Kentucky
What Is Kentucky Medicaid Long-Term Care?
Kentucky Medicaid is a jointly funded state and federal program providing healthcare to low-income individuals, including those 65 and older. This section focuses on long-term care services available to elderly residents, both in facilities and in home settings.
What Types of Long-Term Care Programs Are Available Through Kentucky Medicaid?
What Is Institutional or Nursing Home Medicaid?
This program guarantees benefits to all who qualify. Services are provided exclusively in nursing home settings.
What Are Medicaid Waivers / Home and Community Based Services (HCBS)?
These are not entitlements; enrollment is limited and waitlists may apply. They offer services in home and adult day care settings to delay institutionalization.
What Is Regular Medicaid for the Aged, Blind, and Disabled?
This program also guarantees benefits to all eligible individuals, offering long-term supports such as personal assistance and adult day care.
What Are the Income and Asset Limits for Eligibility?
What Is the Basic Eligibility for a Single Applicant in 2025?
To qualify, a single applicant must:
- Earn less than $2,901 per month
- Own less than $2,000 in countable assets
- Require a nursing home level of care
What Are the 2025 Income and Asset Limits for Each Medicaid Program?
| Type of Medicaid | Single | Married (both applying) | Married (one applying) |
|---|---|---|---|
| Institutional / Nursing Home Medicaid | Income: $2,901/mo Assets: $2,000 Level of Care: Nursing Home | Income: $2,901/mo per spouse Assets: $4,000 Level of Care: Nursing Home | Income: $2,901/mo for applicant Assets: $2,000 for applicant + $157,920 for non-applicant Level of Care: Nursing Home |
| Medicaid Waivers / HCBS | Income: $2,901/mo† Assets: $2,000 Level of Care: Nursing Home | Income: $2,901/mo per spouse† Assets: $4,000 Level of Care: Nursing Home | Income: $2,901/mo for applicant† Assets: $2,000 for applicant + $157,920 for non-applicant Level of Care: Nursing Home |
| Regular Medicaid / Aged, Blind & Disabled | Income: $235/mo‡ Assets: $2,000 Level of Care: Help with ADLs | Income: $291/mo‡ Assets: $4,000 Level of Care: Help with ADLs | Income: $291/mo‡ Assets: $4,000 Level of Care: Help with ADLs |
Notes:
- * All of a beneficiary’s income (except for a $60/month Personal Needs Allowance, Medicare premiums, and possibly a spousal Needs Allowance) must go toward nursing home costs—this is known as the Patient Liability.
- † Based on one’s living arrangement, an HCBS participant may not retain income up to the full limit.
- ‡ Though the stated income limit is very low, SSI recipients are automatically eligible for Regular Medicaid. SSI income thresholds in 2025 are $967/month for an individual and $1,450/month for a couple. The asset limits are $2,000 (individual) and $3,000 (couple).
How Is Income Evaluated for Medicaid in Kentucky?
What Income Is Counted?
Most income types—wages, Social Security, pensions, etc.—are countable. VA Aid & Attendance and Holocaust restitution payments are not.
What Happens to a Couple’s Income?
If only one spouse applies, only their income is counted. The non-applicant may receive a Monthly Maintenance Needs Allowance (MMMNA) up to $2,644/month. The maximum allowed is $3,948/month if shelter expenses are high.
How Is Income Counted Under Regular Medicaid?
Both spouses’ income is considered, and there is no spousal allowance.
What Assets Count Toward the Limit?
What Are Countable and Exempt Assets?
Countable: bank accounts, investments, extra properties.
Exempt: one vehicle, household goods, primary residence, and retirement accounts like IRAs/401Ks in Kentucky.
How Are a Married Couple’s Assets Treated?
Assets are combined, but the non-applicant may keep half up to $157,920 (Community Spouse Resource Allowance) or all up to $31,584 if below that threshold.
What Is the Medicaid Look-Back Period?
Kentucky enforces a 5-year look-back to detect asset transfers under market value. Violations may lead to a period of ineligibility.
What Are the Rules for Medicaid Home Exemptions?
When Is a Home Considered Exempt?
A home is exempt if the applicant or spouse lives in it. If not, the applicant must show intent to return. Equity must not exceed $730,000 in 2025.
What Is Medicaid Estate Recovery?
After death, the state may recover costs from the deceased’s estate, including the home, unless planning prevents it.
What Medical or Functional Needs Must Be Met?
What Level of Care Is Required?
Nursing Home Medicaid and HCBS require a Nursing Home Level of Care. Regular Medicaid requires help with ADLs, not necessarily NHLOC.
What If a Person Exceeds Income or Asset Limits?
What Is the Medically Needy Pathway?
This allows individuals with income over limits to spend down on medical expenses. The 2025 MNIL is $235 (individual) and $291 (couple). The spend-down is calculated over a 3-month period.
How Do Qualified Income Trusts (QITs) Work?
Also called Miller Trusts, they allow excess income to be placed in an irrevocable trust for specific uses, enabling Medicaid eligibility.
What Is an Asset Spend Down?
Applicants may convert countable to exempt assets (home improvements, funeral prepayments, debt payoff). Gifting is not allowed.
What Is Medicaid Planning?
Seniors over the limits can work with Medicaid Planners to legally become eligible and protect their estate from recovery.
What Kentucky Medicaid Programs Help Seniors?
HCB Waiver
This waiver includes services such as adult day health care, meal delivery, and personal assistance. Family members, including spouses, can be paid caregivers.
PACE
PACE combines Medicaid and Medicare into one program and may include additional services like dental or vision care.
Money Follows the Person Program
Also called Kentucky Transitions, it helps Medicaid-eligible individuals transition from institutional care back to the community.
How Can Seniors Apply for Kentucky Medicaid?
Applications may be submitted online at kynect benefits or in person at a Department for Community Based Services (DCBS) office. For help, call 1-855-306-8959.
Why Should Seniors Consider Medicaid Planning Before Applying?
The process is complex. Planning ahead ensures eligibility and protects assets. Consulting a professional is recommended.
