Kentucky Homecare Program: Eligibility, Services, and Costs

The Kentucky Homecare Program pays for in-home help such as personal care, housekeeping, meals, and respite for residents age 60 and older who have trouble managing daily tasks on their own. It’s run through 15 regional Area Agencies on Aging and Independent Living and governed by state regulation 910 KAR 1:180.¹ Many participants pay nothing; others pay a share tied to household income.

Who Qualifies

Three things decide eligibility: your age, how much difficulty you have with daily activities, and whether Medicaid already covers the same help.¹

You must be at least 60. A case manager then conducts an in-home assessment of your activities of daily living (ADLs, meaning basic self-care like bathing, dressing, eating, toileting, and moving from a bed to a chair) and instrumental activities of daily living (IADLs, meaning tasks for independent living like housekeeping, shopping, laundry, transportation, and managing paperwork). You qualify if you have:¹

Two ADL limitations, or
Three IADL limitations, or
One ADL plus two IADL limitations.

Two alternate paths exist. A stable medical condition that requires skilled health services can qualify you even without meeting those thresholds. And if you currently live in a nursing facility, intermediate care facility, or personal care home but could safely come home with support, the program can help bridge that transition.¹

Two boundaries catch people by surprise. First, if Medicaid already covers the same help, you’re generally ineligible. Narrow exceptions exist: you can still qualify if you can’t manage Medicaid’s person-directed services and have no one to act as your representative, or if you can’t access the Home and Community-Based waiver through a traditional provider. Second, the program cannot replace unpaid help you’re already getting from family or other natural supports. If those supports are meeting your needs, you’ll be deemed ineligible. The one exception is respite care, which exists precisely to give those unpaid caregivers a break.¹

What the Program Covers

A case manager builds a care plan around the specific gaps your assessment identifies. Not everyone gets every service, and availability varies by region.²

In-Home Help

Homemaker services cover meal preparation, light cleaning, laundry, and shopping. Personal care goes further, with help bathing, dressing, grooming, eating, and getting around the home. These two services are typically the backbone of a care plan.

Home-delivered meals provide at least one nutritionally balanced meal per day to participants who are homebound. Chore services handle heavier work like deep cleaning, minor repairs, and yard maintenance when they create safety hazards. Home repair services cover small modifications for safety and accessibility, such as grab bars, handrails, better lighting, or bathroom changes to reduce fall risk.¹

Respite and Adult Day Services

Respite care gives temporary relief to unpaid family caregivers. The program also covers adult day health services and specialized Alzheimer’s respite care, which offer structured daytime supervision and activities in a group setting.¹

What You’ll Pay

Three services are always free regardless of income: case management, the initial assessment, and home-delivered meals.¹

Everything else runs on a sliding scale measured against the federal poverty guidelines, with your copayment set as a percentage of the service cost. For 2026, the poverty level for an individual is $15,960 per year.³ If your household income is below 130% of poverty, you pay nothing. From there, copayments step up by income band and household size, reaching full cost at 250% of poverty for every household size.¹ Larger households pay less at every step, so a two- or three-person household stays at zero copay well past the point a single person starts paying something.

Several protections keep costs manageable. If you receive SSI or food assistance, that income doesn’t count toward other family members, and you’re treated as a household of one. If you qualify as “needy aged” under Kentucky law, no fee is assessed. Your case manager can also waive or reduce fees based on extraordinary out-of-pocket medical or living expenses, documented in your case record.¹

If your copayment is zero, the program may invite a voluntary contribution but cannot pressure you, and services will never be withheld if you don’t contribute.

How to Apply

Start with the Area Agency on Aging and Independent Living that serves your county. Kentucky has 15 of them, organized through the state’s Area Development Districts. The Department for Aging and Independent Living (DAIL) within the Cabinet for Health and Family Services keeps a directory, and the federal Eldercare Locator at 1-800-677-1116 can also point you to the right agency.²

Have a few things ready when you call: proof of age (driver’s license, state ID, or birth certificate), information about household income and monthly expenses for the fee calculation, and a specific description of the daily tasks you struggle with. The more concrete you can be about your limitations, the smoother the assessment goes.

A qualified case manager will then schedule an in-home visit for the formal functional assessment. It isn’t pass-fail. The case manager observes your living environment, talks with you about your daily challenges, and measures your ADL and IADL limitations against the thresholds. Eligibility, services, and your copayment are decided from that visit.

Waiting Lists Are Possible

Funding isn’t unlimited. The state acknowledges that some areas keep waiting lists, and not every service is available in every region.² The regulation requires that eligible applicants who can’t be served due to funding be placed on a waiting list.¹

If you land on a list, ask the Area Agency about other programs that could help in the meantime. Older Americans Act funding supports certain services like congregate meals and transportation separately, and Kentucky’s Medicaid Home and Community-Based waiver covers similar supports for people who meet Medicaid’s financial rules. Your case manager or the state’s Aging and Disability Resource Center can walk you through what else you might qualify for while waiting.

If You’re Denied

If your application is denied, your services are reduced, or you’re terminated from the program, you can challenge the decision in two stages.¹

The first stage is informal. Within 30 days of the decision, send a written request to DAIL’s Homecare Program Coordinator with your contact information, the decision you’re disputing, your reasons, and any supporting documents. A three-person panel from the Division of Quality Living reviews the dispute, gives you a chance to present your case, and issues a written decision within 10 business days.

If that doesn’t resolve it, you can request a formal administrative hearing under KRS Chapter 13B within 30 days of the panel’s decision. That request goes to the Office of the Ombudsman and Administrative Review. One important limit: you cannot use the appeal process to dispute being placed on a waiting list for lack of funding, or to challenge a finding that you simply don’t meet the eligibility rules.¹

1
Kentucky Legislative Research Commission. Kentucky Code 910 KAR 1:180 – Homecare Program for the Elderly
2
Cabinet for Health and Family Services. Homecare Program
3
HealthCare.gov. Federal Poverty Level