Help with Paying for Long-Term Care & Nursing Home Costs for Family Members in Florida

We Help You Restructure Assets & Income to Qualify for Medicaid Long-Term Care & Nursing Home Assistance

How Much Does Long-Term Care or a Nursing Home Cost in Florida?

Long-term care and nursing home expenses in Florida are a major concern for many families. In 2024, the average cost of nursing home care in Florida, per month, is $11,478 for a private room and $10,182 for a shared room. These costs emphasize the need for help with paying for long-term care and nursing home costs for family members in Florida, as elder care assistance programs can make managing these expenses more feasible.

What Is the Average Monthly Cost for Nursing Home Care in Florida?

Nursing home care in Florida is one of the most expensive aspects of long-term care. The average monthly cost of nursing home care in Florida is $11,478 for a private room and $10,182 for a shared room. The costs can vary largely depending on the facility’s location and the type of accommodations offered. Facilities with more specialized services or luxurious amenities can charge even higher rates, creating a significant financial burden for many families. Carefully reviewing nursing home contracts can ensure transparency about costs and services.

To address these challenges, families often turn to programs like Medicaid, long-term care insurance, or veterans’ benefits for financial relief. These options can help offset the costs of care, ensuring that loved ones receive the support they need while preserving family assets. Seeking advice from a Florida Medicaid planning attorney can provide valuable guidance for navigating these complex financial decisions.

Does Medicare Cover the Cost of Nursing Home or Long-Term Care?

Medicare provides limited coverage for nursing home and long-term care, and it is often misunderstood. While it is primarily a health insurance program, Medicare can help cover short-term care in a skilled nursing facility under certain conditions. To qualify, the patient must have spent at least three consecutive days in the hospital as an inpatient and require care that is medically necessary for recovery, such as physical therapy or rehabilitation.

Medicare coverage is structured as follows:

• Days 1–20: Full coverage with $0 co-pay per benefit period.
• Days 21–100: The patient pays a coinsurance rate of $204 per day (increasing to $210.50 in 2025).
• Days 101 and beyond: Medicare provides no coverage, and the patient is responsible for all costs.

What Are My Payment Options for Long-Term Care in Florida?

Paying for long-term care in Florida can be challenging, but several financial options can help families manage these significant costs:

Self Pay

For those who do not qualify for assistance programs or have sufficient savings, paying out of pocket is an option. This involves using personal savings, retirement accounts, or other resources to cover the costs of long-term care. While self-pay offers flexibility in choosing care providers, it can quickly deplete financial resources.

Medicaid

Medicaid is one of the most widely used financial assistance programs for long-term care in Florida. It covers nursing home care, in-home care, and community-based services for eligible individuals. Medicaid is generally the best option for covering nursing home costs, as it offers comprehensive benefits for skilled nursing and related services.

Long-Term Care Insurance

Long-term care insurance policies can help offset the costs of nursing home care, assisted living, or in-home care. These policies vary in coverage, so it’s important to review your plan to understand what services are covered. Insurance is particularly helpful for those who plan ahead and secure policies before requiring care.

Veterans’ Benefits

Veterans and their spouses may qualify for financial assistance through programs such as the VA Aid and Attendance Benefit. VA benefits often provide better coverage for assisted living facilities (ALFs) and in-home care than Medicaid, making them an excellent option for these services. To qualify for the Veterans Pension program, applicants must meet the following requirements:

• Military Service:
  • You did not receive a dishonorable discharge.
  • At least one of these must be true:
    • You started on active duty before September 8, 1980, and you served at least 90 days on active duty with at least 1 day during wartime, or
    • You started on active duty as an enlisted person after September 7, 1980, and served at least 24 months or the full period for which you were called or ordered to active duty (with some exceptions) with at least 1 day during wartime, or
    • You were an officer and started on active duty after October 16, 1981, and you hadn’t previously served on active duty for at least 24 months.
• Financial Eligibility:
  • Your yearly family income and net worth must meet certain limits set by Congress.
  • Net worth includes all personal property you own (except your house, car, and most home furnishings), minus any debt owed.
  • The net worth of your spouse is also included in this calculation.
• Age or Disability:
  • At least one of these must be true:
    • You are at least 65 years old.
    • You have a permanent and total disability.
    • You are a patient in a nursing home for long-term care because of a disability.
    • You are receiving Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI).

How Do I Qualify for Medicaid to Cover Nursing Home Costs in Florida?

Qualifying for Medicaid to cover nursing home costs in Florida requires meeting both financial and medical eligibility criteria:

Financial Eligibility

To qualify for Medicaid, applicants must have income and resources within set limits. As of 2024, the income limit is $2,829 per month for individuals, including Social Security, pension payments, and wages. For those exceeding this limit, a Qualified Income Trust (QIT), also known as a Miller Trust, can be established to redirect excess income and meet eligibility requirements.

If countable assets exceed Medicaid’s limit of $2,000, strategies such as spending down assets or utilizing a pooled trust can help preserve resources while achieving eligibility.

• Spending Down Assets: Excess funds can be used for Medicaid-exempt purchases, such as paying off a mortgage, renovating a home, buying a new car, or prepaying funeral expenses with a non-revocable contract.
• Pooled Trust: For individuals with disabilities or those over 65, placing excess funds in a pooled trust allows these resources to be excluded from Medicaid’s asset calculation while ensuring they are used for the applicant’s benefit.

Exempt resources, such as a primary residence, household furnishings, personal belongings, one vehicle, and income-producing property, do not count toward the asset limit.

Medical Requirements

Applicants must demonstrate a need for nursing home care by requiring assistance with at least two of the following activities of daily living:

• Eating
• Bathing
• Dressing
• Transferring (e.g., moving from a bed to a chair)
• Using the bathroom
• Walking

Applicants must also have a medical condition requiring round-the-clock care or skilled nursing services. Documentation, including physician statements and care assessments, is critical to proving medical necessity.

How Can I Protect My Family’s Assets While Paying for Nursing Home Care?

Paying for nursing home care can be a significant financial burden, but there are effective strategies to protect your family’s assets while ensuring access to the care you need. One option is using a special needs pooled trust, which allows funds to be set aside for the Medicaid recipient’s needs without being counted as a gift or jeopardizing eligibility. 

Another strategy involves spending down excess assets on exempt purchases such as buying a new car, paying off a mortgage, renovating or repairing your home, or prepaying funeral expenses with a non-revocable contract. Prepaid funeral arrangements not only comply with Medicaid rules but also provide peace of mind by relieving your family of financial and emotional stress during a difficult time. Working with a Medicaid planning attorney can help you navigate these options and develop a plan tailored to your unique situation, ensuring compliance with Medicaid regulations while protecting your family’s financial future.

Will I Lose My Home If I Go to the Nursing Home on Medicaid?

One of the most common concerns about Medicaid and nursing home care is whether you will lose your home. Fortunately, Medicaid rules in Florida protect homestead property as an exempt asset in most cases. For single individuals, the home remains exempt as long as its equity is below $713,000 (as of 2024). If you are married, there is no equity limit, and the home is fully protected for Medicaid purposes. Additionally, Florida’s homestead property is protected from creditors, even after death, provided the property is not directed to be sold in the will. This ensures that families can preserve their home’s value while qualifying for Medicaid coverage. 
By structuring your estate correctly, applying for Medicaid, and taking advantage of asset protection strategies, you can meet nursing home costs without jeopardizing your financial security. Call or submit a request through our website to request a meet-and-greet with our Florida Medicaid planning attorneys.