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Last updated: 14 September 2026
Indiana can pay some family members who care for an older adult, but there is no simple caregiver paycheck that any family can request. The main paid path is through Medicaid home- and community-based services, especially the Indiana PathWays for Aging waiver. The older adult must qualify, the care must be in an approved service plan, and the family caregiver must meet the rules for that service.
Bottom Line
For most Indiana families, start with the local Area Agency on Aging and ask to be screened for the PathWays Medicaid Waiver. Adult children and several other relatives can be paid for certain approved services. A spouse can be paid only under narrower rules. The approved August 2026 PathWays waiver also sets a 40-hour weekly limit for certain hourly services provided by paid relatives or legal guardians.
If the older adult is not on Medicaid yet, ask for Medicaid application help at the same time. For broader help beyond caregiver pay, see the Indiana senior benefits guide.
Need Help Right Now?
If the older adult is unsafe, abused, neglected, or abandoned, call 911 or Indiana Adult Protective Services at 1-800-992-6978. Indiana lists that number on its Adult Protective Services page. If a hospital or nursing-facility discharge is happening now and care at home may fail, tell the local aging agency that this is a transition situation.
Start Here
- Call your local aging agency. Indiana’s AAA directory lists 1-800-713-9023 as the statewide toll-free route. Ask for PathWays waiver screening, CHOICE screening, and caregiver support.
- Apply for Medicaid if needed. Use the Medicaid benefits portal, or ask the aging agency for help with the application.
- Ask which paid model fits. The main choices are agency Attendant Care, Structured Family Caregiving, or INCharge self-direction. The Indiana home care guide explains other ways to cover care if a paid-family route does not fit.
| Situation | Best first route | Key point |
|---|---|---|
| Not on Medicaid | AAA plus Medicaid application | Screen for waiver, CHOICE, and caregiver support together. |
| Adult child lives with senior | Structured Family Caregiving | It is a live-in, agency-supported model. |
| Care is needed in shifts | Attendant Care | Family caregiver rules and hour limits apply. |
| Senior wants hiring control | INCharge self-direction | Spouse and legal guardian cannot be the self-directed worker. |
| Waiver is delayed | CHOICE and caregiver support | These may help while Medicaid waiver services are pending. |
What Has Changed
August 1, 2026 waiver rules are now in effect. The current approved PathWays waiver says paid relatives may provide only certain named services: Attendant Care, Home and Community Assistance, Skilled Respite, Structured Family Caregiving, and Transportation. For a paid relative or legal guardian who is not a spouse, Attendant Care, Home and Community Assistance, and Skilled Respite are limited to 40 total hours per week per paid caregiver. The spouse rule is separate and narrower.
Indiana also reported 11,779 people on the PathWays Medicaid Waiver waiting list as of August 2026. That is a waiver-services waitlist, not a waitlist for the overall PathWays health plan. Indiana also started a temporary statewide moratorium on new HCBS waiver provider certification and enrollment on August 1, 2026. The provider moratorium notice says the initial period is six months. This provider-side rule does not close the waiver to members, but it can affect provider availability.
How Family Caregiver Payment Works in Indiana
Indiana does not normally send a family member a check simply because that person is caring for an older relative. The older adult first needs an approved benefit or waiver service. The caregiver then works through an approved provider agency or, when self-direction is allowed, through the financial management system used by the program.
The main program is Indiana PathWays for Aging, which serves Medicaid members age 60 and older. Paid family care usually depends on the PathWays home- and community-based services waiver, often called the PathWays Waiver. The waiver lets eligible members receive long-term services at home or in a community setting instead of a nursing facility.
The PathWays health plan itself and the PathWays waiver are not the same thing. A person can be enrolled in PathWays Medicaid without having a waiver slot. Indiana’s waiver waitlist page says there were 11,779 people waiting for PathWays waiver services as of August 2026.
Who May Qualify for the PathWays Waiver
For the main paid-family-caregiver route, the older adult generally must be at least 60, qualify for full Indiana Medicaid, meet nursing-facility level-of-care rules, and live in an eligible home or community setting. The PathWays eligibility FAQ explains that functional eligibility usually means needing help with at least three activities of daily living, such as eating, dressing, or toileting, or being unable to manage medical care independently.
Indiana’s current Medicaid eligibility guide lists a special HCBS waiver income standard of $2,982 per month for one person, effective March 1, 2026. It lists a general asset limit of $2,000 for one person or $3,000 for a married couple. Married couples may have additional protections when one spouse stays in the community, so do not assume the simple asset figure is the final result for a married household.
For nursing-facility level-of-care assessments, Indiana uses a statewide Level of Care Assessment Representative. The LCAR process says Maximus is responsible for completing the assessment within seven calendar days and issuing a level-of-care recommendation within 11 calendar days after a request, unless a qualified assessment is already available.
If disability-related programs may also matter, the Indiana disability benefits guide can help you compare other state resources.
Which Family Members Can Be Paid?
The August 2026 waiver is more specific than older Indiana caregiver summaries. It names the relatives who may be paid, including an adult’s parent, grandparent, aunt, uncle, brother, sister, child, grandchild, niece, nephew, and first cousin, including certain step, adoptive, half, and in-law relationships. Payment is still conditional on the approved service, qualifications, and person-centered service plan.
| Caregiver | Possible paid routes | Important limit |
|---|---|---|
| Adult child or other listed relative | Attendant Care, Home and Community Assistance, Skilled Respite, Structured Family Caregiving, Transportation | Hourly ATTC/HCA/Skilled Respite combined are capped at 40 hours weekly per paid relative. |
| Spouse | Attendant Care or Structured Family Caregiving | Must meet extraordinary-care rules; spouse cannot provide participant-directed Attendant Care. |
| Legal guardian | Attendant Care, Structured Family Caregiving, Transportation | Cannot provide participant-directed Attendant Care; service limits apply. |
Spouse rule: Indiana treats a spouse as a legally responsible individual. For Attendant Care, spouse payment requires “extraordinary care,” such as intensive nursing-care needs, and the spouse must work through an approved provider agency. The current waiver caps spouse-provided Attendant Care at 40 hours per week. Indiana’s extraordinary-care bulletin explains the policy and the Form 450B process.
Main Paid Caregiver Options
Attendant Care
What it helps with: Hands-on, non-skilled help such as bathing, dressing, toileting, mobility, meals, safety, and related household tasks when they are part of the approved service plan.
Who may provide it: A qualified agency worker can be a family member when the waiver’s relationship and service rules are met. A spouse may provide agency-based Attendant Care only under the extraordinary-care rule. A spouse or legal guardian cannot be the self-directed Attendant Care worker.
Reality check: For non-spouse paid relatives, the current waiver limits the combined total of Attendant Care, Home and Community Assistance, and Skilled Respite to 40 hours per week per paid relative caregiver. The plan may authorize other care from other qualified workers when medically and functionally necessary.
Structured Family Caregiving
What it helps with: Daily live-in support when the older adult and principal caregiver share a private home. It can include personal care, homemaker help, companion care, medication oversight allowed by law, and other approved support.
Who may provide it: A qualified relative may be the principal caregiver. A spouse can also be the principal caregiver when the spouse meets the waiver’s extraordinary-care and provider rules.
Reality check: Structured Family Caregiving is an agency service with three need levels. It is not an hourly wage arrangement. The agency must support the caregiver, monitor the plan, and provide backup caregiver coverage. Families considering live-in care may also want the respite care guide for relief options.
INCharge Self-Directed Services
What it helps with: Self-direction gives the PathWays member more control over hiring, scheduling, and supervising workers. PathWays allows self-direction for Attendant Care, Respite, and Home & Community Assistance.
Who may provide it: Indiana’s self-direction page says a worker can be a family member, friend, or other trusted person if qualified. A spouse or legal guardian cannot be hired as the self-directed worker. Workers must be at least 18, pass a background check, and complete required training.
Reality check: The member or unpaid representative takes on employer-style duties. A financial management vendor handles payroll and taxes, but the family still needs a backup plan and must follow the service budget.
How Much Is the Caregiver Paid?
There is no single statewide take-home wage for every Indiana family caregiver. Agency wages and Structured Family Caregiving stipends can vary. Self-directed wages must fit within the member’s approved budget and allowed wage range.
Indiana’s caregiver passthrough rule requires providers to devote at least 70% of Attendant Care reimbursement to direct-service compensation-related costs and 60% of Structured Family Caregiving per diem reimbursement to caregiver stipends or related caregiver costs. Those percentages are not the caregiver’s guaranteed take-home share because payroll taxes, benefits, and other allowed direct-care costs can be included.
How to Start Without Wasting Time
- Call the aging network. Use 1-800-713-9023 or the INconnect location finder. Say you want screening for the PathWays Waiver, CHOICE, and caregiver support.
- Apply for Medicaid. Do not wait for the waiver invitation if Medicaid eligibility is still unresolved.
- Complete the level-of-care process. Keep medical contacts and a list of daily care needs ready for the assessment.
- Ask about the best service. Say: “Should this care be Attendant Care, Structured Family Caregiving, or self-directed care?”
- Confirm the caregiver relationship. Tell the service coordinator whether the proposed worker is a spouse, adult child, legal guardian, or another relative. Different rules apply.
- Confirm the provider and pay. Ask the agency or financial management service for the wage or stipend, training, background-check, timesheet, tax, and start-date rules before you rely on the income.
Documents and Information to Prepare
| Item | Why it helps |
|---|---|
| ID and Indiana address | Confirms identity and residence. |
| Medicaid and Medicare cards | Shows current coverage and member numbers. |
| Income and asset records | Needed for Medicaid financial review. |
| Medical and medication list | Supports level-of-care assessment. |
| Daily care log | Shows help needed with bathing, dressing, transfers, meals, supervision, and safety. |
| Caregiver relationship papers | Important when the caregiver is a spouse, legal guardian, or holds power of attorney. |
Reality Checks
- The waiver can have a long wait. Indiana reported 11,779 people waiting in August 2026. The list changes as invitations are sent and people enter or leave the process.
- Invitation deadlines matter. The waiver invitation rule gives invitees 30 days to accept and 180 days from the invitation date to complete required enrollment steps. If the invitation is rescinded, the person is not automatically put back on the waiting list.
- Provider availability can vary. A family may qualify but still have trouble finding an agency that serves the county, takes the health plan, and will hire the chosen relative.
- Pay is not guaranteed. The service plan decides what care is authorized. The agency or self-directed budget determines what can be paid.
- Medicare alone is not enough. Medicare can cover limited home health in certain situations, but it does not generally pay a family member for long-term daily personal care.
Common Mistakes to Avoid
- Assuming PathWays enrollment automatically means a waiver slot.
- Using old caregiver rules from before the August 2026 waiver amendment.
- Assuming a spouse can use self-direction as the paid worker.
- Counting on more than 40 weekly hours for one paid relative across Attendant Care, Home and Community Assistance, and Skilled Respite.
- Waiting to apply for Medicaid until after a waiver invitation arrives.
- Accepting a caregiver job without asking about wage, stipend, taxes, training, schedule, and backup care.
Denied, Delayed, or Stuck?
Keep every written notice. If a service is denied, reduced, or stopped, the notice should explain the appeal route and deadline. Call the health plan first, then use Member Support Services at 1-877-738-3511 if the problem remains unresolved.
If the person is on the waiver waitlist, keep the mailing address and phone number current. If the need becomes urgent because of a hospital discharge, nursing-facility transition, or serious safety risk, tell the AAA because Indiana uses priority categories for some waiver invitations. For immediate household crises, the Indiana emergency help guide covers food, housing, utility, and other urgent routes.
Backup Options While You Wait
CHOICE
Indiana’s CHOICE program provides state-funded home and community services through Area Agencies on Aging. It is not mainly a family-wage program, but it can help with attendant care, respite, homemaker help, transportation, meals, and other supports. Indiana says CHOICE has no income limit, but it uses cost sharing and has an asset rule.
Family Caregiver Program
The Family Caregiver Program can provide respite, counseling, training, support, and resource help. It generally supports unpaid caregivers rather than creating a wage. Ask the local AAA about it when the waiver is not ready.
Other household support
Caregiver pay may take months or may not fit the family. If the household also needs help with housing, use the Indiana housing help guide. If Medicare premiums or cost sharing are draining the budget, check Indiana Medicare Savings Programs.
Phone Scripts You Can Use
Calling the AAA
“I am helping an Indiana resident age 60 or older who needs daily care at home. We want to know whether a family member can be paid. Can you screen for the PathWays Waiver, CHOICE, Medicaid help, and caregiver support?”
Calling the health plan
“This person is in PathWays and needs help at home. Can a service coordinator review Attendant Care, Structured Family Caregiving, and self-direction, and tell us which option fits the approved needs?”
Asking about spouse payment
“I am the spouse caregiver. Does this case meet the extraordinary-care rule for Attendant Care or Structured Family Caregiving? What documentation is needed, and which approved provider can hire me?”
Asking about pay
“Before I accept this caregiver role, what is the wage or stipend, how are taxes handled, what training is required, and what happens if the approved hours change?”
Useful Indiana Contacts
- INconnect / local AAA: 1-800-713-9023.
- PathWays Enrollment Broker: 1-877-284-9294.
- Member Support Services: 1-877-738-3511.
- Adult Protective Services: 1-800-992-6978.
- Long-Term Care Ombudsman: 1-800-622-4484.
If caring duties are causing burnout, the Indiana aging agencies guide can help you find the county-level office and ask about respite, meals, transportation, and caregiver support.
Resumen en Español
En Indiana, algunos familiares pueden recibir pago por cuidar a una persona mayor, pero normalmente el pago depende de Medicaid y del PathWays Waiver. La persona mayor debe cumplir con las reglas financieras y de nivel de cuidado. Los hijos adultos y otros familiares pueden ser trabajadores pagados en ciertos servicios. Un cónyuge tiene reglas más estrictas y no puede ser el trabajador pagado bajo la opción de autogestión.
Desde el 1 de agosto de 2026, el waiver actual limita ciertos servicios por hora a 40 horas por semana por cada familiar pagado. La mejor primera llamada suele ser al Area Agency on Aging / INconnect al 1-800-713-9023. Si la persona ya está en PathWays y el caso está detenido, llame a Member Support Services al 1-877-738-3511.
Frequently Asked Questions
Can a family member get paid to care for a senior in Indiana?
Yes, in some cases. The main path is the Indiana PathWays for Aging Medicaid waiver. The older adult must meet Medicaid and nursing-facility level-of-care rules, and the approved service plan must allow a service that can be provided by a paid relative.
Can an adult child be paid to care for a parent?
Often, yes. The current PathWays waiver lists an adult child as a relative who may be paid for certain approved waiver services. The caregiver must meet provider or worker requirements, and hourly services can be subject to the 40-hour family-caregiver limit.
Can a spouse be paid as the caregiver?
Sometimes. A spouse may be paid for Attendant Care or Structured Family Caregiving only when the waiver’s legally responsible individual rules are met. Spouse-provided Attendant Care must be extraordinary care, cannot be participant-directed, and is capped at 40 hours per week.
Can a spouse use INCharge self-direction?
A PathWays member may use INCharge self-direction for allowed services, but a spouse or legal guardian cannot be hired as the self-directed worker. Another qualified relative may be hired when the waiver and self-direction rules allow it.
How much does Indiana pay a family caregiver?
Indiana does not publish one statewide take-home wage for every family caregiver. Pay depends on the approved service, the provider or self-directed budget, the caregiver’s role, and the service plan. Ask for the exact wage or stipend before accepting the arrangement.
Is there a PathWays waiver waitlist?
Yes. Indiana reported 11,779 people on the PathWays Medicaid Waiver waiting list as of August 2026. The waitlist is for waiver services, not for the overall PathWays Medicaid managed-care program.
What is the best first call?
If the older adult is not already receiving waiver services, call the local Area Agency on Aging or INconnect at 1-800-713-9023. Ask for PathWays waiver screening, Medicaid help, CHOICE screening, and caregiver support.
About This Guide
Sources: This guide uses official federal, state, local, and other high-trust nonprofit and community sources linked in the article.
Editorial note
This guide is produced under the GFS Editorial Standards using official and other high-trust sources. GFS is not affiliated with a government agency and is not a substitute for official agency guidance. Individual eligibility outcomes cannot be guaranteed.
Corrections
Despite careful verification, errors may occur. Readers may email info@grantsforseniors.org with corrections.
Disclaimer
This article is for informational purposes only and is not legal, financial, medical, tax, disability-rights, immigration, or government-agency advice. Program rules, policies, funding, and availability can change. Readers should confirm current details directly with the responsible official program before acting.
Last updated: 14 September 2026 · Next review: 14 January 2027
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