Medicaid for nursing home and home care in Kentucky

Who qualifies

You must be 65 or older, blind or disabled, and need the level of care a nursing facility gives. Then DCBS checks your income and assets.

If your income is over the limit

You can still qualify by putting income into a Qualifying Income Trust. Income paid into the trust is used to work out your share of the nursing home cost. Ask DCBS for the trust rules before you set one up.

What counts and what does not

• Income: Social Security, pensions and other money you get each month count. SSI and State Supplementation payments are not counted toward what you pay the nursing home. For a veteran or a veteran's spouse, $90 a month of VA pension is not counted.
• Assets that count: Bank accounts, cash, stocks and other property you could turn into cash.
• Assets that do not count: Household goods and personal things, one car used for work or daily needs, burial spaces, and the first $1,500 of a burial reserve or life insurance policy. IRAs, Keoghs and other tax-deferred accounts do not count until you take money out.
• Your home: Your home does not count for the first six months you are in a nursing home. After that it still does not count if your spouse or a dependent family member lives there. Otherwise it can start to count, so ask DCBS what this means for you.
• Gifts and transfers: Gifts or sales for less than fair value can cause a penalty period with no Medicaid payment for nursing home care. You must show the transfer was for a reason other than qualifying for Medicaid.

What a spouse at home can keep

If you are married and your spouse stays at home, Kentucky protects some assets and income for them.

• Assets: Your spouse keeps a share of what you both own. The most they can keep in 2026 is $162,660. There is also a minimum, which rises each year. DCBS works out your amount in a resource assessment. You can ask your county DCBS office for one before you apply for Medicaid.
• Income: Your spouse can get part of your income if their own income is low. It is a standard amount plus extra for high housing costs, up to $4,066.50 a month in 2026.
• Family members: A family allowance can also be given for a dependent family member.

If you think the amounts are too low, for example because of serious money problems, either spouse can ask for a hearing.

What you pay toward your care

After you qualify, DCBS figures your monthly share (patient liability) in this order:

1. You keep $60 a month for personal needs, plus required tax withholdings.
2. Money goes to your spouse at home, if allowed.
3. Money goes to a dependent family member, if allowed.
4. Medical costs Medicaid does not pay, such as Medicare and health insurance premiums, are taken off.

The rest goes to the nursing home. In the month you go into or leave a nursing home, home costs can be taken into account.

Help at home

Home and Community Based (HCB) waiver

This waiver helps you stay at home instead of a nursing home. Services include adult day health care, attendant care, home changes, home-delivered meals and respite for caregivers. You can hire your own workers.

• You must be 65 or older or have a physical disability, need nursing-home-level care, and qualify for Medicaid. HCB has its own financial rules, explained in the Medicaid Waiver Services Fact Sheet from DCBS.
• There is a waiting list. Your place is based on the date the Department for Aging and Independent Living (DAIL) gets your completed application. Apply early.
• Questions: 877-315-0589.

PACE

PACE gives all your medical and long-term care through one team if you are 55 or older, need nursing-home-level care, live in a PACE service area, and can live safely in the community when you join. It is offered in more than 50 counties in several parts of Kentucky. To join, contact the PACE organization for your area. Have your Social Security card and medical information ready. Call DAIL at 888-804-0884 to find out if it serves your county.

How to apply

1. Apply for Medicaid. Apply online at kynect.ky.gov, call DCBS at 855-306-8959, or go to your local DCBS office.
2. Say you need long-term care. Tell DCBS you are applying for nursing facility care or the HCB waiver. If you are married, ask for a resource assessment; each spouse gets a copy.
3. For the HCB waiver, after you apply for Medicaid, apply for HCB through kynect, an Aging and Disability Resource Center, or a Community Mental Health Center.
4. Bring proof to your interview: citizenship, identity, Social Security number, income, resources such as bank statements, health insurance cards and premiums, and medical bills.

After you apply

• Report changes in income, assets or where you live to DCBS.
• Appeal. If you are denied or disagree with your share of cost or the spouse amounts, you can ask for an administrative hearing. Follow the deadline on your notice.

Things people miss

• Over-income does not always mean no. A Qualifying Income Trust can help.
• The HCB waiver list goes by date. Do not wait for a crisis to apply.
• Estate recovery. After you die, Kentucky can claim money from your estate for long-term care Medicaid paid after age 55. It cannot do this while you leave a spouse, a child under 21, or a blind or disabled child. Heirs can ask for a hardship waiver.

Free help

• Aging and Disability Resource Center: 1-877-925-0037.
• SHIP (free Medicare counseling): 1-877-293-7447, option 2.
• DCBS: 855-306-8959.

For what Medicare does and does not pay, read paying for a nursing home and Medicare Part A. For other programs, see all benefits in Kentucky.

Phone numbers: Free help lines for Kentucky agencies

Check what you may qualify for