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 the Level-of-Care Assessment Works
- 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 both of Indiana's waivers is the same: each is an alternative to nursing-facility care for people who meet a nursing-facility level 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
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. 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. Under Indiana's waiver-eligibility criteria, a person must be aged, blind, or otherwise disabled, reside in (or be transitioning into) an HCBS-compliant, non-institutional setting, 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 That "transitioning into" branch matters: someone currently in a nursing facility is not shut out, because moving out of an institution into a qualifying home or community setting is an explicit eligibility path.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 Since July 1, 2025, Maximus, the state's Level of Care Assessment Representative (LCAR) contractor, has conducted that assessment and made the determination, with FSSA doing a final review.State of Indiana. (2025). Indiana Health Coverage Programs bulletin BT202573 — FSSA announces launch of Indiana Level of Care Representative (May 27, 2025). in.gov. Retrieved Oct 15, 2026, from https://www.in.gov/medicaid/providers/files/bulletins/BT202573.pdf
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 may 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. The member's case manager identifies the specific services that meet that person's needs, and the state agency then submits those services for approval and lists them on the 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
Two of these matter to a lot of families. Structured family caregiving lets a caregiver who lives in the home, such as a family member, be paid, through a certified provider agency, for providing the person's daily care and support.Centers for Medicare & Medicaid Services. (1915). Medicaid.gov - Indiana 1915(c) waiver descriptions (CMS-approved services, population and level of care). medicaid.gov. Retrieved Sep 6, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/IN Home modifications can cover changes to the home that make staying there workable. If either fits your situation, raise it with the case manager when the plan of care is built.
How the Level-of-Care Assessment Works
Indiana used to have your local Area Agency on Aging assess a waiver applicant's level of care. Since July 1, 2025, Maximus, as the state's LCAR contractor, conducts nursing facility level-of-care assessments and makes the determinations for the Health and Wellness, PathWays and TBI waivers; FSSA does a final review of every recommendation, and Area Agencies on Aging no longer assess individuals for it.State of Indiana. (2025). Indiana Health Coverage Programs bulletin BT202573 — FSSA announces launch of Indiana Level of Care Representative (May 27, 2025). in.gov. Retrieved Oct 15, 2026, from https://www.in.gov/medicaid/providers/files/bulletins/BT202573.pdf
If you are Medicaid-eligible, not enrolled in PathWays and seeking new waiver services, you or an assisting entity such as an Area Agency on Aging can request the assessment online or by phone from Maximus LCAR at 1-833-597-2777. Trained Maximus evaluators meet you virtually or in person, and you receive the determination by mail. Maximus is responsible for assessing within 7 calendar days and issuing a recommendation within 11 calendar days of the request, unless it receives a completed assessment from a qualified entity. If you are already a PathWays member, your health plan (managed care entity) does the assessment and the LCAR makes a determination recommendation from its results.State of Indiana. (n.d.). Indiana FSSA DDARS — IN Level of Care Assessment Representative (LCAR) page and FAQ. in.gov. Retrieved Oct 14, 2026, from https://www.in.gov/fssa/ddars/in-level-of-care-assessment-representative Indiana has 16 Area Agencies on Aging, and yours can still help with a referral to the LCAR.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,State of Indiana. (n.d.). Indiana FSSA DDARS — IN Level of Care Assessment Representative (LCAR) page and FAQ. in.gov. Retrieved Oct 14, 2026, from https://www.in.gov/fssa/ddars/in-level-of-care-assessment-representative 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
If you do not meet the level of care, the LCAR refers you to Area Agencies on Aging for alternative services or resources, as available.State of Indiana. (n.d.). Indiana FSSA DDARS — IN Level of Care Assessment Representative (LCAR) page and FAQ. in.gov. Retrieved Oct 14, 2026, from https://www.in.gov/fssa/ddars/in-level-of-care-assessment-representative Because capacity and enrollment steps can change, ask Maximus LCAR or your Area Agency on Aging what to expect after the assessment and how enrollment proceeds from there.
How to Apply
There are two things to do, and it is fine to start them at the same time.
First, request the nursing-facility level-of-care assessment: call Maximus LCAR at 1-833-597-2777, or ask your local Area Agency on Aging or Aging and Disability Resource Center for help with a referral.State of Indiana. (n.d.). Indiana FSSA DDARS — IN Level of Care Assessment Representative (LCAR) page and FAQ. in.gov. Retrieved Oct 14, 2026, from https://www.in.gov/fssa/ddars/in-level-of-care-assessment-representative That assessment establishes whether you meet the nursing-facility level of care the waiver requires.State of Indiana. (2025). Indiana Health Coverage Programs bulletin BT202573 — FSSA announces launch of Indiana Level of Care Representative (May 27, 2025). in.gov. Retrieved Oct 15, 2026, from https://www.in.gov/medicaid/providers/files/bulletins/BT202573.pdf
Second, apply for Indiana Medicaid through the FSSA. Federal rules require the state to let you apply through several channels: online, by phone, by mail, in person, or through other commonly available electronic means.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 days for most applicants, and up to 90 days when you apply on the basis of disability.U.S. Government Publishing Office. (2026). 42 CFR 435.912(c)(3) — Timely determination of eligibility (eCFR current text, as revised eff. July 31, 2026). ecfr.gov. Retrieved Aug 7, 2026, from https://www.ecfr.gov/current/title-42/section-435.912 Those are ceilings on the agency, not typical waits and not a guarantee your decision arrives by that date, 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 family member (or a nonfamily caregiver) who lives in the home can be paid, through a certified provider agency, for providing the person's daily care at home.Centers for Medicare & Medicaid Services. (1915). Medicaid.gov - Indiana 1915(c) waiver descriptions (CMS-approved services, population and level of care). medicaid.gov. Retrieved Sep 6, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/IN It is one of the authorized waiver services a case manager can identify for 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 assessment through Maximus LCAR, and a separate Medicaid application.State of Indiana. (2025). Indiana Health Coverage Programs bulletin BT202573 — FSSA announces launch of Indiana Level of Care Representative (May 27, 2025). in.gov. Retrieved Oct 15, 2026, from https://www.in.gov/medicaid/providers/files/bulletins/BT202573.pdf
Learn More
To get started, request a level-of-care assessment from Maximus LCAR or through your local Area Agency on Aging, 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.
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