The cost of nursing home care is one of the biggest financial concerns for seniors and their families — and for good reason. A single year in a nursing home can wipe out decades of savings if you’re not prepared.
But here’s the truth most people don’t hear soon enough: there are more ways to pay for long-term care than most families realize. This guide covers the real options — what works, what doesn’t, and what you should know before making any decisions.
How Much Does Nursing Home Care Actually Cost?
The numbers tell the story, because understanding the scale of the problem is the first step.
According to the Genworth Cost of Care Survey, the national median cost for a semi-private room in a nursing home is approximately $8,669 per month — about $104,000 per year. A private room runs roughly $9,733 per month, or nearly $117,000 per year.
In Florida, costs are slightly below the national average but still substantial — roughly $8,400 per month for a semi-private room and $9,500 per month for a private room. Costs in metro areas like Orlando, Miami, or Tampa may be higher, and they increase every year.
Medicare: What It Does and Doesn’t Cover
Medicare does cover some nursing home costs — but only under very specific, limited conditions. Medicare Part A covers care in a skilled nursing facility (SNF) for up to 100 days after a qualifying 3-day hospital stay. Days 1-20 are fully covered; days 21-100 require a copayment of about $204.50 per day; after day 100, Medicare pays nothing.
Critically, Medicare only covers skilled nursing care — not custodial care (help with eating, bathing, dressing, and daily activities). Since most long-term stays are custodial, Medicare will not pay for most of the time a person spends in a nursing home.
Medicaid: The Primary Payer for Long-Term Nursing Home Care
Medicaid is the single largest payer of long-term nursing home care in the United States. Unlike Medicare, Medicaid does cover custodial care in a nursing home — but there’s a catch.
To qualify for Medicaid long-term care, you must meet strict income and asset limits. In most states, including Florida, this means:
- Your countable assets must generally be below $2,000 (some assets like your primary home may be exempt, up to a certain equity value)
- Your monthly income must fall within your state’s limits, though many states allow individuals to contribute excess income toward their care through a Miller Trust or similar mechanism
The Spend-Down Process
If your assets exceed Medicaid’s limits, you’ll need to spend down — meaning you use your savings to pay for care until your assets reach the qualifying threshold. This is where many families feel the financial pain.
You cannot simply give away assets to qualify faster — Medicaid has a 5-year look-back period and will penalize transfers. Certain assets are exempt, including your primary home (up to an equity limit), one vehicle, and prepaid funeral arrangements. A community spouse is entitled to keep a portion of the couple’s assets through the Community Spouse Resource Allowance.
Planning ahead gives families far more options. An elder law attorney can help structure assets to protect the healthy spouse while qualifying for Medicaid.
Long-Term Care Insurance
If you purchased a long-term care insurance policy years ago, now is when it pays off. These policies are designed to cover nursing home care, assisted living, and sometimes home care.
However, if you don’t already have a policy, purchasing one at age 70 or 80 may be extremely expensive or impossible due to health requirements. If you do have a policy, review the daily benefit amount, waiting period, benefit duration, and covered care types carefully.
Veterans Benefits: Aid and Attendance
If you or your spouse served in the military, you may qualify for the VA Aid and Attendance pension benefit — a monthly payment to help cover long-term care costs. As of 2025, maximum rates range from roughly $1,563 per month for a surviving spouse to $2,883 per month for a veteran with a spouse.
You generally need 90 days of active duty (with at least one day during wartime), a medical need for daily assistance, and income/assets within VA limits. The application process takes several months, so start early — a Veterans Service Organization (VSO) can help at no cost.
Other Options Worth Knowing About
- Reverse mortgages: If you own your home, a reverse mortgage lets you convert home equity into cash. However, if you move into a nursing home permanently and the home is no longer your primary residence for 12 consecutive months, the loan typically becomes due. This works best when a spouse remains in the home.
- Family contributions: Many families share the financial burden among adult children and relatives — whether through direct payments, providing care at home to delay a nursing home, or sharing caregiving duties. These conversations are difficult, but having them before a crisis makes everything easier.
Options You May Not Have Considered
Life Settlements
If you own a life insurance policy that you no longer need or can no longer afford, you may be able to sell it through a life settlement — receiving a lump-sum cash payment that can be used to pay for nursing home care.
The payout is typically approximately 4 times the cash surrender value your insurance company would offer. You stop paying premiums immediately, and the cash can be used for any purpose — nursing home costs, in-home care, or Medicaid planning.
Many seniors carry life insurance policies purchased decades ago for reasons that no longer apply — children are grown, mortgages are paid off, or a spouse has passed. Learn more about what a life settlement is and how it works. A licensed life settlement broker has a fiduciary duty to represent your interests and will shop your policy to multiple competing buyers to get the best price.
Planning Ahead Makes All the Difference
If nursing home care is a possibility for you or a loved one, consider these steps now: consult an elder law attorney about Medicaid planning, review any existing insurance policies, check Veterans benefits eligibility if applicable, and have honest conversations with family about expectations and resources. There is no single solution — but understanding your options puts you in a far stronger position.
Paying for Care Without Losing Everything
If you own a life insurance policy and you’re exploring ways to pay for nursing home care, it costs nothing to find out what your policy might be worth on the secondary market.
A life insurance policy sitting unused could help pay for the care you need right now. Find out what yours is worth — it’s free, fast, and there’s no obligation. Call (321) 270-0279 if you prefer to talk.