Indiana Aged and Disabled Waiver: Now the PathWays and Health and Wellness Waivers
Indiana’s Aged and Disabled (A&D) Waiver no longer exists under that name. On July 1, 2024, it split into two waivers: the PathWays for Aging Waiver for people 60 and older and the Health and Wellness Waiver for people 59 and younger. This page explains the change and how the waivers work, including attendant care that families can direct. It sits alongside our Indiana Long-Term Care Medicaid guide, which covers the nursing home rules.
Figures change periodically. Double-check current amounts before relying on them.
At a glance
| Item | Details |
|---|---|
| Type of program | Medicaid home and community-based services (HCBS) waiver |
| Who runs it | Indiana Family and Social Services Administration (FSSA) |
| Age | Health and Wellness Waiver: 59 and younger; PathWays Waiver: 60 and older |
| Care need | Needs 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 | Yes |
The PathWays and Health and Wellness waivers in brief
To sum up, Indiana Family and Social Services Administration (FSSA) oversees the PathWays and Health and Wellness waivers. Its target group is health and Wellness Waiver: 59 and younger; PathWays Waiver: 60 and older; on care need, the rule is: Needs a nursing facility level of care. Waiting list status in 2026: Yes. More detail on each point follows, and the Indiana state guide covers the shared financial rules. If the PathWays and Health and Wellness waivers is not the right fit, the related pages at the end point to other Indiana programs and general guides.
What the program is
Both waivers serve people who need a nursing facility level of care and have income no greater than 300% of the SSI amount. The Health and Wellness Waiver is managed by FSSA’s Division of Aging with case management, while PathWays services are coordinated through PathWays health plans. Consumer-Directed Attendant Care (CDAC), long part of the A&D Waiver, lets participants hire their own attendants.
Under federal law, Indiana can run home and community-based waivers like the PathWays and Health and Wellness waivers, which bend some ordinary Medicaid rules so care can happen outside a facility. Slots are limited each year, every participant has an individual care plan, and a case manager or coordinator puts services in place. Participants keep their regular Indiana FSSA coverage for medical care; the waiver adds long-term care services to it. See our overview of HCBS waivers.
Who qualifies in 2026
To get the PathWays and Health and Wellness waivers, a person generally has to meet each of these:
- Needs a nursing facility level of care
- Has income no greater than 300% of the SSI amount ($2,982 a month in 2026)
- Qualifies for full Medicaid under Indiana’s long-term care financial rules (see the money test below)
- Lives in Indiana and is a U.S. citizen or qualified non-citizen
The money test. Applicants for the PathWays and Health and Wellness waivers must meet Indiana’s long-term care Medicaid financial rules. Figures shown above are the 2026 Indiana long-term care limits from our state guide. Exempt items generally include the home within the equity cap, a car, household goods and a modest burial fund. If only one spouse needs the PathWays and Health and Wellness waivers, spousal impoverishment rules protect assets and income for the other. See Spousal impoverishment rules.
How the care assessment works. The care test looks at how much help a person needs with everyday activities such as bathing, dressing, eating, using the toilet, moving around and taking medicines, and at memory problems and supervision needs. A nurse or social worker working with Indiana FSSA usually does it in person, wherever the person is living. Have a relative present to describe the hard days, and keep a medication and diagnosis list handy. See Nursing home level of care and Activities of daily living.
What services it can pay for
The plan of care decides which services are used. The PathWays and Health and Wellness waivers can cover:
- Attendant care, including consumer-directed 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
No program pays for everything. The PathWays and Health and Wellness waivers services are based on assessed need, and a family caregiver who is already helping is usually counted when the plan is written. A change in health is a reason to request a reassessment.
Directing your own care and paying family
Consumer-Directed Attendant Care lets participants hire their own attendants, including some family members, with help from a fiscal agent.
How to apply
Getting the PathWays and Health and Wellness waivers means passing a money test and a care test. Step by step:
- Contact your Area Agency on Aging to request an assessment.
- Be placed on the waiting list if slots are full.
- When invited, accept within 45 days and complete steps within 180 days.
- Apply for Medicaid if not already enrolled.
For the paperwork, use our documents checklist before applying for the PathWays and Health and Wellness waivers; Applying for a waiver explains the general process.
Waiting lists
The waivers reached their approved slots in April 2024, and FSSA keeps a waiting list. Invitations go out monthly with priority for people leaving a facility or hospital.
More on how lists work: Waiver waiting lists.
How it relates to nursing home Medicaid
These waivers use the same nursing facility level of care and 2026 income rule ($2,982 a month) as nursing home Medicaid.
What is the same as nursing home Medicaid. Indiana’s financial rules for the PathWays and Health and Wellness waivers track the nursing home rules closely. The five-year look-back still matters: a transfer for less than fair value can delay payment for long-term care services. Estate recovery also applies: the state can seek repayment from the estate of a person who received long-term care services after age 55. Some participants pay a monthly share of income toward services.
Personal needs allowance. If the person does move to a nursing home, Indiana’s 2026 personal needs allowance is $52 a month. Most of the rest of their income goes toward the cost of care. The state guide explains the nursing home side.
Tips for families
- Do not wait for a crisis. Lists and assessments for the PathWays and Health and Wellness waivers take time, and the start date is usually when you first request help.
- Document everything, from forms and letters to who you spoke with at Indiana FSSA and when.
- Read every notice. If services are denied, cut or ended, the notice explains how to request a fair hearing and the deadline. Requesting one before the deadline often keeps services in place during the appeal.
- Report changes in income, assets, address or living situation to Indiana FSSA when they happen.
- Expect yearly reviews of both Medicaid eligibility and the care assessment. See Renewals.
- Think about the spouse at home. Couples have extra protections, but they have to be claimed. A certified Medicaid planner or a legal aid office can explain how the rules apply to a particular family.
Common questions
Is CDAC still available? Consumer-directed attendant care continues under the new waivers.
I was on the A&D Waiver. What happened? Participants moved to the waiver matching their age.
What if I turn 60? People who turn 60 move from the Health and Wellness Waiver to the PathWays Waiver.
Related pages
- Indiana Long-Term Care Medicaid guide
- Indiana PathWays for Aging
- Consumer-directed care
- 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.