Medicaid Long-Term Care Guide in Kentucky
Long-term care eligibility, benefits, and how to apply through the Kentucky Cabinet for Health and Family Services, Department for Medicaid Services.
What makes Kentucky Medicaid different
While Medicaid in Kentucky is jointly funded by the state and federal government, it is administered by the state under federally set parameters. In addition to nursing home care, KY Medicaid pays for non-medical services and supports to help frail seniors live in their homes.
Administered by the Kentucky Cabinet for Health and Family Services, Department for Medicaid Services.
Program Types
Institutional / Nursing Home Medicaid
An entitlement; anyone who is eligible will receive assistance. Benefits are provided in Medicaid-certified nursing home facilities.
Level of care: Nursing Home
Medicaid Waivers / Home and Community Based Services (HCBS)
Not an entitlement; there are a limited number of participants and waiting lists may exist. Intended to delay nursing home admissions, services and supports are provided at home and in adult day care.
Level of care: Nursing Home
Regular Medicaid / Aged Blind and Disabled
An entitlement; anyone who meets the requirements is able to receive benefits. While Regular Medicaid is not Long-Term Care Medicaid, some long-term care services, such as personal care assistance or adult day care, may be available.
Level of care: Help with ADLs
2026 Kentucky Medicaid Long-Term Care Eligibility for Seniors
Institutional / Nursing Home Medicaid*
Medicaid Waivers / Home and Community Based Services†
Regular Medicaid / Aged Blind and Disabled
*All of a beneficiary's monthly income, with the exception of a Personal Needs Allowance of $60 / month, Medicare premiums, and possibly a Needs Allowance for a non-applicant spouse, must go towards nursing home costs. This is called a Patient Liability.
†Based on one's living setting, a program beneficiary may not be able to keep monthly income up to this level.
‡While the income limit is very low, SSI recipients are automatically eligible for Regular Medicaid, including long-term services and supports given functional need criteria are met. In 2026, the SSI pathway allows an individual income up to $994 / month and a couple up to $1,491 / month. The asset limit is $2,000 for an individual and $3,000 for a couple.
Explore Kentucky Medicaid Programs
Compare programs, see caregiver pay rates, get step-by-step application guidance, and check your eligibility — all specific to Kentucky.
Long-term care Medicaid guide
Eligibility · Caregiver pay · How to apply · 2026 data
Important: Rates vary — contact your state Medicaid office for current figures. This tool provides general guidance, not legal or financial advice.
Compare Medicaid Programs — Kentucky
How the main LTC programs available in Kentucky compare side by side.
| Program | Pay | Pay type | Tax-free? | Spouse OK? | Waitlist? |
|---|---|---|---|---|---|
| Consumer-directed HCBS | $13–16/hr | Hourly wage | No | Usually no | Often |
| Structured Family Caregiving (SFC) | Not in Kentucky | Daily stipend | Yes | Usually no | Often |
| Personal Care Agreement | Market rate (from assets) | Private pay | No | Yes | No |
| VA Aid & Attendance | Up to $2,874/mo | Monthly pension | Yes | Yes | No |
Kentucky Medicaid programs
HCBS Waiver
Supports for Community Living
Sources: KFF (Jan 2026), medicaidplanningassistance.org (Feb 2026). Programs and rates change — verify with your state Medicaid office.
How Family Caregivers Get Paid Through Medicaid in Kentucky
If you're a family member providing care, you may be able to get paid through Medicaid — often at rates comparable to a home care agency.
Consumer-directed care — hourly pay
Available in KentuckyHow it works: The person receiving care becomes the "employer" — they hire you and a fiscal intermediary handles payroll, taxes, and paperwork on their behalf. You receive a paycheck just like a regular job.
How to apply: CHFS · chfs.ky.gov/dms
Personal Care Agreement — private pay from assets
Available to any familySources: KFF Medicaid Home Care Survey 2025 (Jan 2026), Careforth FAQ (Jan 2026), IRS Notice 2014-7.
How to Apply for Medicaid Long-Term Care in Kentucky
What to expect when applying for LTC Medicaid and getting family caregiver pay set up in Kentucky. The process typically takes 45–90 days from application to first paycheck.
Apply in Kentucky: CHFS · chfs.ky.gov/dms
Medicaid Eligibility Screener — Kentucky
Answer 7 quick questions — we'll check the financial and care requirements for Kentucky and explain what each one means.
What is the marital status of the person who needs care?
Medicaid looks at only the applicant's income and assets — but being married triggers special protections that let the healthy spouse keep significantly more money.
Sources
- CMS Medicaid — eligibility, HCBS waivers, and long-term services medicaid.gov/medicaid/eligibility
- CMS Medicaid — Home & Community-Based Services (HCBS) medicaid.gov/medicaid/home-community-based-services
- Social Security Administration — SSI Federal Benefit Rate (2026 figures) ssa.gov/oact/cola/SSI.html
- CMS — Spousal Impoverishment standards (CSRA & MMMNA) medicaid.gov/medicaid/eligibility/spousal-impoverishment
- CMS — Estate Recovery and the 5-year lookback period medicaid.gov/medicaid/eligibility/estate-recovery
- IRS Notice 2014-7 — Tax treatment of Medicaid caregiver payments irs.gov/individuals/certain-medicaid-waiver-payments-may-be-excludable-from-income
Educational guidance only — not legal or financial advice. Your state Medicaid office determines actual eligibility.
Key Rules at a Glance
- Nearly any income from any source is counted, including cash from family/friends, employment wages, alimony, pension payments, SSDI, SSI, IRA withdrawals, and stock dividends.
- Nationally, Holocaust restitution payments are not counted as income.
- In KY, the VA Aid & Attendance (A&A) Pension does not count. Exception: A&A is countable for veterans in state-operated VA nursing facilities that accept Medicaid.
- When only one spouse applies for Nursing Home Medicaid or a Medicaid Waiver, only the applicant's income is counted.
- The MMMNA in KY is $2,644 (eff. 7/1/25 – 6/30/26). If a non-applicant's income is under this amount, income can be transferred from the applicant spouse.
- A non-applicant spouse can increase their allowance if housing/utility costs exceed the 'shelter standard' of $793 / month (eff. 7/1/25 – 6/30/26). The Maximum MMMNA is $4,066.50.
- For Regular Medicaid, both spouses' income is counted. There is no MMMNA for a non-applicant spouse.
Kentucky has a very low Regular Medicaid income limit ($235 / month individual), but SSI recipients are automatically eligible with income up to $994 / month.
- Countable assets include cash, stocks, bonds, investments, cryptocurrency, bank accounts (money market, savings, checking), pension funds, and real estate in which one does not reside.
- In Kentucky, IRA's / 401K's are exempt.
- Non-countable (exempt) assets include personal belongings, household furnishings, an automobile, and generally one's primary home.
- Kentucky has a $4,000 asset limit for married couples (both applying), higher than the $3,000 in most states.
- All assets of a married couple are considered jointly owned regardless of the Medicaid program.
- The CSRA allows the non-applicant spouse to retain 50% of the couple's assets, up to $162,660 (2026). If the non-applicant's portion is under $32,532, up to $32,532 can be retained.
- The primary home is automatically exempt if the applicant's spouse, child under 21, or permanently blind or disabled child (of any age) lives in it.
- If this is not the case, there is a home equity interest limit of $730,000 (in 2026).
- Home equity is the value of the home after subtracting outstanding debt. Equity interest is the amount of equity owned by the applicant.
- If neither the applicant nor qualifying family live in the home, the applicant must have Intent to Return.
- There is no home equity limit for Regular Medicaid.
- The home is NOT exempt from Medicaid's Estate Recovery Program. After a beneficiary's death, Kentucky's Medicaid agency attempts reimbursement of care costs through the deceased's estate.
- Kentucky has a 60-month (5-year) Look-Back Period for Nursing Home Medicaid and Medicaid Waiver applications that immediately precedes the application date.
- During the look-back, Medicaid checks all asset transfers to ensure none were gifted or sold under fair market value.
- Violations result in a Penalty Period of Medicaid ineligibility, even if unintentional.
- There is no Look-Back Period for Regular Medicaid.
- The U.S. Federal Gift Tax Rule ($19,000 per recipient in 2026) does not extend to Medicaid eligibility — gifting under this rule still violates the Look-Back Period.
- MMMNA: $2,644 (eff. 7/1/25 – 6/30/26) · CSRA: $162,660 · CSRA Min: $32,532
- When only one spouse applies for Nursing Home Medicaid or a Medicaid Waiver, only the applicant's income is counted.
- The MMMNA in Kentucky is $2,644 (eff. 7/1/25 – 6/30/26). If the non-applicant's income is under this amount, income can be transferred from the applicant spouse.
- A non-applicant spouse can increase their allowance if housing/utility costs exceed the 'shelter standard' of $793 / month. The Maximum MMMNA is $4,066.50.
- The CSRA allows the non-applicant spouse to retain 50% of the couple's assets, up to $162,660. The minimum CSRA is $32,532.
- For Regular Medicaid, both spouses' income is counted and there is no MMMNA or CSRA.
- Medically Needy Pathway — Kentucky has a Spend Down Program for Regular Medicaid applicants over the income limit. The MNIL is $235 / month for individuals and $291 / month for couples. The spend-down is calculated for a 3-month period. Once met, one receives Medicaid benefits for the remainder of the period. The medically needy asset limit is $2,000 for individuals and $4,000 for couples.
- Qualified Income Trusts (Miller Trusts) — QITs allow persons over the income limit to become income-eligible for Nursing Home Medicaid or a Medicaid Waiver. Income deposited into this irrevocable trust does not count for Medicaid eligibility. A trustee manages the funds, which can only be used for specific purposes such as paying medical expenses.
- Asset Spend-Down — Spend excess assets on non-countable items such as home modifications (wheelchair ramps, stair lifts, walk-in showers), prepaying funeral/burial expenses, and paying off debt. Keep documentation as proof the Look-Back Rule was not violated.
- Medicaid Planning — Work with a Medicaid Planning Professional to employ strategies to become eligible and protect your home from Medicaid's Estate Recovery Program.
Kentucky Medicaid Programs
Home and Community Based (HCB) Waiver
Replaced the Kentucky Waiver for the Aged. Benefits may include personal care assistance, adult day health care, respite care, and meal delivery. Program participants can hire the caregiver of their choosing, including family members such as adult children and spouses.
Program of All-Inclusive Care for the Elderly (PACE)
Through PACE, the benefits of Medicare and Medicaid, including long-term care, are available via one program. Additional benefits, such as dental and eye care, may be available.
Money Follows the Person (Kentucky Transitions)
A federal program that helps institutionalized Medicaid-eligible persons transition back home or into the community. Known in Kentucky as Kentucky Transitions.
How to Apply
- Apply online at kynect benefits
- Apply in person at a local Department for Community Based Services (DCBS) office
- Call DCBS at 1-855-306-8959 for questions or application assistance
It is vital that applicants are confident they meet all eligibility criteria before submitting a Medicaid application. For seniors who don't meet the requirements, Medicaid Planning is recommended.
More Kentucky Long-Term Care Resources
Take the Next Step for Kentucky Medicaid
Find out if you qualify or see how Medicaid fits into your overall long-term care plan.
Sources & references
Verified May 2026- Centers for Medicare & Medicaid Services — Long-Term Services & Supports
- Administration for Community Living — State Medicaid Agencies
- Centers for Medicare & Medicaid Services — Medicaid Eligibility
- American Council on Aging — About Medicaid Planning Assistance
- Kentucky Cabinet for Health and Family Services, Department for Medicaid Services — Kentucky Medicaid — Official site