Indiana Medicaid Long-Term Care

Last updated: August 21, 2026 Jurisdiction: Indiana

Indiana's long-term-care Medicaid structure

Indiana Medicaid is administered through the Family and Social Services Administration, with the Office of Medicaid Policy and Planning responsible for Medicaid policy (Indiana FSSA OMPP). For older adults, Indiana PathWays for Aging is the statewide managed long-term-services-and-supports program. CMS lists the PathWays waiver as effective July 1, 2024 and approved through June 30, 2029 (CMS PathWays waiver record).

PathWays is the current program framework for Medicaid members age 60 and older who need nursing-facility care or home- and community-based services. Its arrival does not erase the separate financial and clinical eligibility questions: a person still needs the applicable Medicaid category and level of care (Indiana Medicaid long-term-care guidance; PathWays program summary).

Nursing facilities and care in the community

Indiana Health Coverage Programs reimburses Medicaid-certified nursing facilities for eligible members with an applicable level-of-care determination. The state describes PASRR as part of the process for applicants to Medicaid-certified nursing facilities (Indiana long-term-care provider page; Indiana PASRR guidance).

Home care is not simply a lesser nursing-home benefit. PathWays HCBS can be delivered in a member's home, a loved one's home, adult family care, or assisted living, subject to the person's approved service plan and waiver availability (PathWays HCBS overview). Indiana's official waiting-list notice confirms that waiver capacity is federally approved and that invitations from PathWays and Health and Wellness waiting lists depend on remaining capacity (FSSA HCBS waiting-list information).

How to use the program names correctly

Families should distinguish Medicaid eligibility from plan enrollment and service authorization. PathWays coordinates coverage, but it does not make a financial overage disappear or turn a nonqualifying clinical situation into nursing-facility eligibility. For a person age 60 or older, it is sensible to ask first whether the needed setting is a nursing facility or HCBS, then ask the local assessment contact about level of care and whether a waiver opening is available (FSSA Level of Care Assessment Representative; FSSA PathWays waiting-list process).

For applications, families should separate the clinical record from the financial record. FSSA and the managed-care plan may need different information, and a service coordinator cannot give legal advice about a trust, deed, or transfer. Written notices and deadlines should be retained for any appeal or reconsideration (Indiana long-term-care guidance).

Program takeaway: PathWays for Aging is Indiana's managed LTSS structure for many adults 60 and older, while nursing-facility eligibility, HCBS capacity, financial eligibility, and level-of-care review remain separate decisions (CMS).

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Indiana's long-term-care Medicaid structure

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