Indiana PathWays for Aging
Indiana PathWays for Aging is Indiana’s managed care program for Medicaid members 60 and older, including people in nursing homes and people receiving long-term care at home. A PathWays health plan coordinates care, and members can have Medicare too. For the wider picture, see our Indiana Long-Term Care Medicaid guide.
Figures change periodically. Double-check current amounts before relying on them.
At a glance
| Item | Details |
|---|---|
| Type of program | Managed long-term services and supports (managed care) |
| Who runs it | Indiana Family and Social Services Administration (FSSA), through PathWays managed care plans |
| Age | 60 and older |
| Care need | Varies (long-term care requires a nursing facility level of care) |
| Indiana 2026 income rule (long-term care) | $2,982 a month (special income level). Higher income needs a Miller trust |
| Indiana 2026 asset limit (single applicant) | $2,000 |
| Waiting list | Waiver services have a waitlist; managed care enrollment does not |
PathWays in brief
Put simply, responsibility for PathWays sits with Indiana Family and Social Services Administration (FSSA), through PathWays managed care plans. Who it is for: 60 and older. Care need required: Varies (long-term care requires a nursing facility level of care). On waiting lists, the current picture is: Waiver services have a waitlist; managed care enrollment does not. The sections below repeat these points with more detail, and our state guide covers the Indiana rules that apply to every long-term care program. Other Indiana programs, and general guides on care at home, are linked at the end of this page for comparison with PathWays.
What the program is
PathWays launched in July 2024. It includes the PathWays for Aging Waiver, which replaced the Aged and Disabled Waiver for people 60 and older. Each member has a care coordinator, and those receiving long-term care get a service coordinator who arranges waiver services.
PathWays works through managed care: instead of paying each provider directly, Indiana pays health plans, which arrange care at home, in residential settings and in nursing homes. Members pick a plan where more than one is available, and that plan’s care coordinator manages the plan of care. Eligibility rules still come from the state, and members can appeal if a plan reduces or denies services. See Managed long-term services and supports.
Who qualifies in 2026
A person generally must meet all of these conditions:
- Is 60 or older
- Has Indiana Medicaid
- For waiver services: needs a nursing facility level of care and has income no greater than 300% of the SSI amount
- Lives in Indiana and is a U.S. citizen or qualified non-citizen
Financial eligibility. PathWays requires full Medicaid eligibility under Indiana’s long-term care financial rules. The table’s figures are Indiana’s 2026 long-term care numbers, taken from our state guide. Indiana FSSA’s countable assets do not usually include the home (within the equity limit, if the applicant or a spouse lives there or intends to return), one car, personal belongings and a small burial fund. Married couples get extra protection in Indiana: the spouse at home keeps a share of assets and may get some of the applicant’s income. See Spousal impoverishment rules.
What the care test means in practice. For PathWays, an assessor checks how much help the person needs with bathing, dressing, eating, toileting, mobility and medications, and whether memory loss calls for supervision. For PathWays, an assessor, usually a nurse or social worker, visits the person at home, in the hospital or in the facility. Families should describe the worst days honestly and bring a list of conditions and medicines. See Nursing home level of care and Activities of daily living.
What services it can pay for
What a participant receives under PathWays follows the care plan. Possible services include:
- Nursing facility care
- Attendant care
- Home and community assistance
- Adult day services
- Adult family care
- Assisted living services
- Home-delivered meals
- Home modifications
- Respite
- Structured family caregiving
- Personal emergency response systems
The menu is broad, but the plan is built from need, and unpaid family help is factored in. When needs grow, request an updated assessment.
How to apply
There are two tracks, a financial one and a care one, and both must say yes. The usual path for PathWays is:
- Apply for Indiana Medicaid with FSSA’s Division of Family Resources.
- For waiver services, contact your Area Agency on Aging to request an assessment and be placed on the waitlist.
- When invited, accept within 45 days and complete all steps within 180 days.
- Choose a PathWays plan; the service coordinator writes the plan.
Before contacting Indiana FSSA, see Applying for a waiver and the documents checklist for what to gather.
Waiting lists
The waivers reached their approved slot numbers in April 2024, and FSSA keeps a waiting list. Invitations are sent monthly as slots open, with priority for people leaving a nursing facility or hospital. Invitations must be accepted within 45 days, and all steps completed within 180 days, or the invitation is withdrawn.
See Waiver waiting lists for general tips.
How it relates to nursing home Medicaid
PathWays covers nursing home care and waiver services under one plan. Indiana’s 2026 income rule ($2,982 a month, with a Miller trust above that) and asset limit apply. Nursing home care is not subject to the waiver waitlist.
Where the nursing home rules still apply. As in nearly every state, Indiana’s financial rules for home and community programs follow its nursing home rules closely. Gifts and below-value transfers in the five-year look-back can trigger a penalty period for home care as well as nursing home care. After death, estate recovery can reach services paid from age 55 on. People who keep income above a set allowance may have to pay part of it toward their care each month.
If a nursing home becomes necessary. A Indiana nursing home resident keeps a 2026 personal needs allowance of $52 a month, and most other income goes to the facility. Details are in our state guide.
Tips for families
- Start early. If there is a waiting list or a slow assessment, the clock usually starts when you ask, not when the crisis comes.
- Keep a paper trail: copies of forms and notices, plus the names and dates of every call to Indiana FSSA.
- Use your appeal rights. Notices that deny or reduce services explain how to request a fair hearing; acting quickly can protect current services.
- Tell Indiana FSSA about changes in money, address or household as they happen.
- Mark renewal dates. Eligibility and the care plan are usually reviewed annually; see Renewals.
- Get help with complex PathWays cases, such as a spouse at home or past gifts. A certified Medicaid planner or a legal aid office can review how Indiana’s rules fit a family’s situation.
Common questions
What happened to the A&D Waiver? On July 1, 2024, it split into the PathWays for Aging Waiver (60 and older) and the Health and Wellness Waiver (59 and younger).
Can family be paid? Structured family caregiving pays a live-in caregiver, and some attendant care can be self-directed.
Does PathWays pay for assisted living? Assisted living services in approved settings, not room and board.
Related pages
- Indiana Long-Term Care Medicaid guide
- Indiana Aged and Disabled Waiver (now Health and Wellness)
- Structured family caregiving
- Three kinds of Long-Term Care Medicaid
- PACE programs
Last updated for 2026. General information only, not legal or financial advice. Medicaid Answers is a free educational resource published by Medicaid Answers Foundation.