan.
Questions to ask an agency or an independent caregiver, based on the NIA's hiring worksheet:
- Are you licensed or accredited by the state, local government or a professional association?
- How do you check the background and experience of your caregivers, and can you give references?
- How do you train caregivers, and what are companions allowed and not allowed to do?
- Will it be the same person each time? What happens when they are sick or on vacation?
- How many days and hours will someone come, and is there a minimum number of hours?
- What is included and not included, and will you give me all fees in writing before services start?
- Are you available around the clock for emergencies, and what can you do in one?
- How will you keep the family informed, and who do I contact if there is a problem?
- How much notice do you need if we want to stop?
How companion care is paid for
Companion care is usually paid privately, by the hour. Coverage depends on the program and the state, so check each source before you sign anything.
- Original Medicare. Medicare's home health benefit covers part-time skilled nursing and therapy for people who are homebound. It does not cover 24-hour care at home, homemaker services unrelated to the care plan, or custodial and personal care when that is the only care you need, and companion services fall outside it.
- Medicaid. Nearly all states run home and community-based services (HCBS) waiver programs that can include homemaker, personal care, adult day health and respite services. Each state sets who qualifies, which services it offers and how many people it can serve, so ask your state Medicaid office or Area Agency on Aging.
- Long-term care insurance. Some policies pay for companion visits or homemaker services; read the policy's definition of covered home care.
- Volunteer programs. Friendly visitor and senior companion programs run by community organizations are free.
Mistakes families make with companion care
- Hiring a companion when the real need is help with bathing or the toilet.
- Skipping reference checks because the person "seemed nice".
- Agreeing fees and tasks by phone with nothing in writing.
- Choosing a schedule that suits the family but not the person's best hours of the day.
- Never asking the older adult how they feel about the companion.
Companion care: frequently asked questions
What does a companion caregiver do?
They provide company and light help: conversation, activities, walks, errands, transportation, simple meals and light housekeeping. They also keep an eye on how the person is doing.
What is the difference between companion care and home health care?
Companion care is non-medical. Home health care is skilled nursing or therapy ordered by a doctor and given by a certified agency.
What is the difference between companion care and personal care?
Personal care includes hands-on help with bathing, dressing, grooming, the toilet, eating and moving around. Companion care focuses on company and everyday tasks.
Does Medicare pay for companion care?
Generally no. Original Medicare does not cover custodial care, homemaker services unrelated to a care plan or 24-hour care at home.
Does Medicaid cover companion care?
It depends on the state. Many states offer home and community-based services waivers with homemaker, personal care or respite services, and each sets its own rules.
Is companion care the same as non-medical home care?
Companion care is one type of non-medical home care. Non-medical home care can also include personal care and homemaker services.
How do I find companion care near me?
Ask the doctor, the local senior center or your Area Agency on Aging, or call the Eldercare Locator at 800-677-1116.
How many hours of companion care does someone need?
Start with the hours that cover the loneliest or hardest part of the day. Review the schedule after a month.
Sources
Official guidance on care at home, checked on 27 October 2026.
- National Institute on Aging · Services for older adults living at home ↗Personal care and activities of daily living, friendly visitor and senior companion services, visits under two hours, who pays, Eldercare Locator, checking references and complaints.
- National Institute on Aging · Worksheet: Questions to ask before hiring a care provider ↗Questions on licensing, background checks, training, hours, fees, emergencies and notice.
- National Institute on Aging · Loneliness and social isolation ↗Health risks linked to loneliness and isolation, risk factors, hearing loss, talking to a doctor.
- Medicare.gov · Home health services ↗What the home health benefit covers, the homebound requirement and what Medicare does not pay for.
- Medicaid.gov · Home and community-based services 1915(c) ↗Waiver services such as homemaker, personal care and respite, and how states set limits.
- NHS · Help at home from a paid carer ↗UK needs assessment, care and support plan, CQC registration and employing a carer directly.
Planning care for a parent?
Write down the tasks, days and hours you need before you call the first provider.