By Louisville Senior Advisor Care Team · October 17, 2026
Since July 1, 2024, a Kentucky Medicaid resident of a nursing facility keeps $60 a month from their income as a personal needs allowance (up from $40), under House Bill 6 of the 2024 session. The rest of their income goes to the facility as patient liability.
What is the personal needs allowance?
When a Kentucky nursing home resident qualifies for Medicaid, nearly all of their monthly income, Social Security, pensions and similar, goes to the facility as their share of the cost, called patient liability. Medicaid pays the rest of the facility's Medicaid rate. The personal needs allowance (PNA) is the amount the resident keeps for personal and incidental needs before patient liability is calculated.
The Department for Medicaid Services announced in a provider letter dated August 7, 2024 that House Bill 6 of the 2024 Regular Session raised the PNA from $40 to $60 a month effective July 1, 2024. The change applies to nursing facilities, intermediate care facilities for individuals with intellectual disabilities, institutional hospice and institutional PACE.
How much difference does $20 make?
It sounds small, and it is. But $40 had been the figure for a long time, and residents use the allowance for things Medicaid does not supply: haircuts, clothing, a phone line, snacks, greeting cards, a newspaper. Twenty dollars more a month is $240 a year.
| Setting | Monthly amount the resident keeps | Source |
|---|---|---|
| Medicaid nursing facility | $60 | HB 6 (2024); 907 KAR 20:035 |
| Personal care home with State Supplementation | $60 | 921 KAR 2:015 |
| Family care home with State Supplementation | $40 | 921 KAR 2:015 |
Who manages the allowance?
Often the facility holds it in a resident trust account, especially for residents who cannot manage money. Families should ask how the account works, how withdrawals are recorded and whether statements are sent. If a resident has a representative payee or guardian, that person controls it. The allowance belongs to the resident; it is not meant to offset facility charges.
What about the spouse at home?
The PNA is only the first deduction. When a nursing home resident has a spouse living at home, Kentucky's spousal impoverishment rules in 907 KAR 20:035 allow a community spouse income allowance, which can redirect part of the resident's income to the spouse at home, up to a federal maintenance standard that changes each January. The at-home spouse also keeps a protected share of the couple's resources. Confirm the current dollar figures with the Department for Community Based Services before planning.
What else should families know about Medicaid in a Louisville nursing home?
Kentucky's resource limit for a single applicant is $2,000 (907 KAR 20:025). Medicaid applications go through kynect or DCBS at (855) 306-8959, and transfers for less than fair market value during the look-back period can trigger a penalty. Not every bed in every facility is a Medicaid long-term bed; ask before admission.
Our nursing home roster lists every licensed nursing facility in the seven Louisville-area counties with its CMS rating and licensed beds.
Does the allowance cover clothing and dental care?
It is meant to. Clothing, personal-care items not supplied by the facility, outings, and small purchases come out of the allowance. Larger necessary expenses, such as dentures or hearing aids not covered by insurance, can sometimes be deducted from patient liability as incurred medical expenses under 907 KAR 20:035; ask the facility's business office and DCBS how to document them before paying.
Families sometimes top up a resident's spending money directly. That is allowed, but keep amounts modest and records clear so they are not mistaken for income or resources in a Medicaid review.
What should families ask the business office?
Ask four questions at admission: whether the facility holds resident funds in a trust account, how often statements are issued, what happens to the balance if it grows near the $2,000 resource limit, and what the facility does with the account if the resident dies. Residents' funds in a nursing facility are protected by federal rules, and the long-term care ombudsman, run in the Louisville region by Catholic Charities through KIPDA, can help if something seems wrong.
Is the allowance the same everywhere in Kentucky?
Yes. The $60 nursing facility allowance is set statewide by Kentucky law and Medicaid regulation, so it is the same in a Louisville nursing home as in Bedford, Taylorsville or Paducah. What varies is each resident's patient liability, because it depends on their own income and on any allowance for a spouse or dependent family member at home. DCBS calculates it when Medicaid is approved and recalculates when income changes, such as after a Social Security cost-of-living increase.
Frequently asked questions
What is Kentucky's personal needs allowance in 2026?
$60 a month for a Medicaid resident of a nursing facility, unchanged since it rose from $40 on July 1, 2024.
Does the $60 apply in assisted living?
No. Kentucky Medicaid does not pay for assisted living, so there is no Medicaid PNA there. Personal care homes with State Supplementation residents use a $60 allowance under a different program.
Can the nursing home take the allowance for its bills?
No. The allowance belongs to the resident for personal needs; ask how any trust account is managed.
Who changed the allowance?
The General Assembly, through House Bill 6 of the 2024 Regular Session, as announced by DMS in August 2024.
