How to Pay for In-Home Care
How to Pay for Home Care in Kentucky
Jump to a state to see its Medicaid programs, waivers, and other ways to help pay for in-home care.
This directory lists Kentucky-specific and federal payment sources that can pay for, reimburse, offset, or help plan for home care. Some are direct payment sources; others are indirect supports that reduce the amount of private home care a family must buy. Kentucky's strongest state-specific pathways include the Home and Community Based (HCB) Waiver with Participant Directed Services, the Kentucky Homecare Program, PCAP (a state-funded attendant subsidy), PACE in participating service areas, and the MPW/SCL/ABI waiver tracks for intellectual/developmental disabilities and brain injury (several currently have waiting lists), and VA benefits are broken out because they can be one of the strongest payment pathways for eligible Kentucky veterans and surviving spouses.
Updated August 2026
Reviewed by Valerie VanBooven, RN, BSN
Kentucky Medicaid / HCB
Home and Community Based (HCB) Waiver
YesHelps pay for: Medicaid HCBS alternative to nursing-facility care with attendant care, respite, meals, home adaptations and other approved supports.
Who qualifies: Age 65+ and/or physical disability; Medicaid financial eligibility and nursing-facility level of care. HCB currently has a waiting list.
How to start: Apply for Medicaid/waiver services and ask for HCB screening.
Good to know: Family caregiver payment: Yes, through approved PDS arrangements in some cases
HCB Attendant Care
YesHelps pay for: Hands-on and supportive assistance with approved daily living needs in the home.
Who qualifies: HCB enrollment, assessed need and service-plan authorization.
How to start: Ask the case manager to assess attendant-care needs.
Good to know: Family caregiver payment: Potentially, if delivered through PDS and relationship rules are met
HCB Respite
Yes - respiteHelps pay for: Specialized or non-specialized respite can provide temporary relief for an unpaid caregiver.
Who qualifies: HCB enrollment, assessed need and authorization.
How to start: Ask the case manager to include respite in the person-centered plan.
Good to know: Family caregiver payment: No direct family wage
HCB Home-Delivered Meals
Offsets care costHelps pay for: Meal delivery can reduce caregiver meal-preparation time and support community living.
Who qualifies: HCB enrollment and service-plan authorization.
How to start: Ask the case manager about home-delivered meals.
Good to know: Family caregiver payment: No
HCB Environmental / Minor Home Adaptation
Offsets care costHelps pay for: Approved home modifications can improve accessibility and reduce transfer or supervision burden.
Who qualifies: HCB enrollment, assessed need and prior approval; modifications must meet program criteria.
How to start: Obtain approval before purchasing or starting work.
Good to know: Family caregiver payment: No
Kentucky Medicaid / Self-Direction
HCB Participant-Directed Services (PDS)
YesHelps pay for: Lets eligible HCB participants recruit, hire, schedule and supervise workers with financial-management support.
Who qualifies: HCB enrollment and PDS election; worker and representative rules apply.
How to start: Tell the case manager you want PDS and complete the PDS enrollment process.
Good to know: Family caregiver payment: Yes - friends, neighbors and certain family members may be hired
HCB Paid Family / Legally Responsible PDS Worker
YesHelps pay for: Kentucky can approve certain immediate family members, guardians or legally responsible individuals to provide PDS when requirements are met.
Who qualifies: Written approval is required; current HCB PDS regulation limits a provider to 40 hours per week. A participant representative cannot also be the paid worker.
How to start: Request the required approval before scheduling a family/LRI worker.
Good to know: Family caregiver payment: Yes, with written department approval
MPW Participant-Directed Services
YesHelps pay for: Eligible MPW participants can self-direct non-medical/non-residential services and hire/manage workers.
Who qualifies: MPW enrollment, PDS election and worker/representative rules.
How to start: Request PDS when developing the person-centered plan.
Good to know: Family caregiver payment: Yes - certain family members may qualify
MPW Paid Family / LRI PDS Worker
YesHelps pay for: Certain immediate family members or legally responsible individuals may be approved as paid PDS workers under Kentucky rules.
Who qualifies: Department approval/attestation and service-specific limits apply; participant representative cannot also be paid worker.
How to start: Get approval before relying on family-member wages.
Good to know: Family caregiver payment: Yes, when program requirements and approvals are met
SCL Participant-Directed Services
YesHelps pay for: SCL participants can self-direct eligible services such as personal assistance, respite, community access, day training and supported employment.
Who qualifies: SCL enrollment, PDS election, approved services and worker rules.
How to start: Request PDS during person-centered planning.
Good to know: Family caregiver payment: Yes - friends and certain family members may qualify
SCL Paid Family / LRI PDS Worker
YesHelps pay for: Kentucky permits certain family, guardian or legally responsible workers under PDS when regulatory requirements and approvals are satisfied.
Who qualifies: Current rules limit immediate family/LRI reimbursement to no more than 40 PDS hours/week; representative and provider roles cannot be combined.
How to start: Complete required approval/attestation before scheduling paid family care.
Good to know: Family caregiver payment: Yes, with restrictions
ABI Acute Participant-Directed Services
YesHelps pay for: Eligible ABI participants can self-direct selected non-medical/non-residential services.
Who qualifies: ABI enrollment, PDS election and worker/representative requirements.
How to start: Ask for PDS during service planning.
Good to know: Family caregiver payment: Yes - certain family members may qualify
ABI-LTC Participant-Directed Services
YesHelps pay for: Eligible ABI-LTC participants may self-direct selected services and manage their own workers.
Who qualifies: ABI-LTC enrollment, PDS election and applicable worker rules.
How to start: Ask for PDS during service planning.
Good to know: Family caregiver payment: Yes - certain family members may qualify
Kentucky State / Disability
Personal Care Attendant Program (PCAP)
YesHelps pay for: State subsidy for participant-hired attendants who assist with personal care, housekeeping, shopping, travel, meals and other approved needs.
Who qualifies: Age 18+ with severe physical disability/functional loss of 2+ limbs, need 14-40 attendant hours/week, and ability to direct attendants and handle employer responsibilities.
How to start: Contact DAIL/ADRC for PCAP screening.
Good to know: Family caregiver payment: Participant hires/manages attendant; verify relationship rules locally
Hart-Supported Living Program
Can pay/support home careHelps pay for: Flexible state grant funding for individualized supports that help a Kentuckian with a disability live in a home/community setting and avoid institutionalization.
Who qualifies: Kentucky resident with a disability meeting program criteria; funding is individualized and limited.
How to start: Apply through the regional Hart-Supported Living process.
Good to know: Family caregiver payment: Participant directs supports; family-payment details depend on approved plan
Kentucky State / Aging
Kentucky Homecare Program
YesHelps pay for: State aging program that can provide assessment/case management, personal care/home management, meals, chore, home repair, respite and related supports.
Who qualifies: Generally age 60+ and unable to perform 2 ADLs or 3 IADLs, with risk of institutionalization or ability to return home with services. Local availability/waitlists vary.
How to start: Contact the ADRC or local Area Agency on Aging.
Good to know: Family caregiver payment: No standard family wage; respite supports unpaid caregivers
Homecare Personal Care + Home Management
YesHelps pay for: In-home help with personal care, household tasks and daily routines can reduce private-pay aide hours.
Who qualifies: Homecare enrollment, local assessment and service availability.
How to start: Ask the local AAA about personal care and home management.
Good to know: Family caregiver payment: No standard family wage
Homecare Respite, Meals, Chore + Home Repair
Offsets care costHelps pay for: Respite and practical home supports can reduce unpaid caregiver burden and out-of-pocket household care costs.
Who qualifies: Homecare eligibility and local service/funding availability.
How to start: Ask the local AAA which Homecare services are available.
Good to know: Family caregiver payment: No direct family wage
Caregiver Support
National Family Caregiver Support Program (Kentucky)
Yes - respite/offsetsHelps pay for: Information, counseling/support, training, respite and limited supplemental services for qualifying family caregivers.
Who qualifies: Primarily caregivers of adults 60+ or people with Alzheimer's/related disorders; other caregiver categories also qualify under federal rules.
How to start: Contact the local AAA/ADRC.
Good to know: Family caregiver payment: No direct wage
Aging Network
Area Agency on Aging / Older Americans Act Services
Yes / offsetsHelps pay for: Benefits counseling, case management, nutrition, family caregiver services, personal care, respite, home management and transportation can reduce private spending.
Who qualifies: Age/service-specific eligibility and local funding availability.
How to start: Use the ADRC to reach the local Area Agency on Aging.
Good to know: Family caregiver payment: No direct wage
Integrated Care
PACE - Program of All-Inclusive Care for the Elderly
YesHelps pay for: PACE bundles Medicare/Medicaid-covered medical and long-term services, including in-home supports, for eligible adults in participating service areas.
Who qualifies: Age 55+, live in a PACE service area, meet nursing-facility level of care and be able to live safely in the community at enrollment.
How to start: Contact DAIL or a PACE organization serving the county.
Good to know: Family caregiver payment: No direct family wage
Transition Support
Kentucky Transitions
Yes / transition supportHelps pay for: Helps eligible Medicaid members move from nursing facilities/institutions to community living with housing coordination, personal supports and waiver connections.
Who qualifies: Generally in a nursing facility at least 60 days, Medicaid eligibility, and ability to live safely in community with supports.
How to start: Call Kentucky Transitions for screening.
Good to know: Family caregiver payment: No direct wage
Kentucky State / Brain Injury
Traumatic Brain Injury Trust Fund
Can pay/support home careHelps pay for: Flexible state funding when no other viable payer exists for supports such as case management, companion, respite, residential/day and rehabilitation services.
Who qualifies: Qualifying brain injury; no family income cap. Current limits: $15,000 per person/year and $60,000 lifetime, excluding case management from caps.
How to start: Contact the TBI Trust Fund program.
Good to know: Family caregiver payment: No standard family wage
TBI Trust Fund Companion + Respite
Yes / respiteHelps pay for: Trust-fund dollars may support companion and respite services that directly reduce family caregiving burden.
Who qualifies: Qualifying brain injury, service need and available trust-fund resources.
How to start: Ask TBI Trust Fund staff about companion/respite funding.
Good to know: Family caregiver payment: No standard family wage
Kentucky Medicaid
Medicaid Home Health
Yes - skilled/authorized aideHelps pay for: Medically necessary intermittent skilled nursing, therapy, medical social services, supplies and home-health aide services under a physician-directed plan of care.
Who qualifies: Medicaid coverage, medical necessity, physician order/plan and qualified provider.
How to start: Ask the treating clinician and Medicaid provider about home-health authorization.
Good to know: Family caregiver payment: No
Medicaid Private Duty Nursing (PDN)
Yes - skilled nursingHelps pay for: Continuous skilled nursing beyond ordinary home-health levels for medically complex members in home/normal-life settings.
Who qualifies: Medical necessity, physician prescription/management and Medicaid authorization.
How to start: Ask the treating clinician and Medicaid about PDN criteria.
Good to know: Family caregiver payment: No
Non-Emergency Medical Transportation (NEMT)
Offsets care costHelps pay for: Transportation to covered Medicaid services can reduce family driving and transportation spending.
Who qualifies: Medicaid member with no suitable free transportation; trip must meet program requirements.
How to start: Use the regional Human Service Transportation Delivery broker.
Good to know: Family caregiver payment: No
Medicaid Travel Reimbursement
Offsets care costHelps pay for: For qualifying long-distance care, Medicaid may reimburse approved travel and potentially lodging/meals when program criteria and prior authorization are met.
Who qualifies: Generally scheduled Medicaid-covered care at least 90 miles away; prior authorization rules apply.
How to start: Request authorization before travel.
Good to know: Family caregiver payment: No
Kentucky Medicaid / Insurance
KI-HIPP
Offsets health-care costHelps pay for: Kentucky may help pay eligible employer-sponsored health-insurance premiums for Medicaid members/families when cost-effective.
Who qualifies: Medicaid eligibility plus access to qualifying employer-sponsored insurance; program is voluntary.
How to start: Contact KI-HIPP for screening.
Good to know: Family caregiver payment: No
Kentucky Medicaid / Work Incentive
Medicaid Works
Enables Medicaid coverageHelps pay for: Medicaid buy-in pathway for working Kentuckians with disabilities, helping preserve Medicaid coverage while employed.
Who qualifies: Age 16-64, working, disability criteria and income/resource rules; premiums may apply. Verify current annual thresholds.
How to start: Apply through DCBS/Kynect and identify Medicaid Works.
Good to know: Family caregiver payment: No direct wage
Kentucky Medicaid / IDD
Michelle P. Waiver (MPW)
YesHelps pay for: HCBS for eligible people with intellectual/developmental disabilities, including personal care, respite, day training, behavior supports and home adaptations.
Who qualifies: IDD eligibility, Medicaid financial rules and waiver level of care. MPW currently has a waiting list.
How to start: Apply for MPW and establish waiting-list status.
Good to know: Family caregiver payment: Yes through PDS in qualifying arrangements
MPW Personal Care + Respite
YesHelps pay for: Authorized personal care and respite can replace or reduce private-pay assistance and give unpaid caregivers relief.
Who qualifies: MPW enrollment, assessed need and service-plan authorization.
How to start: Ask the case manager about personal care/respite.
Good to know: Family caregiver payment: Potentially through PDS
Supports for Community Living (SCL) Waiver
YesHelps pay for: Broad HCBS for eligible people with IDD, including personal assistance, respite, residential supports, adaptations, day/community and employment supports.
Who qualifies: IDD eligibility, Medicaid rules and waiver level of care. SCL currently has a waiting list based on category of need.
How to start: Apply and establish SCL waiting-list/category status.
Good to know: Family caregiver payment: Yes through PDS in qualifying arrangements
SCL Personal Assistance
YesHelps pay for: Hands-on and community support for daily activities can replace private-pay aide hours.
Who qualifies: SCL enrollment, assessed need and authorization.
How to start: Ask the case manager to assess personal-assistance needs.
Good to know: Family caregiver payment: Potentially through PDS
SCL Shared Living + Respite
YesHelps pay for: Shared-living and respite arrangements can provide ongoing support or temporary caregiver relief outside an institutional setting.
Who qualifies: SCL enrollment and approved service plan; provider/setting requirements apply.
How to start: Discuss shared living and respite with the SCL case manager.
Good to know: Family caregiver payment: Shared-living relationship/rate rules differ from ordinary PDS wages
SCL Environmental + Vehicle Adaptations
Offsets care costHelps pay for: Accessibility modifications can reduce transfer, mobility and transportation barriers that drive paid-care costs.
Who qualifies: SCL enrollment, assessed need and prior authorization.
How to start: Request approval before purchase or construction.
Good to know: Family caregiver payment: No
Kentucky Medicaid / Brain Injury
ABI Acute Waiver
YesHelps pay for: Intensive rehabilitation-focused HCBS after acquired brain injury, with services such as companion, respite, rehabilitation and home adaptations.
Who qualifies: Age 18+, qualifying acquired brain injury, nursing-facility level of care, Medicaid financial eligibility and expected rehabilitation benefit. Current access may involve a waiting list.
How to start: Apply through Kentucky Medicaid waiver intake.
Good to know: Family caregiver payment: Yes through PDS for eligible services
ABI Companion, Respite + Home Adaptation
Yes / offsetsHelps pay for: Companion/respite services and approved home modifications can reduce direct caregiver hours and household care costs during rehabilitation.
Who qualifies: ABI enrollment, assessed need and authorization.
How to start: Ask the case manager which ABI services match current goals.
Good to know: Family caregiver payment: Potentially through PDS for eligible services
ABI Long-Term Care (ABI-LTC) Waiver
YesHelps pay for: Maintenance-oriented HCBS for people with acquired brain injury after rehabilitation plateau, including community living supports, respite and adaptations.
Who qualifies: Age 18+, qualifying acquired brain injury, nursing-facility level of care and Medicaid financial eligibility. Current access may involve a waiting list.
How to start: Apply through Kentucky Medicaid waiver intake.
Good to know: Family caregiver payment: Yes through PDS for eligible services
ABI-LTC Community Living Supports + Respite
YesHelps pay for: Ongoing community-living and respite services can support safe home living after intensive rehabilitation ends.
Who qualifies: ABI-LTC enrollment and service-plan authorization.
How to start: Discuss community living supports/respite with the case manager.
Good to know: Family caregiver payment: Potentially through PDS for eligible services
Kentucky Medicaid / Complex Medical
Model II Waiver
Yes - skilled nursingHelps pay for: Home-based private-duty nursing for people dependent on a ventilator for at least 12 hours/day, with up to 16 hours/day based on assessed need and staffing.
Who qualifies: Ventilator dependence and waiver/Medicaid clinical eligibility; ongoing plan and level-of-care reassessments apply.
How to start: Ask the treating clinician/Medicaid about Model II screening.
Good to know: Family caregiver payment: No
Kentucky Medicaid / Children
CHILD Waiver
YesHelps pay for: New HCBS pathway for eligible children/youth under 21 who meet inpatient psychiatric or ICF/IID level of care and have exhausted other supports.
Who qualifies: Under 21, qualifying level of care, Medicaid financial eligibility and program criteria. Kentucky is currently accepting participant applications.
How to start: Apply through Kynect/DCBS, ADRC or a CMHC as appropriate.
Good to know: Family caregiver payment: No PDS; current services are agency-delivered
CHILD Community Living Supports + Respite
YesHelps pay for: Community living support and respite can reduce family caregiving burden and help an eligible child remain at home.
Who qualifies: CHILD enrollment, assessed need and certified Medicaid provider.
How to start: Ask the CHILD case manager about authorized CLS/respite.
Good to know: Family caregiver payment: No direct family wage under current agency-only delivery
CHILD Home Modifications + Clinical Supports
Offsets care costHelps pay for: Environmental/minor home modifications and clinical therapeutic supports can reduce safety barriers and out-of-pocket care costs.
Who qualifies: CHILD enrollment, assessed need and authorization.
How to start: Request approval before buying/modifying anything.
Good to know: Family caregiver payment: No
Kentucky Medicaid / Behavioral Health
1915(i) RISE Initiative
Yes / offsetsHelps pay for: Medicaid HCBS for eligible adults with serious mental illness and functional needs who are at risk of hospitalization, homelessness or institutionalization.
Who qualifies: Adult Medicaid beneficiary age 18+ meeting SMI and functional criteria. RISE can coordinate with 1915(c) waivers without duplicating services.
How to start: Contact RISE for eligibility screening and referral.
Good to know: Family caregiver payment: No standard family wage
RISE In-Home Independent Living Supports
YesHelps pay for: In-home skills/support services can help eligible adults maintain housing and daily functioning in the community.
Who qualifies: RISE eligibility and person-centered service plan.
How to start: Ask the RISE care team about in-home independent living supports.
Good to know: Family caregiver payment: No standard family wage
RISE Planned Respite for Caregivers
Yes - respiteHelps pay for: Planned respite can provide temporary relief to unpaid caregivers supporting an eligible RISE participant.
Who qualifies: RISE eligibility, assessed caregiver need and authorization.
How to start: Ask the RISE care team about planned respite.
Good to know: Family caregiver payment: No direct wage
RISE Assistive Technology + Housing / Transportation Supports
Offsets care costHelps pay for: Assistive technology, housing/tenancy support and non-medical transportation can reduce costs that otherwise increase caregiving burden.
Who qualifies: RISE eligibility and service-specific authorization.
How to start: Discuss these supports during RISE person-centered planning.
Good to know: Family caregiver payment: No
Medicare / Medicaid
Medicare Savings Programs (QMB / SLMB / QI)
Offsets health-care costHelps pay for: Kentucky Medicaid can help eligible Medicare beneficiaries pay Part B premiums and, for QMB, other Medicare cost sharing.
Who qualifies: Income/resource rules vary by program and are updated periodically.
How to start: Apply through Kentucky benefits channels; verify current thresholds.
Good to know: Family caregiver payment: No
Medicare
Medicare Part D Extra Help
Offsets care costHelps pay for: Federal subsidy can reduce prescription premiums, deductibles and copays, freeing household funds for care.
Who qualifies: Income/resource rules; some people qualify automatically through Medicaid/MSP/SSI.
How to start: Apply through Social Security or Medicare.
Good to know: Family caregiver payment: No
Medicare Home Health
Yes - limited/skilledHelps pay for: Part-time/intermittent skilled nursing, therapy and qualifying home-health aide care when Medicare home-health criteria are met.
Who qualifies: Homebound/medical-necessity and plan-of-care requirements; Medicare does not cover ongoing custodial care alone.
How to start: Ask the treating clinician about a Medicare-certified home-health referral.
Good to know: Family caregiver payment: No
Medicare Caregiver Training Services
Offsets care costHelps pay for: Medicare can cover caregiver training when needed to help carry out a beneficiary's treatment plan, reducing training costs and improving safe care at home.
Who qualifies: Must meet Medicare coverage and treatment-plan requirements.
How to start: Ask the clinician whether caregiver training is medically necessary and billable.
Good to know: Family caregiver payment: No direct wage
Medicare Hospice Benefit
Yes - hospice/respiteHelps pay for: For eligible terminally ill beneficiaries, hospice can cover interdisciplinary care, medications/equipment related to the terminal illness and short-term respite.
Who qualifies: Hospice eligibility/certification and election requirements.
How to start: Ask the clinician for a hospice evaluation when appropriate.
Good to know: Family caregiver payment: No
Medicare / Dementia
CMS GUIDE Dementia Care Model
Yes - respite/offsetsHelps pay for: Participating GUIDE organizations can provide dementia care coordination, caregiver support and respite benefits for eligible Medicare beneficiaries.
Who qualifies: Traditional Medicare beneficiary with qualifying dementia; access depends on participating GUIDE organization and model eligibility.
How to start: Use CMS/Medicare resources to identify a participating GUIDE provider.
Good to know: Family caregiver payment: No direct family wage
Medicare Advantage
Medicare Advantage Supplemental Benefits
Plan-specificHelps pay for: Some MA plans offer in-home support, meals, transportation, caregiver supports or other supplemental benefits beyond Original Medicare.
Who qualifies: Benefits vary by plan, county, year and eligibility criteria.
How to start: Review the Evidence of Coverage and call the plan before purchasing services.
Good to know: Family caregiver payment: No standard family wage
Food Assistance
SNAP
Offsets care costHelps pay for: Food benefits can reduce grocery spending and preserve household funds for caregiving and home-care expenses.
Who qualifies: Household income/resource and program rules; special rules may apply to older/disabled households.
How to start: Apply through Kentucky benefits channels.
Good to know: Family caregiver payment: No
Energy Assistance
LIHEAP
Offsets care costHelps pay for: Utility assistance can reduce heating/cooling burden and preserve income for home-care needs.
Who qualifies: Income and seasonal program rules apply; availability depends on funding/application period.
How to start: Apply through the local Community Action Agency.
Good to know: Family caregiver payment: No
Home Safety / Energy
Weatherization Assistance Program
Offsets care costHelps pay for: No-cost energy-efficiency and health/safety improvements can lower utility costs for income-eligible renters/homeowners.
Who qualifies: Generally income-based; Kentucky Housing Corporation/local providers administer the program.
How to start: Contact a local weatherization provider through KHC.
Good to know: Family caregiver payment: No
Property Tax Relief
Kentucky Homestead Exemption
Offsets care costHelps pay for: Reduces taxable assessed value for qualifying homeowners age 65+ or totally disabled; the 2025-2026 exemption is $49,100.
Who qualifies: Own and occupy the home and meet age/disability criteria; apply through the county PVA.
How to start: File with the county Property Valuation Administrator.
Good to know: Family caregiver payment: No
Private Insurance
Long-Term Care Insurance
OftenHelps pay for: Depending on the policy, benefits may reimburse home health, personal care, respite or other long-term services.
Who qualifies: Must own a policy and satisfy its benefit trigger, elimination period and covered-service rules.
How to start: Request an in-force illustration and home-care claim packet.
Good to know: Family caregiver payment: Policy-specific
Home Equity
FHA Home Equity Conversion Mortgage (HECM)
Can fund careHelps pay for: Eligible older homeowners may convert home equity to cash that can be used for home-care expenses, with significant costs and long-term implications.
Who qualifies: Generally age 62+, sufficient home equity, HUD counseling and ongoing property-charge obligations.
How to start: Speak with a HUD-approved HECM counselor before proceeding.
Good to know: Family caregiver payment: No
VA
Veteran-Directed Care (VDC)
YesHelps pay for: Self-directed VA budget for eligible Veterans who need personal care and want control over workers and services.
Who qualifies: VA enrollment/community-care eligibility, clinical need and local VDC availability.
How to start: Ask the VA primary care/social-work team about VDC.
Good to know: Family caregiver payment: Yes - family can often be hired subject to local program rules
VA Aid & Attendance / Housebound Pension Add-On
Can fund careHelps pay for: Additional monthly pension amount for qualifying wartime Veterans/survivors who need help with daily activities, are housebound or meet other criteria; funds can help pay for care.
Who qualifies: Must qualify for VA pension plus Aid & Attendance/Housebound criteria.
How to start: Apply through VA or an accredited representative.
Good to know: Family caregiver payment: Indirect - beneficiary controls pension funds
VA / Caregiver
Program of Comprehensive Assistance for Family Caregivers (PCAFC)
Supports home careHelps pay for: For eligible Veterans with serious service-connected disability and qualifying personal-care needs, PCAFC may provide a monthly stipend to a designated primary family caregiver plus training/support.
Who qualifies: Current VA clinical/disability, personal-care and caregiver eligibility rules apply; application and clinical assessment required.
How to start: Apply jointly through VA caregiver support.
Good to know: Family caregiver payment: Yes - stipend to eligible primary family caregiver
Kentucky Medicaid / Coverage
Waiver Special Financial Eligibility / Patient-Liability Screening
Enables coverageHelps pay for: Kentucky waiver financial rules can differ from ordinary Medicaid pathways; correct screening can prevent families from incorrectly assuming income makes HCBS impossible.
Who qualifies: Program-specific Medicaid income/resource, institutional-deeming and patient-liability rules apply.
How to start: Request a formal eligibility determination rather than self-screening out.
Good to know: Family caregiver payment: No
VA Benefits
VA Homemaker & Home Health Aide
YesHelps pay for: VA may authorize community-based aides to help an eligible Veteran with ADLs and selected daily tasks at home.
Who qualifies: VA enrollment/community-care eligibility, clinical need and local availability; copay may apply. Ask VA primary care/social work for an assessment and authorization.
How to start: Ask the VA social worker or care team about VA Homemaker & Home Health Aide.
Good to know: Family caregiver payment: No
Veteran-Directed Care
YesHelps pay for: Flexible self-directed budget for eligible Veterans needing personal care; participant can choose workers and services.
Who qualifies: VA enrollment/community-care eligibility, clinical need and local VDC availability. Ask the VA care team whether VDC is available locally.
How to start: Ask the VA social worker or care team about Veteran-Directed Care.
Good to know: Family caregiver payment: Yes
VA Skilled Home Health
Yes - skilled careHelps pay for: VA may purchase skilled nursing, therapy and related home-health services from authorized community providers.
Who qualifies: Clinical need, VA eligibility/authorization and provider availability. Request through VA care team.
How to start: Ask the VA social worker or care team about VA Skilled Home Health.
Good to know: Family caregiver payment: No
VA Respite Care
Yes - respiteHelps pay for: VA may provide in-home, adult-day or facility respite to give caregivers a break.
Who qualifies: Enrollment, clinical need and local availability/authorization. Ask VA social work/caregiver support about respite.
How to start: Ask the VA social worker or care team about VA Respite Care.
Good to know: Family caregiver payment: No direct wage
PCAFC
Supports home careHelps pay for: May provide a monthly stipend, training, support and certain benefits to an eligible designated primary family caregiver.
Who qualifies: Veteran/caregiver must satisfy current VA disability, personal-care and caregiver criteria. Apply jointly through VA caregiver support.
How to start: Ask the VA social worker or care team about PCAFC.
Good to know: Family caregiver payment: Yes - caregiver stipend
Program of General Caregiver Support Services
Offsets caregiver burdenHelps pay for: Coaching, education, peer support and resources for caregivers of enrolled Veterans; no formal PCAFC eligibility decision is needed for many supports.
Who qualifies: Caregiver supports a Veteran enrolled in VA health care; service-specific rules apply. Contact the VA Caregiver Support Line or local team.
How to start: Ask the VA social worker or care team about Program of General Caregiver Support Services.
Good to know: Family caregiver payment: No stipend
VA Home Based Primary Care
Offsets care/medical travelHelps pay for: Interdisciplinary primary care delivered at home for eligible Veterans with complex chronic disabling disease who have difficulty using clinic-based care.
Who qualifies: VA enrollment, clinical appropriateness and local program availability. Ask VA primary care/social work about HBPC.
How to start: Ask the VA social worker or care team about VA Home Based Primary Care.
Good to know: Family caregiver payment: No
VA Medical Foster Home
Alternative to institutional careHelps pay for: For eligible Veterans needing a supervised home setting, VA may coordinate care in a private residence with trained caregivers; room/board arrangements are separate from VA-covered health care.
Who qualifies: Clinical eligibility, local MFH availability and payment arrangement for room/board. Ask VA social work about Medical Foster Home.
How to start: Ask the VA social worker or care team about VA Medical Foster Home.
Good to know: Family caregiver payment: No family wage
VA Aid & Attendance / Housebound
Can fund home careHelps pay for: Adds monthly pension dollars for qualifying Veterans/survivors with ADL needs, housebound status or other qualifying circumstances.
Who qualifies: Must qualify for VA pension and A&A/Housebound criteria. Apply to VA or through an accredited representative.
How to start: Ask the VA social worker or care team about VA Aid & Attendance / Housebound.
Good to know: Family caregiver payment: Indirect
VA Pension
Can fund careHelps pay for: Needs-based monthly benefit for qualifying wartime Veterans and some surviving spouses; funds can help with household/care costs.
Who qualifies: Service, age/disability, income and net-worth rules apply. Apply through VA or accredited representative.
How to start: Ask the VA social worker or care team about VA Pension.
Good to know: Family caregiver payment: Indirect
VA Community Care Network - Region 2
Can authorize community careHelps pay for: Kentucky is in CCN Region 2, administered by Optum; VA can use authorized community providers when eligibility/referral rules are met.
Who qualifies: VA community-care eligibility plus referral/authorization; not an open-ended private-care reimbursement program. Get VA authorization before assuming community-provider bills will be paid.
How to start: Ask the VA social worker or care team about VA Community Care Network - Region 2.
Good to know: Family caregiver payment: No
Kentucky VA Caregiver Support Teams
Navigation / supportHelps pay for: Lexington and Louisville VA caregiver-support teams can screen for PCAFC, respite, training, resources and local home-care pathways.
Who qualifies: Veteran/caregiver relationship and program-specific eligibility. Call the local Caregiver Support Coordinator/team.
How to start: Ask the VA social worker or care team about Kentucky VA Caregiver Support Teams.
Good to know: Family caregiver payment: Potentially via PCAFC
Where Kentucky Families Can Start
Not sure where to begin? Match your situation to a contact below.
No-wrong-door screening for aging/disability services, Homecare, caregiver supports, PACE and local AAA resources
Kentucky Aging and Disability Resource Center (ADRC)
Medicaid, SNAP and benefit applications/eligibility questions
DCBS Family Support / Medicaid Applications
Medicaid member questions, KI-HIPP and coverage navigation
Kentucky Medicaid Member Services
HCB waiver and participant-directed service questions
HCB / PDS Assistance
IDD waiver questions, MPW/SCL access and service navigation
DBHDID - MPW / SCL
Behavioral-health HCBS eligibility and service questions
1915(i) RISE Initiative
Move from nursing/institutional care to community living
Kentucky Transitions
PCAP, Hart-Supported Living, TBI Trust Fund and disability/aging program navigation
Department for Aging and Independent Living (DAIL)
Utility assistance and local Community Action access
Kentucky LIHEAP / Community Action
PCAFC, respite, caregiver supports and local VA navigation
VA Kentucky Caregiver Support
Before You Rely on Any Payment Source
Planning Point
Why It Matters
HCB currently has a waiting list
Kentucky states that HCB has a waiting list and placement is based on application date. Families should apply early and establish status even if they are using private-pay care in the meantime.
MPW currently has a waiting list
Michelle P. Waiver access is not immediate for everyone. Apply and maintain current contact information rather than assuming services can start as soon as eligibility is established.
SCL currently has a waiting list based on category of need
Supports for Community Living uses category-of-need prioritization. Urgency and category matter, so families should document changing needs and keep the state informed.
ABI and ABI-LTC access can involve waiting lists
Kentucky identifies waiting-list access for its ABI programs. Acute rehabilitation goals and long-term maintenance needs should be screened against the correct ABI track.
Paid-family PDS has important role and hour limits
Kentucky can approve certain immediate family, guardian or legally responsible workers, but written approvals/attestations and service-specific limits apply. HCB/SCL regulations include 40-hour limits, and a participant representative cannot simply serve as the paid worker.
CHILD is current but not participant-directed
Kentucky is accepting participant applications for the new CHILD Waiver. Current CHILD services are delivered by certified Medicaid-enrolled agencies rather than through PDS, so families should not assume they can hire themselves as workers.
Homecare is state/local funding, so availability varies
Kentucky Homecare is administered through the aging network. Some areas may have waiting lists and not every service is available everywhere, making local AAA screening essential.
PCAP is employer-directed and requires a specific level of need
PCAP is not ordinary agency home care: the participant must generally need 14-40 attendant hours per week and be able to instruct/supervise attendants and handle payroll/employer responsibilities.
TBI Trust Fund has defined caps but no family-income cap
The trust fund can fill gaps when no other viable payer exists. Current limits are $15,000 per person per year and $60,000 lifetime, with case-management costs excluded from those caps.
PACE is comprehensive but geographically limited
PACE requires age 55+, nursing-facility level of care, safe community living and residence in a participating service area. Once enrolled, PACE becomes the primary integrated source of covered Medicare/Medicaid services.
Kentucky Medicaid financial tables should be rechecked each year
Programs such as Medicaid Works, MSPs and waiver special financial eligibility use thresholds that can change. Use current state determinations rather than relying on an old dollar figure copied from a prior year.
Kentucky Home Energy Rebates are a future planning item, not a current payment pathway
As of August 14, 2026, Kentucky's Home Energy Rebate site is not yet accepting applications. LIHEAP and Weatherization are included as current cost-offset options; revisit the rebate program when applications open.
Program rules, income limits, and availability change over time and can vary by county. Confirm current details with the program directly, or ask a home care provider in Kentucky to help you navigate the application process.
← Back to How to Pay for In-Home CareHome Care Providers in Kentucky
These providers serve families in Kentucky and can help you apply what you've learned above to your specific situation.
Caring Excellence Personalized Home Care Services – Florence, KY
Serving Kentucky
Caring Excellence Personalized Home Care Services provides home care services in Florence, KY and the surrounding communities it serves.
Services Available
24-Hour Home Care • Companion Care • Personal Care • Dementia & Alzheimer's Care • Respite Care
Communities Served
Union, Villa Hills, Fort Thomas and surrounding areas
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Caring Excellence Personalized Home Care Services – Lexington, KY
Serving Kentucky
Caring Excellence Personalized Home Care Services provides home care services in Lexington, KY and the surrounding communities it serves.
Services Available
24-Hour Home Care • Companion Care • Personal Care • Dementia & Alzheimer's Care • Respite Care
Communities Served
Lexington, Winchester, Georgetown and surrounding areas
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Caring Excellence Personalized Home Care Services – Louisville, KY
Serving Kentucky
Caring Excellence Personalized Home Care Services provides home care services in Louisville, KY and the surrounding communities it serves.
Services Available
24-Hour Home Care • Companion Care • Personal Care • Dementia & Alzheimer's Care • Respite Care
Communities Served
Louisville, Middletown, Prospect and surrounding areas
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Connecting Hearts Home Care
Serving Kentucky
Connecting Hearts Home Care provides home care services in Fort Thomas, KY and the surrounding Northern Kentucky communities it serves.
Services Available
24-Hour Home Care • Personal Care • Companion Care • Dementia & Alzheimer's Care • Respite Care • Hospital-to-Home Care
Communities Served
Fort Thomas, Alexandria, Cold Spring and surrounding areas
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