Written & Reviewed by
Last updated: May 4, 2026
Bottom line: Indiana does not have a simple cash program that pays any family caregiver on request. For many older adults, the real paid-family-caregiver path runs through Indiana PathWays for Aging and the PathWays Waiver services. Adult children and other relatives may be paid when the senior qualifies and the service plan allows it. A spouse may be paid only in limited cases under the PathWays waiver amendment, and a spouse still cannot be hired as a worker under INCharge self-direction. As of April 2026, the PathWays Waiver waitlist had 11,791 people, even though the larger PathWays health plan program does not have its own waitlist.
If you also need other help for an older adult, keep this page focused on caregiver pay and use the Indiana senior benefits guide for wider state programs.
Emergency help now
- If the senior is unsafe, abused, neglected, or abandoned, call 911 or Indiana Adult Protective Services at 800-992-6978.
- If a hospital discharge or nursing-home return home is happening now and care may fall apart, call your local Area Agency right away. Say it is a hospital or nursing-facility transition.
- If the person is already in PathWays and services stopped or were denied, call the health 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 age 60+ and already on full Medicaid | Confirm or choose your PathWays health plan. Ask how to reach your service coordinator. | 87-PATHWAY-4: 877-284-9294 |
| You are already waitlisted | Keep your address and phone number current. Watch for a waiver invitation letter. | AAA or health plan service coordinator |
| 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 |
Contents
- Emergency help now
- Quick help box
- What this help looks like
- Quick facts
- Who qualifies
- Best programs and options
- How to apply
- Document checklist
- Reality checks
- Common mistakes
- Best options by need
- Denied, delayed, or waitlisted
- Backup options
- Phone scripts you can use
- Local resources
- Rural and community notes
- Resumen en español
- FAQ
- About this guide
What this help actually looks like in Indiana
For seniors in Indiana, paid family caregiving usually comes through Medicaid home care. It is not a stand-alone caregiver paycheck. The older adult must usually qualify first. Then the care must be approved in a service plan.
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 payroll and taxes.
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 waiting for a waiver slot, the backup options are usually CHOICE and the Older Americans Act Family Caregiver Program. Those programs can help with support, respite, and local services, 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 who meet the state’s Medicaid category rules.
- The PathWays Waiver can include Attendant Care, Structured Family Caregiving, respite, transportation, home modifications, home-delivered meals, and other home and community services.
- Maximus LCAR handles many level-of-care determinations. Indiana says a determination is usually issued within 11 calendar days of the request.
- Indiana’s Medicaid guide lists a special HCBS waiver income standard of $2,982 a month for one person as of March 1, 2026. It also lists an asset test of $2,000 for one person and $3,000 for a married couple.
- For July 1, 2025 through June 30, 2026, Indiana says the PathWays Medicaid Waiver has 39,842 approved slots. The April 2026 waitlist count was 11,791 people.
- 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, have full Medicaid, meet nursing-facility level of care, and live in or move into an approved home or community setting.
For money rules, Indiana says the HCBS waiver income limit is 300% of the maximum Supplemental Security Income amount. The March 1, 2026 Medicaid 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. A home the person lives in, one vehicle, and burial spaces may be excluded.
For care needs, Indiana says functional eligibility generally means the person needs help with at least three activities of daily living, such as eating, dressing, or toileting, or cannot care for themself medically.
Which relatives can be paid in Indiana?
| Relative or helper | Agency Attendant Care | Structured Family Caregiving | INCharge self-directed worker | Important Indiana rule |
|---|---|---|---|---|
| Spouse | Limited yes | Limited yes | No | Spouse payment is narrow. For Attendant Care, it is tied to extraordinary care, agency-based care, and a weekly cap. |
| Adult child | Yes | Yes, if living together | Yes, unless barred by role | Adult children are often allowed. A legal guardian cannot be hired as a self-directed worker. |
| Other relative | Yes | Yes, if living together | Usually yes | Indiana allows many relatives, such as siblings, grandchildren, nieces, nephews, aunts, uncles, and first cousins. |
| Legal guardian of an adult | Limited yes | Yes | No | A legal guardian may be limited under Attendant Care and cannot be a self-directed worker. |
Important: In Indiana, payment is not made straight from the state to the relative. The state pays an approved provider agency, or in self-direction a payroll vendor. That provider or vendor pays the caregiver.
Best programs, protections, portals, and options in Indiana
PathWays Waiver Attendant Care
What it is: Indiana’s caregiver overview describes Attendant Care as hourly, hands-on, non-skilled help. It can include bathing, dressing, toileting, meals, mobility, reminders, and household tasks.
Who can use it: A PathWays Waiver member whose service plan approves Attendant Care. Adult children and many other relatives can be paid. Since the December 31, 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 often 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 July 1, 2025, providers must pass through at least 70% of Attendant Care reimbursement to direct care. That can include wages, payroll taxes, benefits, and related costs, so it is not the same as take-home pay.
How to apply or use it: Start with your local AAA, complete Medicaid and level-of-care steps, and ask the service coordinator whether your family caregiver can be hired under the PathWays plan.
What to gather first: Keep a written list of every task the caregiver does. If you are asking for spouse payment, ask whether Form 450B review is required. Indiana uses the extraordinary-care review for spouse care tied to intensive nursing needs.
Structured Family Caregiving
What it is: Structured Family Caregiving is a live-in model. The older adult and the main caregiver must live together. 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 current PathWays 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 July 1, 2025, at least 60% of the per-diem reimbursement must pass through to direct caregivers or caregiver costs.
How to apply or use it: Ask the service coordinator whether Structured Family Caregiving fits better than Attendant Care. Ask for provider choices in your plan network.
What to gather first: Be ready to show that the caregiver and senior live together or will live together. This is daily support. It is not skilled nursing. If heavy nursing needs are the main issue, also ask about home health and the spouse extraordinary-care rule.
INCharge Self-Directed Services
What it is: INCharge gives the older adult more control over who helps and how. For PathWays members, Indiana lists Attendant Care, Respite, and Home & Community Assistance as self-directed services.
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 people you recruit. 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 another trusted person instead of using a home-care agency. Indiana says the member chooses wages within an allowed range from the self-directed budget. The public page does not post one statewide take-home wage. Ask the service coordinator or payroll vendor for the current range tied to the plan.
How to apply or use it: Tell the service coordinator that you want self-direction. Indiana says Palco is the Financial Management Services vendor that helps with payroll and taxes.
What to gather first: Self-direction means you take on employer tasks. These may include interviewing, training, scheduling, supervising, and keeping a backup 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 or 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 backup options when Medicaid is not ready or the waiver is waitlisted.
How it helps: The state says CHOICE can cover services such as homemaker help, respite, adult day, meals, transportation, and attendant care. CHOICE has no income limit, but it does have cost-sharing. Indiana lists an asset rule of $250,000, with the first $20,000 in countable assets excluded.
How to apply or use it: Start with your AAA. For CHOICE only, Indiana’s CHOICE page lists 800-986-3505 as the contact number. The state AAA page also lists 800-713-9023 for local AAA help.
What to gather first: Bring income and asset information because CHOICE uses cost-sharing. Also ask whether being on CHOICE may affect priority for monthly waiver invitations.
Older Americans Act Family Caregiver Support
What it is: Indiana’s Family Caregiver Program supports unpaid caregivers through Older Americans Act funds.
Who can use it: Caregivers helping a loved one age 60 or older. It may also help adult family members or informal caregivers age 18 and older who care 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. You can also use the INconnect Alliance page to look for local help.
What to gather first: Have the caregiver’s and care recipient’s basic information ready. Also write down the top stress points, such as bathing help, night supervision, wandering, lifting, or missed work.
How to apply or use it without wasting time
- Call the local AAA first. Ask for waiver screening, CHOICE screening, and caregiver support. The Indiana AAA guide can help you understand what to ask.
- Apply for Medicaid right away. Use the FSSA Benefits Portal if the senior is not already on full Medicaid.
- Prepare for level-of-care review. Since 2025, Maximus LCAR handles many PathWays waiver level-of-care steps.
- Choose or confirm the PathWays health plan. Plan choice and changes go through 87-PATHWAY-4 at 877-284-9294.
- Ask one direct question: “Is Attendant Care, Structured Family Caregiving, or self-direction the best fit for this family?”
- Confirm the agency takes your plan. Provider directories can change. Ask the plan and the agency before you count on a provider.
- If waitlisted, watch the dashboard. Indiana says you can check placement on the HCBS Waitlist Dashboard. It may take at least five business days for a new placement to show.
- If invited, move fast. Indiana’s waiver invitation policy 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 papers
- 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 asking for spouse payment under extraordinary care, doctor information for the 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 plan program.
- Spouse payment exists only in limited situations. It is not the same as adult-child payment.
- Indiana does not publish one statewide take-home wage for every family caregiver.
- The state does not publish one total timeline from first call to first paycheck.
- Provider agencies may have their own hiring steps, background checks, training, and start dates.
Common mistakes to avoid
- Trusting old Indiana A&D waiver articles without checking current PathWays rules.
- Applying to PathWays health coverage but never starting the waiver process with the AAA.
- Failing to write down how much hands-on help the senior needs every day.
- Assuming Structured Family Caregiving and Attendant Care are the same. They are not.
- Assuming a spouse can always be paid. Indiana’s spouse rule is narrow.
- Missing the 30-day or 180-day waiver invitation deadline.
- Choosing an agency before confirming it accepts the senior’s PathWays health plan.
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 | It is usually better for shift-based help. |
| A spouse wants to be paid | Ask about Structured Family Caregiving and extraordinary-care Attendant Care | 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 backup program. |
| The senior is leaving a hospital or nursing home | AAA immediately | Transitions may get priority in the waiver invitation process. |
What to do if denied, delayed, blocked, or waitlisted
If the level-of-care result is wrong, read the official letter. It should explain appeal rights and the appeal process. Keep the envelope, the letter, and any deadline.
If the problem is inside the PathWays plan, file the plan grievance or appeal. Also call Member Support Services at 877-738-3511. This can help when a case is stuck between a plan, provider, and service coordinator.
If the person is waitlisted, use the 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 chosen agency will not hire relatives, ask the service coordinator for other agencies. Also ask whether self-direction is allowed in that case. If the issue is plan-related, call 87-PATHWAY-4 to ask about plan options.
If you get a waiver invitation, do not sit on it. Missing the 30-day acceptance window or failing to finish the required steps within 180 days can lead to the invitation being rescinded. The person is not placed back on the waiting list automatically. They can reapply, but that means more delay.
Plan B and backup options
- CHOICE: Ask about CHOICE if Medicaid is not ready yet or the waiver is waitlisted.
- Family Caregiver Support: Ask for respite, training, counseling, and support groups while you wait.
- Transportation reimbursement: Indiana Medicaid lets a family driver enroll so mileage can be reimbursed for covered medical trips arranged through the broker.
- PACE: If the senior is 55 or older, needs nursing-home level care, can live safely in the community, and lives in a service area, Indiana’s PACE program may help. It is not a family-caregiver wage program.
- Other household help: Caregiver pay may take time. While waiting, check charities helping seniors, utility bill help, food programs, and Indiana housing help.
- Health cost help: If Medicare costs are making care harder to afford, check Medicare Savings Programs.
- Homeowner help: If property taxes are part of the strain, see Indiana property tax relief.
- Tools: For simple next-step checklists, use the senior help tools.
Phone scripts you can use
Calling the AAA before Medicaid or waiver approval
“Hi, I am calling for an older adult in Indiana who may need paid family caregiver help. They are age 60 or older and need help at home. Can you screen them for the PathWays Waiver, CHOICE, Medicaid application help, and caregiver support?”
Calling a PathWays health plan
“Hi, I am calling about a PathWays member. We need to know if the service plan can include Attendant Care, Structured Family Caregiving, or self-direction. Can you connect us with the service coordinator and explain the next step?”
Asking about spouse payment
“Hi, I am the spouse caregiver. I understand Indiana allows spouse payment only in limited cases. Can you tell me whether this case may meet the extraordinary-care rule, whether Form 450B is needed, and which provider agencies can handle this?”
Calling after a delay or denial
“Hi, I need help with a delayed or denied PathWays waiver service. Please tell me the appeal deadline, how to file a grievance or appeal, and who can review the case today.”
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. Use this to choose or change a PathWays health plan.
- Member Support Services: 877-738-3511. Use this for unresolved PathWays problems.
- Health plan member services: Anthem 833-412-4405, Humana 866-274-5888, and UnitedHealthcare 800-832-4643.
- Long-Term Care Ombudsman: 800-622-4484. Use this for nursing-home or assisted-living complaints.
- Adult Protective Services: 800-992-6978. Use this 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 health plan to check every available provider agency. Also ask about self-direction if a trusted family member can do the work and the rules allow it.
If English is not the family’s first language, ask the agency or health plan for language help before an assessment or appeal call. Do not sign forms you do not understand.
Resumen en español
En Indiana, algunos familiares pueden recibir pago por cuidar a un adulto mayor, pero casi siempre depende de Medicaid y del programa PathWays. No es un programa simple de dinero en efectivo. La persona mayor debe cumplir con las reglas de Medicaid, necesitar un nivel de cuidado parecido al de un hogar de ancianos, y tener un plan de servicios aprobado.
Los hijos adultos y otros parientes suelen tener la vía más clara. El cónyuge solo puede recibir pago en casos limitados. Un cónyuge no puede ser trabajador bajo la opción de autogestión. Si la persona mayor vive con el cuidador, pregunte por Structured Family Caregiving. Si necesita ayuda por horas, pregunte por Attendant Care.
También hay lista de espera para el PathWays Waiver. Si la persona mayor no tiene Medicaid todavía, o si está esperando, 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. Si el caso ya está en PathWays y está detenido, llame a Member Support Services: 877-738-3511.
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 approves Attendant Care, Structured Family Caregiving, or self-directed services.
Can a spouse be paid in Indiana?
Sometimes, but the rule is narrow. Indiana allows spouse payment only in limited cases. For Attendant Care, the spouse must be paid through an approved provider agency and the case must meet the extraordinary-care rule. A spouse cannot be hired as a self-directed worker.
Can an adult daughter or adult son be paid to care for a parent?
Usually yes, if the parent qualifies and the service plan approves the care. Adult children may be allowed under Attendant Care, Structured Family Caregiving, and self-direction. A legal guardian cannot be hired as a self-directed worker.
Does the senior need Medicaid, or is Medicare enough?
For paid family care in Indiana, Medicaid is usually required. Medicare by itself does not pay a family member for long-term daily care. 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 pays provider agencies a set rate for services. The caregiver’s actual pay can be lower because provider pass-through rules may include payroll taxes, benefits, transportation, and other costs.
Is there really a waitlist in Indiana?
Yes. Indiana says there is no waitlist for the overall PathWays health plan program, but there is a waitlist for PathWays Waiver services. As of April 2026, the PathWays Waiver waitlist had 11,791 people.
What happens if I miss my waiver invitation deadline?
Indiana gives you 30 days to accept a waiver slot and 180 days from the invitation date to complete the required steps. If you miss the deadline, the invitation can be rescinded and the person is not put back on the waitlist automatically.
Are caregiver payments taxable?
Maybe. Some in-home waiver caregiver payments may not be taxed under IRS rules, but this depends on the situation. Indiana cannot give 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 or 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.
About this guide
We check this guide against official government, local agency, and trusted nonprofit sources. GrantsForSeniors.org is independent and is not a government agency.
Program rules, funding, and eligibility can change. Always confirm details with the official program before you apply.
See something wrong or outdated? Email info@grantsforseniors.org.
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: Last verified May 4, 2026. Next review September 4, 2026.
Corrections: If a phone number, rate, or link changes, email info@grantsforseniors.org so we can review and update this guide.
Disclaimer: This article is for general education only. It is not legal, tax, medical, disability, or financial advice. It does not create eligibility for benefits, services, caregiver pay, or approval.
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