Can I get paid to care for my spouse in Kentucky?
Yes — Kentucky lets a spouse be paid.
Kentucky is one of the states where the person who needs care can hire their own husband or wife and have the program pay for it. You do the caring you are already doing. The state pays you for it.
What has to be true
- Your spouse lives in Kentucky and needs long-term care help at home.
- Your spouse has Medicaid, or can qualify. We check that with you for free.
- You pass a background check. No license or certificate is needed.
- The care your spouse needs is written into their plan — that is what the hours are paid against.
What Kentucky pays family caregivers
$29.04/hr
Your exact pay is set by the program and your care plan. We'll tell you your real number before you enroll.
Source: Kentucky Medicaid program data · Updated September 2026
What Kentucky's rule actually says
yes — friends and relatives including adult children and spouses can be hired under PDS
The programs this runs through in Kentucky: Participant Directed Services (PDS), HCB Waiver, Michelle P. Waiver. Who runs them: KY Cabinet for Health and Family Services — Dept. for Aging and Independent Living (DAIL) 877-315-0589; Waiver Help Desk 844-784-5614
826,700 people in Kentucky are 65 or older. Most of them are cared for at home, by a relative — usually without being paid for it.
How to start in Kentucky
Apply via kynect.ky.gov, phone 855-306-8959, or in person; PDS enrollment goes through the case manager or the regional Area Development District/AAA.
self-directed with mandatory financial management services agency for payroll/taxes; support broker/case manager assists
See if you qualify →Spouse questions in Kentucky, answered
Can I get paid to care for my husband or wife in Kentucky?
Yes. Kentucky allows it. The published rule: yes — friends and relatives including adult children and spouses can be hired under PDS
Why do some states allow this and others don't?
Medicaid has long treated care between spouses as a family duty rather than paid work. Self-directed programs changed that in many states by making the person who needs care the employer — they choose their own worker, and in some states that can be a spouse. It is a state-by-state policy choice, not a federal rule.
How much would I earn in Kentucky?
Reported pay in Kentucky runs around $29.04/hr, though your exact rate is set by the program and the care plan.
Does my spouse need Medicaid first?
Yes. These are Medicaid programs, so your spouse has to qualify for Kentucky Medicaid and need long-term care help. Many families assume they earn too much and never apply. The rules for long-term care are not the same as regular Medicaid — check before you rule yourself out.
Is there a waitlist in Kentucky?
HCB Waiver ~17,800 slots/yr — waitlist forms when full; Michelle P. Waiver has a long-standing multi-year waitlist
How do we start?
Apply via kynect.ky.gov, phone 855-306-8959, or in person; PDS enrollment goes through the case manager or the regional Area Development District/AAA.
Sources: medicaidplanningassistance.org · chfs.ky.gov · apps.legislature.ky.gov · Updated September 2026. Rules change — always confirm with the program.
Where most Kentucky caregivers are
Counties with the most residents aged 65 and older. The rules are the same everywhere in Kentucky — pick yours for the local picture.
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