Kentucky Medicaid Long-Term Care Eligibility in 2025
Kentucky Long-Term Care (KY Medicaid)
Kentucky Medicaid, administered by the Kentucky Cabinet for Health and Family Services’ Department for Medicaid Services, provides healthcare benefits for low-income individuals of all ages. Medicaid long-term care benefits for seniors aged 65 and older cover nursing home care and non-medical services to help seniors remain in their homes. There are three main categories of Medicaid long-term care programs for which Kentucky seniors may qualify:
1) **Institutional / Nursing Home Medicaid** – An entitlement program providing benefits exclusively in nursing homes. All eligible individuals receive assistance.
2) **Medicaid Waivers / Home and Community Based Services (HCBS)** – Not an entitlement; services are provided at home, adult day care, or similar settings to delay or prevent nursing home admissions. Waiting lists may apply.
3) **Regular Medicaid / Aged, Blind, and Disabled (ABD)** – An entitlement program offering various long-term care services, such as personal care assistance or adult day care, to all eligible individuals.
Eligibility for 2025:
Eligibility for Medicaid long-term care programs involves meeting financial and medical criteria. Requirements vary by program, marital status, and change annually.
**Simplified Eligibility Criteria for Single Nursing Home Applicant:**
1. Income Limit: $2,901 / month
2. Asset Limit: $2,000
3. Medical Need: Nursing Home Level of Care
2025 Kentucky Medicaid Long-Term Care Eligibility for Seniors
| Type of Medicaid | Single | Married (both spouses applying) | Married (one spouse applying) |
|---|---|---|---|
| Institutional / Nursing Home Medicaid | $2,901 / month* | $2,901 / month per spouse* | $2,901 / month for applicant* |
| Medicaid Waivers / HCBS | $2,901 / month† | $2,901 / month per spouse† | $2,901 / month for applicant† |
| Regular Medicaid / ABD | $235 / month‡ | $291 / month‡ | $291 / month‡ |
*All of a beneficiary’s monthly income, except for a $60 personal needs allowance and certain other deductions, must go toward nursing home costs.
†Income limits may vary based on living settings.
‡SSI recipients are automatically eligible, with income limits of $967 (individual) and $1,450 (couple) under the SSI pathway.
Income and Asset Exceptions
**Countable vs. Non-Countable Income:** Most income sources, including wages, pensions, and Social Security benefits, are counted toward Medicaid’s income limits. Exceptions include Holocaust restitution payments and VA Aid & Attendance pensions (except in state-operated VA facilities).
**Spousal Rules:** Non-applicant spouses may retain income up to $2,555/month (Minimum Monthly Maintenance Needs Allowance, MMMNA) and additional allowances if housing costs exceed $766.50/month. The maximum spousal income allowance is $3,948/month in 2025.
Asset Rules
**Countable vs. Non-Countable Assets:** Countable assets include bank accounts, stocks, and non-residential real estate. Exempt assets include personal belongings, one automobile, household furnishings, and the primary home (up to $730,000 in equity).
**Community Spouse Resource Allowance (CSRA):** Non-applicant spouses can retain 50% of the couple’s assets, up to $157,920, or $31,584 if total assets are below this threshold.
Medicaid Planning and Spend Down
Applicants exceeding income or asset limits may qualify through:
1. **Spend Down Program:** Reduces income eligibility by allowing medical expenses to be deducted. The 2025 medically needy income limit is $235/month (individual) and $291/month (couple).
2. **Qualified Income Trusts (QIT):** Excess income can be deposited into a trust, making it non-countable.
3. **Asset Spend Down:** Allows conversion of countable assets into exempt ones by paying debts, prepaying funeral costs, or making home modifications.
Specific Kentucky Medicaid Programs
1. **Home and Community Based (HCB) Waiver:** Includes personal care, respite care, and meal delivery, with the option to hire family caregivers.
2. **Program of All-Inclusive Care for the Elderly (PACE):** Combines Medicaid and Medicare benefits, with additional services like dental and vision care.
3. **Money Follows the Person:** Helps institutionalized persons transition back home or into the community.
How to Apply for Kentucky Medicaid
Applications can be submitted online at kynect benefits, in person at local Department for Community Based Services offices, or by calling 1-855-306-8959. Proper planning ensures eligibility before applying, as the process can be complex.