When a parent starts needing help at home, most families quickly discover there's a whole vocabulary they've never encountered before: companion care, home health aide, personal care, skilled nursing. These terms aren't interchangeable — and choosing the wrong type of care can mean paying out-of-pocket for services insurance would cover, or hiring someone who can't legally provide the help your loved one actually needs.
This guide breaks it down clearly so you can make a confident, informed decision.
What Is Companion Care?
Companion care (also called non-medical home care or personal care) covers social and practical support for adults who are largely independent but benefit from daily assistance. A companion caregiver is not a licensed medical professional. Their role is to reduce isolation, help with daily tasks, and keep life manageable.
Typical companion care services include:
- Conversation and social engagement
- Light housekeeping, laundry, and errands
- Meal preparation
- Transportation to appointments or activities
- Medication reminders (not administration)
- Personal hygiene assistance (bathing, dressing, grooming)
What Is a Home Health Aide (HHA)?
A home health aide is a trained, state-certified paraprofessional who provides hands-on personal care and basic health-related services under the supervision of a licensed nurse or therapist. HHAs bridge the gap between companion care and skilled nursing — they can do everything a companion caregiver does, plus more medically oriented tasks.
Additional HHA services include:
- Vital signs monitoring (blood pressure, pulse, temperature)
- Wound care assistance (non-complex)
- Assistance with prescribed exercises
- Catheter care (in some cases)
- Reporting health changes to supervising nurses
What About Skilled Nursing?
For completeness: skilled nursing involves licensed nurses (RN or LPN) performing clinical tasks — IV therapy, complex wound care, injections, post-surgical monitoring. This is distinct from both companion care and HHA services and is typically ordered by a physician.
Side-by-Side Comparison
| Category | Companion Care | Home Health Aide | Skilled Nursing |
|---|---|---|---|
| Primary tasks | Companionship, errands, light ADLs | Personal care + basic health monitoring | Clinical/medical procedures |
| Licensing (Colorado) | No state license required; agency registration varies | 75-hr state-approved training + competency eval | RN or LPN state license |
| Supervision required | No clinical oversight required | Supervised by RN or therapist | Self-directing (licensed) |
| Typical hourly cost (SW Denver) | $22–$30/hr | $28–$40/hr | $65–$110/hr |
| Medicare coverage | Not covered | Covered when medically necessary | Covered when medically necessary |
| Medicaid (CO HCBS waiver) | Often covered | Often covered | Covered |
| Long-term care insurance | Usually covered | Usually covered | Usually covered |
| Private pay | Yes | Yes | Yes |
When Is Each Type of Care Appropriate?
Mom lives alone and is lonely
Cognitively sharp but increasingly isolated since dad passed. A companion visits 3x/week for meals, errands, and conversation.
Dad needs a driver
Can't drive after a minor stroke but is otherwise independent. A caregiver handles grocery runs and medical appointments.
Post-hip surgery recovery
Discharged from rehab but still needs help bathing, dressing, and doing prescribed PT exercises at home. Medicare likely covers.
Managing early-stage dementia
Needs medication reminders, help with ADLs, and someone who can alert the family nurse if behavior changes.
How to Decide Which Your Parent Needs
Use these questions as a quick decision guide:
- Does your parent have an active medical need? If their doctor has prescribed home care or they're recovering from surgery, start with an HHA (and ask about Medicare coverage).
- Is safety the main concern? Fall risk, dementia wandering, or missed medications typically require HHA-level supervision.
- Is loneliness or logistics the main concern? Companion care is usually the more cost-effective fit.
- What's the budget? If insurance doesn't cover HHA services in your parent's situation, companion care at $22–$30/hr may be the sustainable option.
Pro tip: Many families start with companion care and transition to HHA services as needs evolve. A good agency will assess your parent's needs honestly and recommend the right level — not the most expensive one.
Colorado Licensing Requirements
Colorado regulates in-home care through the Colorado Department of Public Health and Environment (CDPHE) and the Department of Regulatory Agencies (DORA).
Companion/Non-Medical Caregivers
Colorado does not require individual licensure for non-medical companion caregivers. However, agencies providing personal care services must register with the state and are subject to background check requirements. Independent caregivers operating through platforms like Care.com are not state-regulated.
Home Health Aides
HHAs in Colorado must complete a minimum 75 hours of state-approved training, including classroom and supervised clinical hours, and pass a written and practical competency evaluation. Agencies employing HHAs must be licensed by CDPHE as Home Care Agencies if they receive Medicare/Medicaid reimbursement.
What This Means for Families
Always ask any agency you're considering for their CDPHE license number and whether their aides have completed the required HHA training. For independent caregivers, request references and verify that a background check has been conducted.
Cost Ranges in SW Denver (2026)
Rates in the southwest Denver metro — including Lakewood, Littleton, Englewood, Highlands Ranch, and Centennial — currently run:
- Companion care: $22–$30 per hour (live-in rates: $180–$250/day)
- Home health aide: $28–$40 per hour (live-in: $220–$300/day)
- Minimum visit requirements: Most agencies require 2–4 hour minimums per visit
Costs vary based on agency vs. independent caregiver, shift timing (overnight and weekend premiums apply), and whether care is covered by Medicaid or long-term care insurance.
How to Find Both Types on SW Denver Care
SW Denver Care's provider directory lists screened home health aide agencies and companion care services serving the southwest Denver metro. Each listing includes the services offered, service areas, licensing status, and contact information — so you can compare options in one place without spending hours on hold.
You can filter listings by care type (companion vs. HHA), zip code, and insurance accepted. It's the fastest way to build a shortlist of vetted providers in your neighborhood.
Frequently Asked Questions
Can a companion caregiver give my parent their medications?
No. Companion caregivers in Colorado are not licensed to administer medications or perform any medical tasks. If your parent requires medication management, you'll need a home health aide or a licensed nurse. A companion can remind your parent to take their medications, but cannot handle pills directly.
Does Medicare pay for companion care at home?
Generally no. Medicare does not cover non-medical companion care. It may cover limited home health aide services only when tied to a skilled nursing or therapy need ordered by a physician. Colorado's Medicaid Home and Community Based Services (HCBS) waiver and long-term care insurance are the most common payers for companion and personal care services.
What is the difference between a home health aide and a CNA in Colorado?
A Certified Nursing Assistant (CNA) completes a state-approved training program (75+ hours) and passes a competency exam administered by Colorado's CDPHE. Home health aides must complete at least 75 hours of training but may not hold full CNA certification. In practice, many HHAs in Colorado are also CNAs — and many agencies hire CNAs for HHA roles.
How do I find vetted home care providers in SW Denver?
SW Denver Care (swdenvercare.com/listings) maintains a directory of screened home health aide agencies and companion care providers serving the southwest Denver metro area, including Lakewood, Littleton, Englewood, Highlands Ranch, and Centennial. Each listing includes insurance accepted and service type so you can find the right match quickly.
Find the Right Care for Your Family
Browse our directory of vetted companion care and home health aide providers serving SW Denver — filter by care type, zip code, and insurance accepted.
Browse SW Denver Care Providers →