Kentucky-specific Medicaid spend-down rules
Kentucky administers Medicaid through the Cabinet for Health and Family Services (CHFS), with financial eligibility handled by the Department for Community Based Services (DCBS). Nursing facility and Michelle P waiver applications in Jefferson, Fayette, and Warren counties follow the same long-term care resource test.
Nursing facility Medicaid covers skilled and intermediate care after a level-of-care review confirms the need. Michelle P Home and Community Based Services can serve some adults in their own homes, but asset tests still follow the same $2,000 resource standard for the applicant.
Kentucky does not offer a medically needy income spend-down for nursing facility cases the way Pennsylvania does. Families above the $2,982 monthly special income limit must assign excess funds to a Qualifying Income Trust, also called a Miller Trust, established in Kentucky and approved by DCBS.
Community spouses may keep the greater of the CSRA calculation or certain income protections under spousal impoverishment rules. Kentucky uses the federal home equity cap of $713,000 in 2026 unless a spouse or dependent child still lives in the house.
Burial spaces, one vehicle, and up to $1,500 in a designated burial fund can be excluded if titled correctly. Prepaid funeral contracts follow separate CHFS policy guidance under 907 KAR 20:035.
Look-back reviews cover asset transfers made within 60 months before application. Penalty length equals the uncompensated transfer amount divided by the average monthly nursing facility cost published by Kentucky DMS.
Rural applicants in Owensboro and Paducah follow the same resource test as families in Louisville. Michelle P slot availability varies by region, but the $2,000 asset cap does not.
Department for Medicaid Services staff may review clinical need for certain waiver paths, while DCBS determines financial eligibility. Keep both agency letters in your file when you appeal a denial.
Common mistake: Assuming Kentucky exempts a second home because a cousin lives there. Non-homestead real estate counts unless occupied by a spouse or dependent child under DCBS rules. Budget property taxes and sale costs before you rely on an appraisal.