How to Pay for In-Home Care in Florida

Paying for in-home care is one of the biggest worries families bring to us. The good news is that there is often more than one way to cover it. The hard part is that each option has its own rules. This guide walks through the main ways Florida families pay for non-medical home care, from Medicare and Medicaid to VA benefits, insurance and tax breaks.

Medicare: what it covers and what it doesn't

Original Medicare has a home health benefit, but it is designed for skilled, short-term care. According to Medicare.gov, it covers part-time or intermittent skilled nursing, physical, occupational and speech therapy, and home health aide care only when you are also receiving skilled nursing or therapy. To qualify, you must be homebound, a doctor must order the care and a Medicare-certified home health agency must provide it.

Medicare does not pay for:

• 24-hour care at home
• Meal delivery
• Homemaker services such as shopping and cleaning that are not related to your care plan
• Personal care such as bathing, dressing and using the bathroom when that is the only care you need

Medicare also doesn't pay for long-term custodial care, and neither do Medicare Supplement (Medigap) policies. In short, Original Medicare generally doesn't cover non-medical home care when it's the only care needed.

Medicare Advantage extra benefits

Since 2019, Medicare Advantage plans have been allowed to offer in-home support services as a supplemental benefit, to help people with daily activities at home. These benefits are still limited. KFF found that in 2026, about 7 percent of individual Medicare Advantage plans and 25 percent of Special Needs Plans offer in-home support services. If your loved one has a Medicare Advantage plan, call the plan and ask whether it includes in-home support, how many hours and which providers you can use.

Florida Medicaid Long-Term Care

Florida's Statewide Medicaid Managed Care Long-Term Care program, often called SMMC LTC, is the largest public source of help with home care. According to the Agency for Health Care Administration, you may qualify if you are:

• 65 or older and eligible for Medicaid, or 18 or older and eligible for Medicaid because of a disability, and
• Found by the Department of Elder Affairs to need nursing home level of care

Plans must offer services that include adult companion care, homemaker services, personal care, attendant care, respite care, home-delivered meals, caregiver training and transportation, based on medical need. The goal is to help people get care at home or in the community rather than in a nursing home.

How to apply

1. Get screened. The first step is a phone screening with your local Aging and Disability Resource Center. In Orange, Osceola and Seminole Counties, that is Senior Resource Alliance. The screening takes about 45 minutes to an hour.
2. Wait list placement. The screening gives a priority score. Space for home and community services is limited, so people with higher priority are placed on the wait list, and others are given information about community resources. You can ask to be rescreened if your situation changes.
3. Eligibility. When you are released from the wait list, a doctor, nurse practitioner or physician assistant completes a medical form, the Department of Children and Families reviews financial eligibility and Elder Affairs staff visit to assess the level of care.
4. Choose a plan. If you qualify, you pick a managed care plan, which arranges services through its network of providers.

Other Florida programs for older adults

Florida's Department of Elder Affairs funds several programs through local Area Agencies on Aging. Each has its own rules and may have a wait list.

• Community Care for the Elderly (CCE) serves people 60 and older with functional impairments. Services can include companionship, homemaking, personal care, respite, shopping help and transportation. Clients may pay a co-payment based on their ability to pay.
• Home Care for the Elderly (HCE) supports people 60 and older who live with a family caregiver and are at risk of nursing home placement. It includes a basic monthly subsidy of $160 paid to the caregiver, and it has income and asset limits.
• Alzheimer's Disease Initiative (ADI) provides respite and support for caregivers of adults with Alzheimer's disease or related dementias, including in-home respite, adult day care, caregiver training and support groups.

In Central Florida, Senior Resource Alliance is the place to start for all of these programs.

Benefits for veterans and surviving spouses

VA pension with Aid and Attendance

Veterans who served during a wartime period and meet income and net worth limits may qualify for a VA pension. The Aid and Attendance benefit adds to that pension for veterans who need help from another person with daily activities such as bathing, dressing and eating. Surviving spouses can also qualify.

For December 2025 through November 2026, the maximum yearly pension with Aid and Attendance is $29,093 for a veteran with no dependents and $34,488 for a veteran with one dependent. These are limits, not guaranteed payments: the VA pays the difference between the limit and your countable income. Unreimbursed medical expenses, which can include in-home care, may reduce countable income. The net worth limit is $163,699, not counting your home and car. See the current VA pension rates for details.

VA home care programs

Enrolled veterans who meet clinical criteria may also receive Homemaker and Home Health Aide Care, where an aide from a VA-contracted organization helps at home, or Veteran-Directed Care, which gives the veteran a budget to hire their own caregivers. A copay may apply. Ask the veteran's VA care team about eligibility.

Long-term care insurance

If your loved one bought a long-term care insurance policy, now is the time to read it closely. According to the Administration for Community Living, most policies pay benefits when a person needs help with two or more of six activities of daily living, or has a cognitive impairment. The insurer usually confirms this with its own assessment.

Things to check in the policy:

• Home care coverage. Most policies cover care at home, but some pay only for licensed agencies and others allow family caregivers.
• Elimination period. Like a deductible measured in time, often 30, 60 or 90 days, during which you pay for care yourself.
• Daily or monthly limit and the lifetime maximum.
• Claim paperwork. Ask what records the insurer needs from the care provider.

Life insurance and home equity

Some families turn to assets they already have:

• Accelerated death benefits. Some life insurance policies let you take part of the death benefit early to pay for long-term care. This reduces what heirs receive and may affect Medicaid eligibility.
• Life settlements. Selling a policy to a third party can bring cash, but the proceeds may be taxable.
• Reverse mortgages. Homeowners 62 and older can borrow against their home equity. The Consumer Financial Protection Bureau recommends meeting with a HUD-approved counselor first, since the loan balance grows over time and must be repaid when the owner sells or moves out.

Tax breaks that can help

Two federal tax rules may lower the cost of care. Always check with a tax professional about your situation.

• Medical expense deduction. According to IRS Publication 502, you can deduct medical expenses above 7.5 percent of your adjusted gross income if you itemize. This can include personal care services for someone who is chronically ill and receiving care under a plan prescribed by a licensed health care practitioner. General household help usually doesn't count.
• Child and Dependent Care Credit. If you pay for care for a spouse or dependent who can't care for themselves and lives with you, so that you can work, IRS Publication 503 explains that you may be able to claim a credit on up to $3,000 of expenses for one person or $6,000 for two or more. You can't count the same expense for both this credit and the medical deduction.

Private pay and family support

Most families pay at least part of the cost out of pocket, from savings, retirement income or help from adult children. Starting with a smaller schedule and adding hours as needs grow can make care more affordable. For current local rates, see our guide to the cost of in-home care in Orlando.

Quick comparison

Next steps

1. Write down what help your loved one needs and how many hours a week. Our guide to signs your parent may need help at home can help.
2. Call Senior Resource Alliance to ask about Medicaid screening and state programs.
3. Check any Medicare Advantage plan, long-term care policy and veterans benefits.
4. Talk with home care providers about cost, schedules and the payment types they accept. We are happy to walk you through it during a free consultation.

This article is general information, not medical, legal or financial advice. Program rules and costs change; check with the organizations linked above or talk with a qualified professional about your situation.