Indiana Medicaid HCBS waivers (home and community-based services) pay for long-term care through two Medicaid programs, the PathWays for Aging Waiver and the Health and Wellness Waiver.Centers for Medicare & Medicaid Services. (n.d.). IN PathWays for Aging Waiver (2407.R00.00) — Medicaid.gov (CMS). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/165531 Both are 1915(c) HCBS waivers, a federal Medicaid authority that lets a state pay for care outside an institution for people who meet a nursing-facility level of need, and both are run by the Indiana Family and Social Services Administration (FSSA). The PathWays for Aging Waiver serves people 60 and older, and the Health and Wellness Waiver serves people 59 and younger. The PathWays for Aging and Health and Wellness waivers replaced Indiana's former Aged and Disabled Waiver on July 1, 2024, splitting that one program into two so the office serving working-age adults and the office serving older adults each runs its own waiver.Centers for Medicare & Medicaid Services. (n.d.). IN PathWays for Aging Waiver (2407.R00.00) — Medicaid.gov (CMS). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/165531 If you are helping a parent stay at home instead of moving to a nursing facility, one of these two waivers is almost certainly the door you are looking for.
In This Guide
- What Indiana Medicaid HCBS Waivers Are
- The Two Programs: PathWays for Aging and Health and Wellness
- Who Qualifies for Indiana Medicaid HCBS Waivers
- What These Waivers Cover
- How Enrollment Works Through the Area Agencies on Aging
- How to Apply
What Indiana Medicaid HCBS Waivers Are
Home and community-based services are the long-term supports Medicaid pays for outside of an institution: help in your own home, a family member's home, or a community setting, rather than in a nursing facility. Federal Medicaid law lets a state deliver these supports through a 1915(c) waiver, which "waives" the usual rule that long-term care be provided in an institution and lets the state cover community care instead. The core idea behind every 1915(c) waiver is the same: it serves people who would otherwise need nursing-facility care but can be safely supported at home for a comparable cost.Centers for Medicare & Medicaid Services. (n.d.). IN PathWays for Aging Waiver (2407.R00.00) — Medicaid.gov (CMS). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/165531
Indiana used to run a single program for this population, the Aged and Disabled Waiver. On July 1, 2024, the state split it into two waivers divided by age, so that each of the two FSSA offices that serve these groups administers its own program.Centers for Medicare & Medicaid Services. (n.d.). IN PathWays for Aging Waiver (2407.R00.00) — Medicaid.gov (CMS). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/165531 The waiver for older adults, the PathWays for Aging Waiver, is a 1915(c) authority approved by the federal Centers for Medicare & Medicaid Services (CMS), carrying CMS waiver number IN 2407.R00.00, effective July 1, 2024 through June 30, 2029. It is delivered through Indiana's PathWays managed long-term services and supports program, which operates under concurrent 1915(b)(1) and 1915(b)(4) managed-care authority, meaning eligible members receive their waiver services through a managed-care plan.Centers for Medicare & Medicaid Services. (n.d.). IN PathWays for Aging Waiver (2407.R00.00) — Medicaid.gov (CMS). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/165531
The Two Programs: PathWays for Aging and Health and Wellness
The line between the two waivers is age, and it decides which FSSA office you deal with and how services reach you.
The PathWays for Aging Waiver serves adults age 65 or older, plus adults with physical or other disabilities ages 60 to 64, who meet a nursing-facility level of care. It is administered by the FSSA Office of Medicaid Policy and Planning and delivered through the PathWays managed long-term services and supports program.Centers for Medicare & Medicaid Services. (n.d.). IN PathWays for Aging Waiver (2407.R00.00) — Medicaid.gov (CMS). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/165531
The Health and Wellness Waiver serves people ages 0 to 59 who meet that same nursing-facility level of care. It is administered by the FSSA Division of Disability and Rehabilitative Services.Centers for Medicare & Medicaid Services. (n.d.). IN PathWays for Aging Waiver (2407.R00.00) — Medicaid.gov (CMS). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/165531
| Feature | PathWays for Aging Waiver | Health and Wellness Waiver |
|---|---|---|
| Who it serves | Adults 65 and older, and adults with physical or other disabilities ages 60 to 64 | People ages 0 to 59 |
| Administered by | FSSA Office of Medicaid Policy and Planning | FSSA Division of Disability and Rehabilitative Services |
| Level of care | Nursing-facility level of care | Nursing-facility level of care |
| Federal authority | 1915(c) waiver (CMS IN 2407.R00.00), with concurrent 1915(b)(1) and 1915(b)(4) managed-care authority | 1915(c) waiver |
For most families reading this for an aging parent, the PathWays for Aging Waiver is the relevant program.Centers for Medicare & Medicaid Services. (n.d.). IN PathWays for Aging Waiver (2407.R00.00) — Medicaid.gov (CMS). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/165531 The Health and Wellness Waiver matters when the person needing care is younger than 60.
Who Qualifies for Indiana Medicaid HCBS Waivers
Eligibility for either waiver rests on two separate tests, a functional one and a financial one, and you have to clear both.
The functional test is a nursing-facility level of care. To qualify, a person must be aged, blind, or otherwise disabled, live in a non-institutional setting that complies with federal HCBS rules, and need the kind of daily care a nursing facility would provide.Centers for Medicare & Medicaid Services. (n.d.). IN PathWays for Aging Waiver (2407.R00.00) — Medicaid.gov (CMS). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/165531 This level-of-care determination is made at the front door by your local Area Agency on Aging, not by you or your doctor alone.
The financial test ties the waiver to Medicaid eligibility. Income must be no greater than 300% of the maximum federal Supplemental Security Income (SSI) amount, and the applicant must also qualify for Medicaid under the state's other rules.Centers for Medicare & Medicaid Services. (n.d.). IN PathWays for Aging Waiver (2407.R00.00) — Medicaid.gov (CMS). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/165531 Because the exact dollar figures and the countable-asset rules change each year, confirm the current numbers before you plan around them; our guide to Indiana Medicaid income and asset limits walks through the amounts that apply now.
What These Waivers Cover
The point of a waiver is to fund the specific supports that let someone stay home instead of moving to a facility. Authorized waiver services include attendant care, adult day service, assisted living, home-delivered meals, home modifications, respite care, structured family caregiving, personal emergency response systems, specialized medical equipment and supplies, and transportation.Centers for Medicare & Medicaid Services. (n.d.). IN PathWays for Aging Waiver (2407.R00.00) — Medicaid.gov (CMS). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/165531 You do not receive all of these automatically. A case manager works with the member to identify the specific services that meet that person's needs and writes them into a plan of care.Centers for Medicare & Medicaid Services. (n.d.). IN PathWays for Aging Waiver (2407.R00.00) — Medicaid.gov (CMS). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/165531
Two of these matter to a lot of families. Structured family caregiving lets a live-in family member be paid, through a state-contracted provider agency, for providing the person's daily care in the home.State of Indiana. (n.d.). Indiana PathWays for Aging: Members and Caregivers. in.gov. Retrieved Jul 13, 2026, from https://www.in.gov/pathways/members-and-caregivers/ Home modifications can cover changes to the home, such as ramps or bathroom safety equipment, that make staying there workable. If either fits your situation, raise it with the case manager when the plan of care is built.
How Enrollment Works Through the Area Agencies on Aging
Indiana routes waiver access through its network of Area Agencies on Aging. Indiana has 16 Area Agencies on Aging, and the one covering your county is where the process begins: the agency makes the initial level-of-care determination that decides functional eligibility.Centers for Medicare & Medicaid Services. (n.d.). IN PathWays for Aging Waiver (2407.R00.00) — Medicaid.gov (CMS). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/165531 Alongside that determination, the applicant must also apply for Medicaid itself, since waiver services are only available to people who qualify for the program.Centers for Medicare & Medicaid Services. (n.d.). IN PathWays for Aging Waiver (2407.R00.00) — Medicaid.gov (CMS). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/165531
Because capacity, timing, and any enrollment steps specific to your county can change, ask your Area Agency on Aging directly what to expect after the level-of-care screen and how enrollment proceeds from there. They handle this every day and can tell you where you stand.
How to Apply
There are two things to do, and it is fine to start them at the same time.
First, contact your local Area Agency on Aging for the level-of-care screen. The agency serving your county performs the assessment that establishes whether you meet the nursing-facility level of care the waiver requires.Centers for Medicare & Medicaid Services. (n.d.). IN PathWays for Aging Waiver (2407.R00.00) — Medicaid.gov (CMS). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/165531
Second, apply for Indiana Medicaid through the FSSA. Federal rules require the state to let you apply through several channels: online through the state's benefits portal, by phone, by mail, or in person at a local office.U.S. Government Publishing Office. (n.d.). 42 CFR 435.907 — Application (eCFR, current). ecfr.gov. Retrieved Jul 13, 2026, from https://www.ecfr.gov/current/title-42/section-435.907 Our step-by-step guide to applying for Indiana Medicaid covers the documents and the portal in detail.
Once your Medicaid application is in, federal timeliness rules set the outer limit on how long the state can take to decide it: no more than 45 calendar days for most applicants, and up to 90 calendar days when you apply on the basis of disability.U.S. Government Publishing Office. (2024). 42 CFR 435.912 Timely determination and redetermination of eligibility (2024 ed.) — govinfo.gov. govinfo.gov. Retrieved Jun 25, 2026, from https://www.govinfo.gov/content/pkg/CFR-2024-title42-vol4/pdf/CFR-2024-title42-vol4-sec435-912.pdf Those are ceilings, not typical waits, but they tell you when to follow up if you have not heard back.
Frequently Asked Questions
Do PathWays for Aging Waiver services come through a managed-care plan?
For the PathWays for Aging Waiver, yes. Indiana delivers that waiver through its PathWays managed long-term services and supports program, which operates under concurrent 1915(b)(1) and 1915(b)(4) managed-care authority, so enrolled members receive their waiver services through a managed-care plan.Centers for Medicare & Medicaid Services. (n.d.). IN PathWays for Aging Waiver (2407.R00.00) — Medicaid.gov (CMS). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/165531 The Health and Wellness Waiver is administered separately, by the FSSA Division of Disability and Rehabilitative Services.
Can a family member be paid to help under these waivers?
Yes, through structured family caregiving. Under this waiver service, a live-in family member can be paid, through a state-contracted provider agency, for providing the person's daily care at home.State of Indiana. (n.d.). Indiana PathWays for Aging: Members and Caregivers. in.gov. Retrieved Jul 13, 2026, from https://www.in.gov/pathways/members-and-caregivers/ It is one of the authorized waiver services a case manager can include in a member's plan of care.Centers for Medicare & Medicaid Services. (n.d.). IN PathWays for Aging Waiver (2407.R00.00) — Medicaid.gov (CMS). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/165531 If this is what your family is hoping for, ask the case manager how structured family caregiving works when your plan of care is developed.
Do these waivers pay for nursing home care?
No. These are home and community-based waivers, designed as an alternative to nursing-facility care for people who could otherwise need it but prefer to stay in their home or community.Centers for Medicare & Medicaid Services. (n.d.). IN PathWays for Aging Waiver (2407.R00.00) — Medicaid.gov (CMS). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/165531 If you are looking at nursing-home coverage instead, see our guide to Indiana Medicaid and nursing home care.
Do I have to qualify for Medicaid to use one of these waivers?
Yes. These are Medicaid waivers, so their services are only available to people who qualify for Indiana Medicaid. You must apply for and be found eligible for Medicaid in addition to meeting the nursing-facility level of care the waiver requires.Centers for Medicare & Medicaid Services. (n.d.). IN PathWays for Aging Waiver (2407.R00.00) — Medicaid.gov (CMS). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/165531 That is why the process has two parts: the level-of-care screen through your Area Agency on Aging, and a separate Medicaid application.
Learn More
To get started, contact your local Area Agency on Aging for a level-of-care screen and apply for Indiana Medicaid through the FSSA. Find personalized help understanding Indiana Medicaid HCBS waivers at brevy.com.
The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.