Indiana
What Is Indiana Medicaid Long-Term Care?
Medicaid offers health coverage to low-income individuals of all ages. Although there are several categories, this section focuses on Indiana Medicaid eligibility for seniors aged 65 and older. Beyond nursing facility care, Indiana Medicaid also pays for supportive, non-medical services to help elderly individuals continue living at home, in adult foster care homes, or in assisted living.
What Types of Long-Term Care Medicaid Programs Are Available in Indiana?
What Is Institutional / Nursing Home Medicaid?
This is an entitlement program, meaning all eligible individuals are guaranteed benefits. Services are provided exclusively in licensed nursing facilities.
What Are Medicaid Waivers / Home and Community Based Services?
These are not entitlement programs. Participation is limited, and there may be waitlists. Services are designed to delay nursing home admissions and can be received at home, in adult foster care, adult day care, or assisted living.
What Is Regular Medicaid / Aged, Blind, and Disabled (ABD)?
Also an entitlement program, this offers long-term care benefits such as adult day care and personal care assistance to those who meet eligibility requirements.
What Are the Income and Asset Requirements for Eligibility?
Eligibility criteria differ depending on the program and the applicant’s marital status. Indiana updates these criteria annually and offers multiple pathways to eligibility.
What Are the 2025 Financial Criteria for a Single Nursing Home Applicant?
To qualify, a single applicant must:
- Have income below $2,901 per month
- Own assets under $2,000
- Require a nursing home level of care
What Are the 2025 Financial Limits for All Applicant Types?
See chart above or Medicaid Eligibility Test for assistance. Not meeting all criteria does not mean you are ineligible.
How Is Income Defined and Treated in Indiana Medicaid?
What Counts as Income?
Most sources of income—like wages, pensions, alimony, Social Security, and dividends—are counted. Exceptions include Holocaust restitution and supplemental VA pensions (Aid & Attendance and Housebound).
How Is Income Treated for Married Couples?
If only one spouse applies for Nursing Home or HCBS Waiver Medicaid, only that person’s income counts. The non-applicant may be eligible to receive income up to $2,643.75 per month (MMMNA) and possibly more if housing costs exceed $793.13, though total income cannot exceed $3,948/month.
If one spouse applies for Regular Medicaid, both spouses’ incomes are counted. No income allowance exists for the non-applicant spouse in this case.
What Assets Count Toward the Medicaid Limit?
What Are Countable and Exempt Assets?
Countable assets include savings, stocks, real estate (excluding the home), and retirement accounts. Exempt assets include:
- Personal items and household furnishings
- One vehicle
- Irrevocable burial trusts
- The primary residence (with conditions)
How Are Assets Treated for Married Couples?
Assets are considered jointly owned. Under Spousal Impoverishment Rules, the non-applicant may keep up to 50% of assets—up to $157,920 in 2025—or $31,584, whichever is greater.
What Is Indiana’s Medicaid Look-Back Period?
Indiana enforces a five-year look-back period for Nursing Home and Waiver Medicaid to ensure no assets were improperly transferred. Violations result in a penalty period.
Indiana allows up to $1,200 in total annual gifts to family or nonprofits without penalty. Note that IRS gift tax rules do not exempt such gifts from Medicaid rules.
How Is the Home Treated Under Indiana Medicaid Rules?
To be exempt, the applicant or spouse must reside in the home. If no spouse lives there, the home equity must be under $730,000 (2025). If the applicant no longer lives in the home, they must express intent to return.
The home is not protected from Indiana’s Estate Recovery Program, which seeks reimbursement after the beneficiary’s death.
What Medical or Functional Requirements Must Be Met?
Applicants must require long-term care. For Nursing Home and Waiver Medicaid, this means needing a Nursing Home Level of Care (NHLOC). For Regular Medicaid, assistance with Activities of Daily Living (ADLs) is required, though not necessarily NHLOC.
What If Someone Exceeds Medicaid’s Income or Asset Limits?
What Is a Qualified Income Trust (QIT)?
Also known as a Miller Trust, a QIT allows applicants over the income limit to qualify. Income deposited in this irrevocable trust is excluded from eligibility calculations.
What Is an Asset Spend Down?
Applicants can spend down excess assets on exempt items like home improvements, funeral expenses, or debt repayment. Gifts or undervalued sales are not permitted and may trigger penalties.
What Is Medicaid Planning?
This approach helps individuals who are over-income or over-asset but cannot afford care. Medicaid Planners assist with strategies to gain eligibility and protect assets like the home from estate recovery.
What Are Indiana’s Specific Long-Term Care Medicaid Programs?
Health & Wellness (H&W) Waiver
As of July 1, 2024, the H&W Waiver replaced the Aged & Disabled Waiver for people under 60. Those aged 60+ were transitioned to the Pathways for Aging program.
Pathways for Aging
This managed care program serves adults 60 and older, offering both medical care and long-term services. It supports living at home, in assisted living, or adult foster care. Services may include personal care, adult day care, home modifications, and more. Beneficiaries may choose their caregivers, including family.
PACE (Program of All-Inclusive Care for the Elderly)
PACE combines Medicaid and Medicare benefits into one program and may offer additional services such as dental or vision care.
Structured Family Caregiving (SFC)
SFC allows a senior to live with a relative—like an adult child—and have that person compensated as their caregiver. Under Pathways, even spouses or legal guardians can be paid.
Money Follows the Person (MFP)
This federal program assists individuals in moving out of institutional settings and back into the community while continuing to receive Medicaid support.
How Can Seniors Apply for Indiana Medicaid?
Seniors can apply online via the Indiana FSSA Benefits Portal or in person at a local Division of Family Resources (DFR) office. Phone applications are also accepted at 1-800-403-0864.
Before applying, seniors should ensure they meet all eligibility criteria. Those unsure or ineligible are encouraged to seek Medicaid Planning assistance, as the application process can be complex.
