Background: Home health care services for older adults are essential to their ability to age in place as independently as their health will allow. Prior research examining care service utilization has typically included age, but has generally not looked at how different older adult age groups use care services, and examined centenarians specifically. Objective: The present research is designed to examine if the predictors of care services utilization are the same for those in their 80s and those aged 100 and over and if centenarians will need more services than those in their 80s. Methods: The data reported in the current study were collected from 213 proxies of community-dwelling octogenarians (63) and centenarians (150) during 2001-2009 by the Georgia Centenarian Study team. Results: Significant differences were found between octogenarians and centenarians in their care service use, except in the total number of hours they used care services and the number of care services that were provided by friends. For the three care service variables (i.e., number of care services, total number of care service hours, and number of services provided by a paid helper), the predisposing factors age and education were the primary predictors of care service use. Of the enabling factors, urbanicity was the only significant predictor and it is only significant for total number of care service hours. Discussion: Octogenarians and centenarians have different home care service needs and there also appear to be differences in care service usage based on education, ethnicity, urbanicity, and need factors. Care service organizations as well as policy makers need to address the future increase in home care service use and help make sure that education, ethnicity, and urbanicity are not barriers to receiving services.