Written by a parent, not a doctor. Nothing here is medical advice.

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Kentucky program

Nursing and personal care at home through Medicaid

Medicaid can pay for nursing and aide help at home when your child needs it.

What it is

Medicaid can pay for nursing and aide help at home when your child needs it.

Your child’s care needs determine the hours and tasks Medicaid will consider. The discharge nurse and doctor prepare the request. Children under 21 also have a federal route for medically necessary Medicaid services.

Eligibility rules
  • The child must be on Kentucky Medicaid.
  • The treating clinician documents the need; the plan or the state contractor authorises.
  • EPSDT Special Services is for members under 21. The private-duty nursing regulation does not impose that same age ceiling.
  • You must live in Kentucky.
What you get
  • Approved nursing and aide hours at home without a family charge.
  • Equipment and supplies when covered and approved.
Amounts and limits
  • Nursing hours follow assessed medical need and an approved plan of care. A parent’s paid-caregiver work limit is not the child’s nursing-hour limit.
If you decide to apply
  1. Ask the discharge nurse and doctor to describe the tasks and hours your child needs at home.
  2. Ask the clinic which Medicaid office or plan receives the request, and keep a copy.

Home nursing through Medicaid: 502-564-7540 · Official page ↗

If you decide to apply
  • The decision comes from the child's Medicaid managed-care plan, or the state's authorization contractor for a child on plain Medicaid.
  • The clinician sends prior authorization to the managed-care plan or, for fee-for-service Medicaid, the state contractor on form MAP-9.
  • An EPSDT Special Services request should identify that route. It reaches medically necessary services within federal Medicaid categories, including some Kentucky does not otherwise cover.
Good to know

Paid nursing for your child is different from paying a parent to provide care.

Other details
  • Medicaid does not pay a parent or other close relative living in the home as the child’s private-duty nurse.
  • Paying a parent through an approved waiver’s participant-directed services is a separate route. The waiver team confirms the current qualifications, approval and work limits.
Official sources
Ask your social worker

“What home help could benefit our child, what are its limits, and could you help us decide whether to request an assessment?”

Why I’m asking: I want to understand what support could make care at home manageable.

More background and detailed requirements
Additional program information and published rules

Who does what

The three parts, side by side. The agency decides; nobody on this page does.

You

Ask for the request early, keep a copy, and chase it by name.

Your social worker

The clinician documents the need and sends the prior-authorisation request to the right desk.

The care team

The discharge nurse writes the hours and the tasks; the doctor signs the order.

Who decides
The child's Medicaid plan, or the state's authorisation contractor.
Ask the care team
“Can we start the home nursing authorisation now rather than at discharge, and can you confirm whether it goes to the managed-care plan or the state contractor?”

How to apply

First step: Ask the discharge nurse today to start the prior-authorisation request, and ask which desk it goes to.

  1. Ask the team to start the nursing request before discharge, not after.
  2. Ask which desk it goes to: the managed-care plan or the state contractor.
  3. If a service is refused because Kentucky does not cover it, ask for it again as a child health benefit request, naming it.

Official application / program page ↗

Where it starts: The clinician sends the prior-authorisation request. For plain Medicaid it goes to the state contractor on form MAP-9; for a managed-care child it goes to the plan. Enquiries on 502-564-7540.

What to gather

  • The child's Medicaid number and plan name
  • The discharge summary and the list of tasks needed at home

How long: Kentucky publishes no state decision deadline for these requests. Ask the plan for its own clock in writing.

What a yes looks like

An authorisation naming hours a week and an agency that will staff them. Ask how many of the approved hours the agency can actually fill.

What a no looks like, and the next move

Ask whether it was refused on medical necessity or on paperwork, and ask for it again under the child health benefit, named.

Watch out

  • The request goes to the managed-care plan or to the state contractor, depending on how your child's Medicaid is arranged. The wrong desk loses weeks.
  • A request for the child health benefit has to say so. Ask the team to name it in the request.
  • A parent can be paid only through a waiver's participant-directed services, and leukaemia alone rarely reaches those waivers.

The numbers and the rules

The arcane layer, kept on purpose. Checked September 11, 2026.

What it is worth

Nursing and aide hours at home authorised by the child's Medicaid plan, with a special-services route for anything the federal programme covers for a child under 21.

  • $40/week — Maximum paid hours a week for a legally responsible carer under participant-directed services, across all participants

Covers: Private duty nursing hours at home · Aide and personal-care hours · Equipment and supplies through the child health benefit · Enquiries on 502-564-7540

Legal protection: The child health benefit reaches services Kentucky Medicaid does not otherwise cover

What it costs the family: No cost when Medicaid authorises it.

The eligibility facts, as published

Coverage
the child must be on Kentucky Medicaid
Medical
the treating clinician documents the need; the plan or the state contractor authorises
Age
the special-services route is for a child under 21
Residency
Kentucky

The trap: Who authorises depends on how your child's Medicaid is arranged. A child in a managed-care plan goes through the plan; a child on plain Medicaid goes through the state's authorisation contractor on form MAP-9. Ask the team which one applies before they send the request, or it goes to the wrong desk.

Where I read this

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