Indiana PathWays for Aging Home Care Guide

What PathWays for Aging is

Indiana PathWays for Aging (often shortened to PathWays) is a Medicaid managed care program for many Hoosiers age 60 and older who receive full-coverage Medicaid based on age, blindness, or disability—with or without Medicare. The Family and Social Services Administration (FSSA) launched PathWays to help older adults get coordinated medical care and long-term supports so more people can age at home instead of in a nursing facility.

PathWays is operated through managed care entities (MCEs)—health plans that coordinate care. Official PathWays materials have listed Anthem, Humana, and UnitedHealthcare as PathWays plans. Always confirm the current plan list and your enrollment options on in.gov/pathways or with Medicaid member services, because plan participation can change.

Who is eligible for PathWays

According to FSSA PathWays eligibility pages, PathWays is for Indiana Medicaid members who are:

• 60 years of age and older
• Eligible for a full-coverage aged, blind, or disabled Medicaid category (with or without Medicare)
• May be living in a nursing or long-term care facility, approved for HCBS waiver services, or in related long-term support situations described by the state

Who is not eligible

Official PathWays materials state that members who are not eligible include people under age 60; Healthy Indiana Plan (HIP) or Hoosier Healthwise members of any age; certain DDRS waiver members (such as Family Supports, Community Integration and Habilitation, and Traumatic Brain Injury waivers); room-and-board-only situations; End Stage Renal Disease waiver members; certain breast and cervical cancer category members; residents in intermediate care facilities for intellectual/developmental disabilities; and members limited to emergency services only due to citizenship status.

If you are unsure which Medicaid category you (or your loved one) are in, ask your caseworker, health plan, or AAA rather than guessing from a card alone.

PathWays program vs. PathWays Waiver

This distinction confuses many families. PathWays the managed care program coordinates medical and long-term services for eligible members 60+. Separately, the Indiana PathWays for Aging Waiver is the home- and community-based services (HCBS) waiver that can authorize services such as attendant care, home and community assistance, respite, adult day services, home modifications, and other supports listed by the state.

You can be enrolled in PathWays without currently receiving waiver services. Waiver services require meeting nursing facility level of care, Medicaid eligibility compatible with the waiver, an approved service plan, and an available waiver slot. FSSA has published that there is no waiting list for the overall PathWays for Aging managed care program itself—but there can be a waiting list for PathWays Waiver services when capacity is full.

Services families often look for

When someone is approved for PathWays Waiver services, authorized services may include (among others published by Indiana Medicaid): attendant care, home and community assistance, respite care, adult day service, home-delivered meals, home modifications, personal emergency response systems, transportation, structured family caregiving, and related supports. The member’s case manager / care coordinator helps identify needs; the state must approve the service plan.

Service definitions and provider rules are detailed in FSSA/OMPP provider modules. Families should ask which services are on the current plan of care—not assume every listed service is automatically available.

How to get started

For older adults who may need home care paid by Medicaid, a practical path looks like this:

• Contact your local Area Agency on Aging for Options Counseling and waiver screening (statewide locator 800-713-9023).
• Apply for or confirm full-coverage Medicaid eligibility through official FSSA channels.
• Ask whether you should enroll in / are already in PathWays for Aging.
• Complete nursing facility level-of-care assessment steps as directed (processes can involve the AAA, Maximus, or the MCE depending on status—confirm locally).
• If invited from a waiting list, respond by the deadline stated in your notice (FSSA has used time-limited invitation and completion windows; confirm current deadlines with your AAA or plan).
• Work with your care coordinator on a service plan and choose certified providers.

Working with a home care agency under PathWays

Even when Medicaid will pay, families still choose among certified providers and schedule caregivers. Ask agencies whether they are enrolled/certified for the specific PathWays Waiver services you need, what counties they cover, and how they handle weekends, call-offs, and dementia care.

This site can help you get matched with agencies that serve your county. Eligibility decisions still rest with FSSA, your MCE, and your case manager—not with us.

Frequently asked questions