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, assisted living facility, or home and community-based care setting. Before exploring your options, it helps to understand what nursing home care actually costs in Florida. In 2025, the average annual cost of a nursing home in Florida is approximately $104,000 for a shared room and $118,000 for a private room. Catching this number early is critical for planning.

5 Ways to Pay for Long-Term Care

1. Cash or Private Pay

The very wealthy can pay out of pocket for whatever long-term care they need. In 2025, those costs average between $104,000 and $138,000 per year in Florida. All but the wealthiest individuals will find that long-term care expenses are absolutely devastating to a lifetime of savings and will put undue stress on a spouse and family.

A subset of private pay is the reverse mortgage. This is a useful tool for those who need to access cash quickly and who do not mind that the home may be sold after they pass away or move out. While we do not sell reverse mortgage products, if this is something you are interested in, we can connect you with a reverse mortgage specialist.

2. Long-Term Care Insurance

Long-term care insurance gained popularity in the 1990s and early 2000s when policies were affordable and the products were relatively new. More recently, LTC insurance carriers discovered they had severely underestimated future payouts and have 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 strongly encourage you to do so.

It is also worth understanding how long-term care insurance claims actually work before committing to a policy. Contact our office and we can put you in touch with an LTC insurance broker we trust.

3. VA Benefits

Veterans and spouses of veterans may have access to an improved pension for the elderly and disabled. The VA Aid and Attendance benefit provides up to $1,453 per month for a single veteran and up to $1,903 per month for a veteran with a spouse, as of 2026. This benefit can be extremely useful for those who need help paying for home health aides or assisted living. It is generally not enough to cover full nursing home costs on its own, but it can meaningfully reduce the financial burden.

4. Medicare

Medicare's limited long-term care benefit covers up to 100 days of skilled nursing or rehabilitation care. After 100 days, Medicare stops paying. This benefit applies only to rehab or skilled nursing care. Medicare does not pay for assisted living or home health care, although it does cover certain doctor-prescribed home therapies such as physical therapy, occupational therapy, and speech therapy. For a full breakdown, see our Medicare 101 guide, or review the key differences between Medicare and Medicaid.

5. Medicaid ICP and Medicaid Waiver

To qualify for the Florida Medicaid ICP program or the Florida Medicaid Waiver program to pay for home health care, assisted living, or skilled nursing home 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 disavow nearly all of your income to put yourself into a naturally impoverished position that meets Medicaid's income and asset requirements.

The second option is to call us. There is a better way.

Call our Florida Medicaid planning attorneys at (305) 419-3369. We serve Miami-Dade, Broward, and all of Florida remotely and online. We can walk you through which fully legal and ethical Medicaid planning strategies will best allow you to protect hundreds of thousands of dollars in assets while qualifying for care coverage. It is also important to understand the Medicaid five-year look-back period, which governs how prior asset transfers are reviewed at the time of your application. Our job is to empower you with options.

What If I Do Not Want to Go into a Nursing Home

As an elder law attorney, I understand that avoiding the 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. When that is no longer practical, assisted living facilities provide excellent services to the elderly and are very different from nursing homes. In Florida, assisted living now averages $4,500 to $5,500 per month, roughly half the cost of nursing home care.

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 with eating, moving around, and bathing, a nursing home becomes the only practical solution.

My job is to provide every available option and to make that decision together with my clients, including staying at home longer. If you are at this stage, our guide to choosing a nursing home in Florida is a helpful starting point.

Do Nursing Homes or Assisted Living Facilities Discriminate Against Medicaid Recipients

Federal law prohibits facilities from providing a lower standard of care or treatment to Medicaid recipients compared to 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 at the outset, a facility may try to discourage your entry. If you enter as a private pay resident and then switch to Medicaid status, you will be fully protected by federal law. The one practical difference is that private pay residents can obtain a private room, while Medicaid recipients are generally placed in a semi-private room.

Do All Nursing Homes Accept Medicaid

Yes. To receive the proper accreditations to open their doors, all nursing homes must designate a number of Medicaid beds. This is not the case with assisted living facilities. Some ALFs accept Medicaid and others do not. For more on protecting your home and assets from nursing home expenses, speak with a Florida Medicaid planning attorney as early as possible.

Frequently Asked Questions

Q. How does a person pay for a nursing home

A. Nursing homes, assisted living facilities, and home health care all cost more than most people anticipate. In Florida, nursing home care now averages over $100,000 per year. If you need help paying for long-term care, Medicaid may be an option. Medicaid has specific income and asset limits for qualification, and if you exceed those limits, Medicaid planning may help get you within the qualifying range.

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

A. One of the most common ways to pay for assisted living when no other funds are available is by applying for Medicaid. Medicaid benefits help cover the cost of long-term care when other means of payment are not possible.

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

A. The average monthly cost for assisted living in Florida is approximately $4,500 to $5,500 per month as of 2025, depending on location and level of care. Areas like Miami and Boca Raton tend to run on the higher end of that range.

Q. Is assisted living the same as a nursing home

A. Though the terms are sometimes used interchangeably, they describe different types of long-term care. Assisted living facilities generally provide personal care only, such as help with bathing, dressing, and meals. Nursing homes provide both personal care and around-the-clock medical care. The right setting depends on the level of medical supervision a person requires.

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