How to Pay for Nursing Home; Assisted Living Facility; or Home Health Care?

There are five ways to pay for long term care in a nursing home, ALF, or home and community based care setting. Most families are only aware of two or three of them. Understanding all five is the first step toward making a plan that does not drain a lifetime of savings unnecessarily.

The Five Ways to Pay for Long Term Care in Florida

1. Cash and Private Pay

The very wealthy can simply pay out of pocket for whatever long term care they need. These costs can range from approximately $30,000 per year to over $150,000 per year depending on the level and setting of care. All but the wealthiest individuals will find that long term care costs are absolutely devastating to the life savings of the care recipient and will put undue stress on their spouse and family. As a subset of this category, reverse mortgages are worth mentioning. A reverse mortgage is a tool for those who need to access cash quickly and who do not mind losing their house after they pass away or move out of the home. This will be appropriate for some and inappropriate for others who want to keep the house in the family. While we do not sell reverse mortgage products, if this is something you are interested in, we can put you in touch with a reverse mortgage specialist to assist.

2. Long Term Care Insurance

LTC insurance gained popularity in the 1990s and early 2000s because the products were affordable and relatively new. More recently, LTC insurance carriers discovered they severely underestimated what they would eventually need to pay out, and have significantly tightened their underwriting standards as a result. This insurance, while not impossible to obtain, has become increasingly difficult and unaffordable for many Floridians. That being said, if you can afford one of these LTC policies, we would strongly encourage you to do so. Our guide on long term care insurance basics covers what to look for in a policy and what questions to ask before purchasing. Feel free to contact our office and we can put you in touch with a long term care insurance broker that we trust.

3. VA Benefits

Veterans and surviving spouses of veterans may have access to an improved pension for the elderly and disabled that can provide approximately $1,000 to $2,000 per month depending on a variety of factors. The VA Aid and Attendance benefit can be extremely useful for elders who need assistance paying for home health aides and ALF care. However, this benefit will generally not be sufficient for those requiring nursing home level care, where costs typically exceed $9,000 to $12,000 per month in Florida. Qualifying for the VA Aid and Attendance benefit requires meeting specific service, income, and medical need criteria. An elder law attorney can help determine whether you or a loved one qualifies and assist with the application.

4. Medicare

Medicare's limited long term care benefit will only assist with up to 100 days of skilled nursing or rehab care following a qualifying hospital stay of at least three days. After 100 days, Medicare stops paying entirely. This benefit only applies to rehab or skilled nursing care. Medicare does not pay for assisted living facility care or ongoing home health care, although it will pay for certain doctor-prescribed home therapies such as physical therapy, occupational therapy, and speech therapy. Many families are caught off guard by how quickly Medicare coverage ends. Understanding the difference between Medicare and Medicaid for long term care purposes is essential before making any financial decisions about care planning.

5. Medicaid ICP and Medicaid Waiver

To qualify for the Florida Medicaid ICP program for nursing home care or the Florida Medicaid Waiver program for home health care or assisted living facility care, you have two options. The first option is to burn through nearly all of your life savings, sell nearly all of your assets, and spend down nearly all of your income to put yourself into a naturally impoverished position that meets Medicaid's financial requirements. The second option is to call us. As Florida Medicaid planning lawyers, we can map out a variety of completely legal and ethical strategies that will allow you to protect hundreds of thousands of dollars in assets while still qualifying for Medicaid. There is no five-year wait required for the planning strategies we use. We can also help you avoid spending down your assets unnecessarily in order to reach eligibility. We can also shelter much of your assets so you are not forced into destitution to qualify for any Medicaid long term care programs. Our job is to empower you with options.

What Does Long Term Care Actually Cost in Florida

Before choosing a payment strategy, it helps to understand what you are actually paying for. Long term care costs in Florida vary significantly depending on the type and level of care required. Nursing home care in a semi-private room typically costs between $9,000 and $13,000 per month in Florida. Private rooms cost more. Memory care units within nursing facilities are often at the higher end of that range. Over the course of a year, full nursing home care can easily exceed $100,000, and for couples where one spouse needs care for multiple years, the financial impact can be catastrophic without proper planning. Assisted living facilities in Florida typically cost between $2,500 and $6,000 per month depending on location, level of services, and the quality of the facility. Memory care units within assisted living facilities tend to run higher, sometimes reaching $7,000 to $8,000 per month or more. It is important to note that Medicaid does not cover room and board at an ALF. Medicaid covers the medical and personal care services component, but the accommodation cost must be paid separately. Home health care costs depend entirely on how many hours of care are needed per week. At an average of $25 to $35 per hour for a home health aide in Florida, someone needing 40 hours of care per week is looking at approximately $4,000 to $5,600 per month just for aide services. Medicaid can help cover these costs, but there is a waitlist and the number of approved hours is determined by the managed care plan.

I Do Not Want to Go Into a Nursing Home. What Are My Options

As an elder law attorney, I understand that avoiding a nursing home is sometimes the primary goal. Our services do not only plan for how to get someone into a nursing home. An experienced elder law attorney can also help clients plan for affordable in-home care and, when that is no longer practical, assisted living facilities, which are very different from nursing homes and provide excellent services to the elderly. Understanding the difference between your care options is an important first step. Our guide on assisted living versus nursing home care explains the key distinctions and helps families decide which setting is appropriate for their loved one's level of need. Unfortunately, going to a nursing home can sometimes be a necessity rather than an option. When 24-hour skilled medical care is required, in addition to basic custodial assistance such as help with eating, moving around, and bathing, a nursing home becomes the only solution. But it is my job to provide every available option and make decisions together, including strategies for staying at home longer.

Do Nursing Homes or Assisted Living Facilities Discriminate Against Medicaid Recipients

Federal laws prohibit facilities from providing any lower standard of care or treatment to Medicaid recipients compared to private pay residents. However, it will generally be easier to enter a nursing home or assisted living facility as a private pay resident first. If you disclose your intent to apply for Medicaid before entry, they may try to discourage admission. But if you enter as a private pay resident and subsequently transition to Medicaid status, you will be fully protected by federal law. The only other major difference is that a private pay resident will be able to obtain a private room, while Medicaid recipients will typically be placed in a semi-private room.

Do All Nursing Homes Accept Medicaid

Yes. In order to receive the proper accreditations to open their doors, all nursing homes must maintain a designated number of Medicaid beds. This is not the case with assisted living facilities. Some ALFs accept Medicaid, while others do not. When helping families choose a facility, we can assist with identifying which ALFs in your area participate in the Medicaid Waiver program.

Why Most People Do Not Plan Until It Is Too Late

The most common situation I encounter is a family that contacts me only after a loved one has already been admitted to a nursing home or is about to be. The urgency is understandable. But acting earlier, even a few months before a crisis, dramatically expands the planning options available. Florida Medicaid planning is not about hiding assets or gaming the system. It is about using the rules exactly as written to protect what a person has worked their entire life to build, so that a spouse does not become impoverished and children are not left with nothing after years of private pay expenses. If your or your loved one's assets currently exceed $2,000 or their monthly income exceeds $2,982, which are the 2026 Florida Medicaid eligibility limits, it does not mean Medicaid is out of reach. It means planning is needed. Contact an experienced Florida Medicaid planning attorney to discuss your options.

Related Resources

• How Many Seniors Will Need Nursing Home Care?
• Long Term Care Insurance Basics
• Assisted Living vs. Nursing Home: What Type of Care Do You Need?

Frequently Asked Questions About Paying for Long Term Care in Florida

Q. How does a person pay for a nursing home in Florida?

A. There are five main ways to pay for nursing home care in Florida. These are private pay using personal savings or a reverse mortgage, long term care insurance, VA Aid and Attendance benefits for eligible veterans and spouses, Medicare for the first 100 days of skilled nursing care following a qualifying hospital stay, and Florida Medicaid for those who meet the financial eligibility requirements or who work with a Medicaid planning attorney to qualify. Most families ultimately rely on Medicaid for ongoing nursing home coverage because private pay costs quickly exhaust savings.

‍Q. How can I pay for assisted living with no money?

A. One of the most common ways to pay for assisted living when personal funds are limited is by applying for the Florida Medicaid Waiver program. Medicaid benefits help cover the cost of personal care and medical services at an ALF, though room and board must still be paid separately. If income or assets currently exceed Medicaid limits, a Medicaid planning attorney can often help structure a legal path to eligibility without waiting five years.

‍Q. What is the average monthly cost for assisted living in Florida?

A. The average monthly cost for assisted living in Florida varies by location and level of services. The state average is roughly $3,500 to $5,000 per month for standard assisted living. Memory care units typically run higher, sometimes $6,000 to $8,000 per month or more. These figures cover room, board, and personal care but do not include the cost of additional medical services.

‍Q. Is assisted living the same as a nursing home?

A. No. Assisted living facilities provide personal care assistance and a residential environment for seniors who need help with daily activities but do not require constant skilled medical supervision. Nursing homes provide both medical care and personal care around the clock for individuals with more serious or complex medical needs. The financial costs, Medicaid programs that apply, and level of medical oversight all differ between the two settings.

‍Q. Will Medicare pay for nursing home care long term?

A. No. Medicare covers up to 100 days of skilled nursing or rehabilitation care following a qualifying hospital stay of at least three days. It does not cover ongoing custodial nursing home care, assisted living, or ongoing home health aide services. After the Medicare benefit is exhausted, families must turn to private pay, long term care insurance, or Medicaid for continued coverage.

‍Q. What happens to a spouse's assets when their partner goes into a nursing home?

A. Florida and federal Medicaid law includes spousal impoverishment protections specifically designed to prevent the at-home spouse from becoming destitute. In 2026, the community spouse is permitted to keep up to $162,660 in countable assets, known as the Community Spouse Resource Allowance. The at-home spouse may also be entitled to a portion of the Medicaid recipient's monthly income under the Minimum Monthly Maintenance Needs Allowance. A Florida Medicaid planning attorney can help ensure these protections are fully applied.