How to Pay for Home Care in Miami, FL
Updated October 2026, Reviewed by Valerie VanBooven RN BSN
Most Miami families pay for in-home care with private funds, long-term care insurance, or both. Medicare does not pay for ongoing personal or companion care at home. Our Miami office is a Florida-licensed nurse registry, and that changes how payment and insurance claims work. This guide explains each payment option, and what to ask when care is arranged through a registry.
Companion Services of America accepts private pay and long-term care insurance. Call our Miami office at (305) 697-6448 for a free, no-obligation assessment.
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Payment options at a glance
Payment source | Can it help pay for care arranged through a registry? | Where to start |
Private pay (savings, income, family support) | Yes | Call us for a written estimate |
Long-term care insurance | Depends on the policy. Many cover home care, but confirm registry-arranged care qualifies | Call your insurer, then call us |
Medicare | No, not for ongoing personal or companion care | Medicare.gov or 1-800-MEDICARE |
VA Pension with Aid and Attendance | Can add monthly income that families use toward care | VA, or an accredited Veterans Service Officer |
Florida Medicaid Long-Term Care (SMMC LTC) | Covers in-home services through plan network providers for eligible adults | Elder Helpline, 1-800-963-5337 |
Tax deductions, HSA or FSA funds | Some care costs may qualify | A tax professional |
What Medicare does and doesn’t cover
Medicare does not pay for:
- 24-hour care at home
- Personal care, such as bathing or dressing, when that is the only care needed
- Companion care, homemaker services, or meal preparation
Medicare may cover part-time, intermittent home health services when the person is homebound, a doctor orders the care, and a Medicare-certified home health agency provides it. Examples include skilled nursing or therapy after a hospital stay. A nurse registry is not a Medicare-certified home health agency, so Medicare will not pay for care arranged through a registry.
Many Miami families use private-pay care through a registry alongside Medicare-covered home health, or after it ends.
Medicare Advantage plans sometimes offer limited in-home support benefits. These vary by plan, so check your plan’s Evidence of Coverage.
Tax breaks and pre-tax accounts
Some home care costs may be tax-deductible as medical expenses. This can apply when the care is a qualified long-term care service for someone who is chronically ill, under a plan of care from a licensed health care practitioner. Deductions apply only if you itemize, and only above a percentage of income.
Other options to ask about:
- Health Savings Account (HSA) funds may cover qualified long-term care services.
- Dependent care accounts or credits may apply when you pay for care of a parent you claim as a dependent.
Because registry caregivers are independent contractors, ask a tax professional how to document payments and what forms, if any, apply to your situation.
First: how a nurse registry works
A nurse registry is different from a home care agency.
- The registry refers caregivers. Companion Services of America’s Miami office is a Florida-licensed nurse registry (License #30212885). We refer qualified caregivers, home health aides, and nurses to families.
- Caregivers are independent contractors. Under Florida law, a caregiver referred by a registry is an independent contractor, not a registry employee. You’ll receive a written disclosure of this when the service contract is made.
- You’ll see two parts to the cost: the caregiver’s charges and the registry’s fee. Ask us to show both clearly in your written estimate, and to explain who invoices you and when.
This matters most for insurance. Some long-term care policies treat care arranged through a registry differently from care provided by an agency. Always confirm with your insurer first.
Private pay
Most Miami families pay for in-home care privately. They use savings, retirement income, or contributions from family members, including adult children who live out of state.
Private pay gives you the most flexibility. You can arrange a few hours a week, overnight help, or round-the-clock care, and change the schedule as needs change.
For a planning benchmark, the 2025 CareScout Cost of Care Survey lists the Florida median at $32 per hour for non-medical in-home care. See our Miami cost of home care guide for sample monthly budgets. Your total cost includes the caregiver’s charges and the registry fee, so ask for a written estimate that shows both.
Long-term care insurance
Long-term care insurance can help pay for home care in Miami. The key question for registry-arranged care is whether your policy covers care from an independent caregiver referred by a nurse registry.
Questions to ask your insurer before care starts
- Does my policy cover home care arranged through a Florida nurse registry?
- Does the caregiver need a specific license or certification, such as a CNA or home health aide?
- What is my daily or monthly maximum, and my lifetime maximum?
- Has my elimination period (waiting period) started, and how are days counted?
- Does the policy pay me, or can it pay the registry or caregiver directly?
- What documentation do you need: a plan of care, invoices, caregiver time sheets?
Getting these answers in writing before care begins helps avoid denied claims later.
How benefits usually start
Most policies begin paying once:
- A benefit trigger is met. Usually the person needs help with at least two activities of daily living, such as bathing, dressing, eating, toileting, transferring, or continence. Severe cognitive impairment, such as dementia, also typically qualifies. A licensed health care practitioner certifies the need.
- The elimination period has passed. This is often 30 to 100 days.
- The care and the caregiver meet the policy’s requirements.
How we help with claims
We can provide documentation that insurers commonly request, such as caregiver credentials, care records, and itemized statements of the caregiver’s charges and the registry fee.
Veterans Benefits
VA Pension with Aid and Attendance
Wartime veterans and surviving spouses who need help with daily activities may qualify for an added monthly payment called Aid and Attendance. It’s paid on top of the VA pension. The VA pays it directly to the veteran or spouse, so it can be used toward private-pay care arranged through a registry.
Eligibility depends on military service dates, income and net worth limits, and medical need. Applications can take several months, so start early.
Where to start: call the VA at 1-800-827-1000, or contact an accredited Veterans Service Officer. Accredited help is free. The Florida Department of Veterans’ Affairs can also connect you with a local officer in Miami-Dade.
VA health care home services
Veterans enrolled in VA health care may qualify for homemaker and home health aide services that the VA arranges through approved community providers. Ask your VA primary care team or social worker at the Miami VA.
Florida Medicaid Long-Term Care
Florida’s Statewide Medicaid Managed Care Long-Term Care program (SMMC LTC) helps eligible adults receive care at home instead of in a nursing home. Services can include personal care, homemaker help, and respite.
To qualify, a person generally must:
- Be 65 or older, or 18 or older with a disability
- Meet Florida Medicaid’s financial eligibility rules
- Need nursing-facility level of care
Enrollment starts with a screening through the local Aging and Disability Resource Center. In Miami-Dade, that’s the Alliance for Aging. There may be a waitlist. Once enrolled, care comes from providers in the managed care plan’s network.
Where to start: call the Florida Elder Helpline at 1-800-963-5337 (1-800-96-ELDER).
Companion Services of America’s Miami registry does not accept Medicaid. Families waiting for Medicaid enrollment sometimes arrange private-pay care through us in the meantime.
Other resources families use
- Life insurance. Some policies offer accelerated benefits for chronic illness, or have cash value you can borrow against.
- Home equity. Some older homeowners use a reverse mortgage or home equity line to fund care.
- Annuities or hybrid life and long-term care policies.
- Read our “How to Choose Home Care Guide“
These are major financial decisions. Speak with a licensed financial or elder law professional first.
How to get started
- Call our Miami office at (305) 697-6448. We’ll schedule a free assessment.
- Call your long-term care insurer and ask whether registry-arranged care is covered. Use the questions above.
- Gather your documents: insurance policies, VA paperwork, and a list of current medications and providers.
- Review your written estimate. It should show the caregiver’s charges, the registry fee, and who invoices you.
- Sign the service contract. You’ll receive the independent contractor disclosure, and we’ll match you with a caregiver.
Frequently asked questions
Does Medicare pay for home care in Miami? Not for ongoing non-medical care. Medicare does not cover personal care, companion care, or 24-hour care when that is the only care needed. It may cover short-term skilled home health care that a doctor orders from a Medicare-certified home health agency. A nurse registry is not one of those agencies.
Will long-term care insurance pay for care through a nurse registry? It depends on your policy. Many policies cover home care, but some have specific rules for registry-arranged or independent caregivers. Ask your insurer before care starts, and ask us which documents we can provide for your claim.
What is a nurse registry, and how is it different from an agency? A Florida nurse registry refers caregivers and nurses to families. The caregivers are independent contractors, not registry employees. An agency employs its caregivers directly. Your service contract will include a written disclosure of the independent contractor relationship.
Can VA benefits help pay for home care in Miami? Possibly. The VA’s Aid and Attendance benefit adds monthly income for eligible wartime veterans and surviving spouses. It’s paid directly to the veteran or spouse, who can use it toward private-pay care.
Does Florida Medicaid cover home care? Florida’s SMMC Long-Term Care program covers in-home services for eligible adults through providers in the plan’s network. Call the Elder Helpline at 1-800-963-5337 to start the screening.
How much does home care cost in Miami? The 2025 CareScout survey lists the Florida median at $32 per hour for non-medical in-home care. See our Miami cost guide for sample monthly budgets, or call for a written estimate showing caregiver charges and the registry fee.
Talk with our Miami team.
Call (305) 697-6448 for a free assessment and a clear, written estimate. We serve Miami, South Miami, Coral Gables, Coconut Grove, Pinecrest, Miami Beach, and surrounding Miami-Dade communities.
This page is general information, not legal, tax, financial, or insurance advice. Coverage and eligibility depend on your specific policy and situation. Confirm details with your insurer, the VA, Medicare, Florida Medicaid, or a qualified professional.
