Paid Family Caregiver Programs in Indiana

Last updated: 6 April 2026

Bottom line: Indiana does not have a simple state cash program that pays any family caregiver on request. For most older adults, the real paid-family-caregiver path runs through Indiana PathWays for Aging and the PathWays Medicaid Waiver service list, which includes Attendant Care and Structured Family Caregiving. Adult children and other relatives often qualify. A spouse may qualify only in limited cases under the PathWays waiver amendment effective 31 December 2025, and spouses still cannot be hired as self-directed workers under INCharge Self-Directed Services. As of March 2026, the PathWays Waiver waiting list stood at 12,075 people, even though the overall PathWays health program itself does not have a separate waitlist.

Emergency help now

1. If the senior is unsafe, abused, neglected, or abandoned, call 911 or Indiana Adult Protective Services at 800-992-6978.
2. If a hospital discharge or nursing-home return home is happening now and care will fall apart, call your local Area Agency on Aging right away and say it is a hospital or nursing-facility transition.
3. If the person is already in PathWays and services stopped or were denied, call the plan and Member Support Services at 877-738-3511 the same day.

Quick help box

If this sounds like you	Do this first	Best contact
You are not on Medicaid or the waiver yet	Ask for PathWays waiver screening, CHOICE screening, and Medicaid application help.	INconnect / local AAA: 800-713-9023
You are already age 60+ and on Medicaid	Confirm or choose your PathWays health plan and ask how to reach your service coordinator.	87-PATHWAY-4 (877-284-9294)
Your case is stuck, denied, or the plan is not helping	Ask for member support and appeal guidance right away.	Member Support Services: 877-738-3511

What this help actually looks like in Indiana

For seniors in Indiana, paid family caregiving usually comes through Medicaid home care, not a stand-alone caregiver paycheck. In practice, there are three main paths for older adults:

• Agency-based Attendant Care under the PathWays Waiver.
• Structured Family Caregiving, which is a live-in caregiving model under the same waiver.
• Self-directed services through Indiana’s INCharge Self-Directed Services, where the older adult directs the worker and a payroll vendor handles the paperwork.

That is the real Indiana picture in 2026. If a senior does not have Medicaid, does not meet nursing-facility level of care, or is still waiting for a waiver slot, the state’s backup options are usually CHOICE and the Older Americans Act Family Caregiver Program. Those can help a lot, but they usually do not pay a family member a wage.

Quick facts

• PathWays is Indiana’s Medicaid managed care program for people age 60 and older.
• The PathWays Waiver service list includes Attendant Care, Structured Family Caregiving, respite, transportation, home modifications, and more.
• Maximus, Indiana’s Level of Care Assessment Representative, handles PathWays waiver level-of-care determinations and says they are typically issued within 11 calendar days of a request.
• Indiana’s March 1, 2026 Medicaid guide lists a special HCBS-waiver income standard of $2,982 a month for one person, plus an asset test of $2,000 single or $3,000 married.
• The PathWays Waiver has a waiting list, and Indiana says hospital discharges, nursing-facility transitions, and CHOICE transitions get priority monthly invitations.
• The three PathWays health plans are Anthem, Humana, and UnitedHealthcare.

Who qualifies

To reach Indiana’s main paid-family-caregiver options, the older adult usually must be age 60 or older and in PathWays, have full Medicaid, meet nursing facility level of care, and live in or move into an HCBS-compliant home or community setting.

For money rules, Indiana’s waiver page says the HCBS waiver income limit is 300% of the maximum SSI amount. The March 1, 2026 eligibility guide lists that special waiver standard at $2,982 a month for one person. The same guide lists the asset test at $2,000 for one person and $3,000 for a married couple, while excluding a home you live in, one vehicle, and burial spaces.

For care needs, Indiana says functional eligibility generally means help with at least three activities of daily living, such as eating, dressing, or toileting, or being unable to care for yourself medically. That level-of-care review is now done through Indiana’s LCAR process.

Which relatives can be paid in Indiana?

Relative or helper	Agency-based Attendant Care	Structured Family Caregiving	Self-directed worker under INCharge	Important Indiana rule
Spouse	Limited yes	Limited yes	No	Spouse payment is a narrow extraordinary-care exception. For Attendant Care, Indiana limits it to agency-based care and a 40-hour weekly cap.
Adult child	Yes	Yes, if living together	Yes	Adult children are among the relatives Indiana allows. If the adult child is also the legal guardian, self-direction is not allowed.
Other relative	Yes	Yes, if living together	Usually yes	Indiana lists many relative categories, including siblings, grandchildren, nieces, nephews, aunts, uncles, and first cousins.
Legal guardian of an adult	Yes, agency-based only	Yes	No	Indiana bars legal guardians from participant-directed Attendant Care.

Important: In Indiana, payment is not made straight from the state to the relative. The state pays either an approved provider agency or, for self-direction, the payroll vendor described on the INCharge page, and that entity pays the caregiver.

Best programs, protections, portals, and options in Indiana

PathWays Waiver Attendant Care

What it is: Indiana’s Attendant Care overview describes hourly, hands-on, non-skilled help with bathing, dressing, toileting, meals, mobility, reminders, and household tasks.

Who can use it: A PathWays Waiver member whose service plan authorizes Attendant Care. Adult children and many other relatives can be paid. Under the 31 December 2025 waiver amendment, a spouse can be paid only in narrow extraordinary-care cases and only through an approved provider agency.

How it helps: This is the better fit when the caregiver does not live with the senior or when care works better in set shifts. Indiana pays the provider $34.36 an hour. Since 1 July 2025, providers must pass through at least 70% of Attendant Care reimbursement to direct caregivers, but that can include payroll taxes and benefits, so it is not the same as take-home wage.

How to apply or use it: Start with your local AAA, complete Medicaid and level-of-care steps, and then ask the service coordinator and provider agency whether your family caregiver can be hired under your PathWays plan.

What to gather or know first: Keep a written list of every task the caregiver does. If you are asking for spouse payment, ask whether physician Form 450B and state review for extraordinary care are required. Indiana also limits paid family Attendant Care hours.

Structured Family Caregiving

What it is: Structured Family Caregiving is a live-in model. The older adult and the principal caregiver must live together, and the caregiver provides daily support based on the person’s assessed needs.

Who can use it: A PathWays Waiver member living with a qualified caregiver. Adult children, other relatives, and in limited cases spouses can qualify under the current PathWays waiver rules.

How it helps: This is often the best Indiana option when a daughter, son, grandchild, or spouse already lives with the senior. The state pays the provider agency a daily rate of $77.54 for Level 1, $99.71 for Level 2, or $133.44 for Level 3. Since 1 July 2025, at least 60% of the per-diem reimbursement must pass through to direct caregivers.

How to apply or use it: Ask the service coordinator whether SFC fits better than Attendant Care, and ask for provider choices in your plan network.

What to gather or know first: Be ready to show that the caregiver and senior live together or will live together. SFC is daily support, not a skilled nursing benefit. If heavy nursing needs drive the request, also ask about home health and the spouse extraordinary-care exception.

INCharge Self-Directed Services

What it is: Indiana’s INCharge Self-Directed Services gives the older adult more control over who helps and how. For PathWays members, the current self-directed services listed for older adults are Attendant Care, Respite, and Home & Community Assistance.

Who can use it: A PathWays Waiver member who can manage hiring or who has an unpaid representative to help. Indiana says you can hire friends, family members, neighbors, or other people you recruit, but a spouse or legal guardian cannot be hired as the self-directed worker.

How it helps: Self-direction can work well when a senior wants to hire an adult child or other trusted relative directly instead of going through a home-care agency. Indiana says the member chooses wages within an allowed range from the self-directed budget, but the public consumer page does not post one public statewide wage. Ask the service coordinator or payroll vendor for the current range tied to your budget.

How to apply or use it: Tell the service coordinator that you want self-direction, then follow the INCharge setup steps. Indiana says Palco is the Financial Management Services vendor that helps with payroll and taxes.

What to gather or know first: Self-direction means you are taking on employer tasks like interviewing, training, scheduling, supervising, and keeping a back-up plan. If your family cannot manage that, the agency model may be easier.

CHOICE

What it is: Indiana’s CHOICE program is state-funded home and community help for older adults and adults with disabilities.

Who can use it: People age 60 and older, or adults with disabilities, who are at risk of losing independence. CHOICE is not the main paid-family-caregiver program, but it is one of the best Indiana back-up options when Medicaid is not ready or the waiver is waitlisted.

How it helps: The state says CHOICE can cover services like homemaker help, respite, adult day, meals, transportation, and attendant care. CHOICE has no income limit, but it does have cost-sharing and an asset rule of $250,000 with the first $20,000 in countable assets excluded.

How to apply or use it: Start with your local AAA. This is also smart while waiting for Medicaid or a waiver slot.

What to gather or know first: Bring income and asset information because CHOICE uses cost-sharing. Also know that people transitioning from CHOICE get priority in Indiana’s monthly waiver invitation process.

Older Americans Act Family Caregiver Support

What it is: Indiana’s Family Caregiver Program under the Older Americans Act supports unpaid caregivers.

Who can use it: Caregivers helping a loved one age 60 or older, plus adult family members or other informal caregivers age 18 and older caring for a person of any age with Alzheimer’s disease or a related disorder.

How it helps: This program can provide respite, counseling, training, support groups, and local resource help. It does not usually pay a family wage. Indiana says there are no income or asset limits, but funding is limited and voluntary contributions may be requested.

How to apply or use it: Call your local AAA or INconnect.

What to gather or know first: Have the caregiver’s and care recipient’s basic information ready, along with a short list of the biggest daily stress points.

How to apply or use it without wasting time

1. Call your local AAA first. Indiana says AAAs are the place to apply for waiver services, and the state also says the Medicaid process often goes more smoothly if the AAA helps.
2. Apply for Medicaid right away. Use the FSSA Benefits Portal if the senior is not already on full Medicaid.
3. Prepare for the level-of-care review. Since July 2025, Maximus handles PathWays waiver assessments.
4. Choose or confirm the PathWays health plan. Indiana says plan choice and changes go through 87-PATHWAY-4.
5. Ask one direct question: “Is Attendant Care, Structured Family Caregiving, or self-direction the best fit for this family?”
6. Confirm the agency really takes your plan. Indiana says provider directories may not always be up to date.
7. If waitlisted, watch the dashboard. Indiana says you can confirm placement on the HCBS Waitlist Dashboard and that names can take at least five business days to appear.
8. If invited, move fast. Indiana now gives people 30 days to accept the slot and 180 days from the invitation date to finish the required steps.

Checklist of documents or proof

• Photo ID for the senior and the helper
• Social Security numbers and dates of birth
• Proof of Indiana address
• Medicaid card, Medicaid ID, or Medicaid application confirmation
• Medicare card, if the person also has Medicare
• Income and asset records, such as bank statements and benefit letters
• Doctor names, diagnoses, medication list, and recent hospital or rehab paperwork
• A simple daily care log showing help with bathing, dressing, transfers, supervision, meals, and safety
• Guardianship papers or power-of-attorney papers, if any
• If seeking spouse payment under extraordinary care, the doctor information needed for Form 450B review

Reality checks

• Indiana does not have a simple “sign up and get paid to care for Mom” program for seniors.
• The main paid-family-care path is usually Medicaid only.
• The waiver waitlist is real, even though PathWays itself is not waitlisted as a health program.
• Spouse payment exists only in limited extraordinary-care situations.
• Indiana does not publish one statewide take-home wage for every family caregiver, and the state does not publish one total approval timeline from first call to first paycheck.

Common mistakes to avoid

• Trusting old Indiana A&D waiver articles without checking the current PathWays waiver.
• Applying to PathWays health coverage but never starting the waiver process with the AAA.
• Failing to document how much hands-on help the senior actually needs every day.
• Assuming Structured Family Caregiving and Attendant Care are the same thing. They are not.
• Missing the 30-day and 180-day waiver invitation deadlines.

Best options by need

If the senior’s situation looks like this	Best Indiana starting point	Why
An adult child already lives with the senior	Structured Family Caregiving	It is Indiana’s live-in paid caregiver model.
The family needs hourly help, not live-in care	Attendant Care or self-directed Attendant Care	Better for shift-based help.
A spouse wants to be paid	Ask about SFC first; ask about extraordinary-care Attendant Care if medical needs are intense	Spouse rules are much narrower than adult-child rules.
The senior is over income, not on Medicaid, or still waiting	CHOICE plus Medicaid screening	It is Indiana’s main non-Medicaid back-up program.
The senior is leaving a hospital or nursing home	AAA immediately	Those transition groups get first priority for monthly waiver invitations.

What to do if denied, delayed, blocked, or waitlisted

If the level-of-care result is wrong, read the official letter. Indiana says the LOC outcome letter includes your appeal rights and the appeal process.

If the problem is inside the PathWays plan, file the plan grievance or appeal and also call Member Support Services at 877-738-3511. That is often the fastest way to get a stuck case moving.

If the person is waitlisted, use the HCBS Waitlist Dashboard, keep the mailing address and phone number current, and ask the AAA for the original level-of-care date and any priority category. Indiana says the waiting list is fluid, not a fixed numbered line.

If the family’s chosen agency will not hire relatives, ask the service coordinator for other provider agencies, or ask whether self-direction is allowed in that case. If a provider issue is plan-related, Indiana lets members use 87-PATHWAY-4 to discuss plan options.

If you get a waiver invitation, do not sit on it. Under Indiana’s current invitation rules, missing the 30-day acceptance window or failing to finish the required steps within 180 days can lead to rescission, and the person is not placed back on the waiting list automatically. They can reapply, but that means more delay.

Plan B / backup options

• CHOICE: Best state back-up if Medicaid is not in place yet. See Indiana’s CHOICE page.
• Family Caregiver Support: Good for respite, counseling, and training while you wait. See Indiana’s Family Caregiver Program.
• Transportation reimbursement: Indiana Medicaid also lets a family member or close associate enroll as a transportation provider so mileage can be reimbursed for covered trips.
• PACE: If you live in a service area and need a fuller care model, Indiana’s PACE program may be worth asking about. It is not a paid-family-caregiver wage program, but it can reduce family burden.

Local resources in Indiana

• INconnect / Area Agencies on Aging: 800-713-9023 — best first call for waiver screening, CHOICE, caregiver support, and local help.
• PathWays Enrollment Broker: 877-284-9294 — choose or change a PathWays health plan.
• Member Support Services: 877-738-3511 — help with unresolved PathWays problems.
• Long-Term Care Ombudsman: 800-622-4484 — for nursing-home or assisted-living complaints.
• Adult Protective Services: 800-992-6978 — for abuse, neglect, or exploitation.
• FSSA Benefits Portal — apply for or renew Medicaid online.

Diverse communities and rural Indiana notes

If dementia is part of the story, Indiana’s Family Caregiver Program can support adult caregivers of people with Alzheimer’s disease and related disorders, even when the person receiving care is under age 60.

If you live in a rural county and one provider says no, do not stop there. Ask the AAA, service coordinator, or plan to check every available provider agency and to discuss self-direction. Indiana’s PathWays waiver itself says expanding HCBS access, especially in rural areas, is a program goal.

FAQ

Can a senior in Indiana have a family member paid to provide care?

Yes, but usually only through Medicaid. The older adult normally must be age 60 or older, have full Medicaid, meet nursing-facility level of care, and have a service plan that authorizes Attendant Care, Structured Family Caregiving, or self-directed services under PathWays.

Can a spouse be paid in Indiana?

Sometimes, but the rule is narrow. As of March 2026, the current PathWays waiver allows spouse payment only in extraordinary-care situations, and the spouse must be paid through an approved provider agency. A spouse still cannot be hired as a self-directed worker.

Can an adult daughter or adult son be paid to care for a parent?

Usually yes. Indiana’s relative-provider rules allow adult children in Attendant Care and Structured Family Caregiving, and adult children can also be self-directed workers if they are not the legal guardian.

Does the senior need Medicaid, or is Medicare enough?

For paid family care in Indiana, Medicaid is usually required. Medicare by itself does not create a long-term paid-family-caregiver benefit for seniors. If the person does not have Medicaid yet, start with the AAA and the FSSA Benefits Portal.

How much do family caregivers get paid in Indiana?

There is no single statewide take-home wage. Indiana says the provider is paid $34.36 an hour for Attendant Care and $77.54, $99.71, or $133.44 a day for Structured Family Caregiving, depending on level. But the family caregiver’s actual cash pay can be lower because provider pass-through rules may include payroll taxes, benefits, and other costs.

Is there really a waitlist in Indiana?

Yes. Indiana says there is no waiting list for the overall PathWays health program, but there is a waitlist for the PathWays Waiver services. As of March 2026, that waitlist had 12,075 people.

What happens if I miss my waiver invitation deadline?

Indiana’s current waiver invitation policy gives you 30 days to accept the slot and 180 days from the invitation date to complete Medicaid financial eligibility, the functional assessment, and the service plan. If you do not finish in time, the invitation can be rescinded and you are not put back on the waiting list automatically.

Are caregiver payments taxable?

Maybe. Indiana’s family-caregiver overview says current IRS guidance indicates some in-home waiver caregiver payments may not be taxed by the IRS, but the state also says it cannot provide tax advice. Ask the provider agency or payroll vendor what forms you will receive, and ask a tax professional before assuming pay is tax-free.

What is the best first phone call to make?

If the senior is not already on the waiver, call the local AAA / INconnect at 800-713-9023. If the senior is already in PathWays and the case is stuck, call Member Support Services at 877-738-3511.

Resumen breve en español

En Indiana, sí existe una manera para que algunos familiares reciban pago por cuidar a un adulto mayor, pero casi siempre depende de Medicaid y del programa PathWays. Los hijos adultos y otros parientes suelen tener la vía más clara. El cónyuge solo puede calificar en casos limitados y no puede ser trabajador bajo la opción de autogestión.

También hay lista de espera para el PathWays Waiver. Si la persona mayor no tiene Medicaid todavía, o si está en espera, pregunte por CHOICE y por el Family Caregiver Program. La mejor primera llamada casi siempre es al Area Agency on Aging / INconnect: 800-713-9023.

About This Guide

Editorial note: This guide was prepared for GrantsForSeniors.org and written for Indiana seniors, caregivers, and adult children who need practical next steps. We used official Indiana Medicaid, PathWays, FSSA, and AAA sources first.

Verification: Rules, waitlist information, and phone numbers were checked against official Indiana pages and documents available through March 2026, including the state waitlist page last updated 19 March 2026.

Corrections: State benefit rules change. If a phone number, rate, or link changes, compare this guide with the official Indiana source linked in the relevant section and update this page promptly.

Disclaimer: This article is for general education only. It is not legal, tax, medical, or financial advice, and it does not create eligibility for benefits.