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:

1. Cash/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 $150,000 per year. All but the wealthiest individual will find that long-term care costs are absolutely devastating to the life savings of the LTC recipient (and will put undue stress upon their spouse and/or family).

As a subset of this category we can discuss reverse mortgages. The link discusses this tool in more detail. But essentially, this is a fine tool for those who quickly need to access cash and who don't mind losing their house after they pass away or move out of the house (obviously this is going to 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 they were affordable and relatively new insurance products. More recently, LTC insurance carriers have discovered that they severely underestimated what they would need to eventually pay out and have tightened up 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 polices, we would strongly encourage you to do so.

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. Veterans and spouses of veterans may have access to an improved pension for the elderly and disabled that may provide about $1,000 - $2,000 per month depending on a variety of factors. The VA Improved Pension / VA Aid and Attendance benefit can be extremely useful for those elders who need assistance paying for home health aids and ALF. But the benefit will not be of much use for those requiring nursing home level of care.

4. Medicare. Medicare's limited long-term care benefit will only assist with 100 days of skilled nursing or rehab care. After 100 days Medicare stops paying! This benefit only pertains to rehab or skilled nursing. Medicare does not pay for ALF or home-health care (although they will pay for certain doctor-prescribed home therapies, such as PT, OT, and speech therapy).

5. Medicaid ICP / Medicaid Waiver. To qualify for Florida Medicaid ICP program or Florida Medicaid Waiver program (to pay for home health care, assisted living facility care or skilled-nursing home care), you have two options:

(i) burn through nearly all of your life savings, sell nearly all of your assets, and disavow nearly all of your income to put yourself into a naturally impoverished position that will meet Medicaid’s ICP/waiver requirements; or (there’s a better way)

(ii) call us, your Florida Medicaid-Planning Lawyers – 305-931-0478 (based out of Miami-Dade and Broward but serving all of Florida remotely and online. We can map out a variety of Medicaid planning options, and walk you which completely legal and ethical strategies will best allow you to save hundreds of thousands of dollars in the cost of care for you or your loved one. 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.

I don’t want to go into a nursing home – What are my options?

As an Elder Law attorney, I understand that this is sometimes the primary goal. Our services do not only plan for how to get someone into a nursing home. An experienced elder law lawyer will also be able to help his or her clients plan for ways to obtain affordable in-home care. When that is no longer practical, assisted living facilities (very different than nursing homes) provide some excellent services to the elderly.

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 (eating, moving around, bathing, etc..), a nursing home becomes the only solution.

However, it is my job to provide my clients with every available option to them, and then making a decision together – including 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 vs. private pay residents. However, it will 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, they may try to discourage entry. But if you enter as a private pay resident and subsequently switch to Medicaid status you will be fully protected. The only other major difference is that, as a private pay resident will be able to obtain a private room. Medicaid recipients will usually 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 have a designated number of "medicaid beds." This is not the case with Assisted Living Facilities, some ALFs will accept Medicaid, others may not.  


We care. We listen. We can help. Call Us at (305) 931-0478.