Kentucky HCBS Medicaid Waiver Program

Waiver Description

Kentucky’s Home and Community Based Services Medicaid waiver provides care and support services to the elderly in their homes, allowing them to avoid institutionalization in a nursing home should they choose to do so. This waiver achieves the dual objectives of allowing individuals to age in place and saving money for the state of Kentucky.

Caring for the elderly at home is considerably less expensive than doing so in a nursing home. This is largely because it leverages family members as primary caregivers. Of course, the added benefit is individuals typically prefer to remain living in their homes. Please note that program participants are also able to live in adult foster care homes. 

There is a Consumer Directed Option (CDO) for this waiver that allows participants to choose their own care providers for the non-medical care services they receive under this waiver. Family members and friends can be hired as paid caregivers, including spouses and adult children.

In Kentucky, it is also referred to as Participant-Directed Services (PDS). Not all services provided under this waiver are appropriate for consumer control. But those that require little to no medical skills training can be self-directed. Chief among these are personal care, homemaker services, unskilled respite care, and minor home adaptations. The one exception is that program participants who live in adult foster care homes are not able to self-direct their care.

Eligibility Guidelines

General Requirements

The Home and Community Based Waiver for the Aged considers both general requirements and financial requirements.

Residence – an applicant must be a resident of the state of Kentucky.

Age – participants must be at least 65 years of age. This waiver is also open to those designated as disabled by Social Security who are 64 years of age and under. 

Functional Ability – participants must require nursing home level care and be willing and able to receive that care in their home or community. 

Financial Requirements

Income Limits
In 2023, an unmarried applicant is allowed income up to 300% of the Federal Benefit Rate (FBR). In dollar terms, an individual cannot have more than $2,742 a month in income. Married applicants, when both spouses are applying, are each allowed up to $2,742 a month in income, as income is considered separately.

If the applicant is married and his or her spouse is not also applying for Medicaid services, the applicant is able to transfer some of his or her income to the non-applicant spouse (also referred to as the community spouse) to prevent him or her from becoming impoverished. As of 2023, the applicant can transfer a maximum of $3,715.50 a month to the non-applicant spouse. This is called the Maximum Monthly Maintenance Needs Allowance (MMMNA).

Asset Limits
For a single applicant, in 2023, countable resources must be valued at less than $2,000. Married couples that apply together can have up to $4,000 in assets. Items that are considered exempt from the applicant’s countable assets include the home in which the applicant lives (the home equity must be valued at or under $688,000), a primary vehicle, and certain other personal items.

For applicants who are married, all assets are considered jointly owned. Learn more here. If only one spouse is applying for Medicaid, the non-applicant spouse may be allowed up to $148,620 in joint assets. In Medicaid-speak, this is called the Community Spouse Resource Allowance (CSRA). Please note that the applicant spouse is still able to keep $2,000 in countable assets.

Over the Financial Limits?

Individuals who exceed the financial limits may still qualify for this waiver (and Kentucky Medicaid). A variety of options exist that can help individuals or families lower their monthly income or their countable assets so that they meet the program’s requirements. One can do this by working with a Medicaid Planning professional. This approach is only advised when consulting with a professional.