How to Pay for Home Care in Indiana (2026 Guide)

What Has Changed

The biggest 2026 change for families seeking long-term home care is the PathWays waiver waitlist. Indiana reported 11,779 people on the PathWays Medicaid Waiver waiting list as of August 2026. The state also says there is not a waitlist for the overall Indiana PathWays for Aging managed-care program; the waitlist applies to the home- and community-based waiver services. Check the current waiver waitlist page before making care plans.

Indiana also now describes its aging network as 15 Area Agencies on Aging serving 16 planning and service areas. The statewide entry number remains 1-800-713-9023 through the Indiana AAA directory.

Know the Care Type First

Families often use the words “home care” for two different services. That can send them to the wrong payer.

If you are comparing agencies and individual workers, the GFS guide to agencies versus caregivers can help you compare supervision, backup staffing, payroll, and cost tradeoffs.

What Medicare May Pay For

Medicare can cover home health when the person meets Medicare’s rules, including being homebound and needing part-time or intermittent skilled services. Covered care can include skilled nursing, therapy, medical social services, and home health aide care when the aide service is part of qualifying skilled home health care.

Medicare does not turn into full-time custodial care. It does not cover 24-hour-a-day care at home, meal delivery, homemaker services unrelated to the care plan, or personal care when that is the only care needed. Medicare says skilled nursing and home health aide services are generally limited to 8 hours a day combined and 28 hours a week, with up to 35 hours a week for a short time when medically necessary.

Indiana Medicaid and PathWays for Aging

For many Indiana seniors who need ongoing care at home, Medicaid is the most important public payment path. PathWays eligibility generally covers full-benefit Indiana Medicaid members age 60 and older who qualify through an aged, blind, or disabled category.

PathWays is not the same as the waiver

This distinction matters. A person can be enrolled in the PathWays managed-care program without yet receiving PathWays home- and community-based waiver services. The waiver has separate medical and financial rules, and Indiana currently has a waiting list for waiver access.

To begin the waiver route, contact the local AAA for screening and intake. Indiana’s Level of Care Assessment Representative handles nursing-facility level-of-care evaluations for waiver services. When a person is invited from the waiver waitlist, the state requires timely action. Current guidance says an invitee has 30 days to accept the invitation and 180 days from the invitation date to complete the required steps to start waiver services.

2026 financial rules

Indiana’s 2026 Medicaid limits say the general aged, blind, and disabled income limit is $1,330 per month for one person and $1,803.33 for two people, effective March 1, 2026. The general asset guide shows $2,000 for one person or $3,000 for a married couple. For people who are institutionalized or eligible for home- and community-based waiver services, the same guide says monthly income can be as high as $2,982 based on the individual’s income. A patient or waiver liability may apply.

Do not self-deny based on those numbers. Married couples can have special spousal protections, and different Medicaid categories count income and assets differently. Apply and let Indiana make the determination.

How to start

1. Apply for Medicaid online, by phone, by mail, or through a local Division of Family Resources office. DFR’s phone number is 1-800-403-0864.
2. Tell the AAA that the person needs long-term services at home and ask about the PathWays waiver process and current waiting-list steps.
3. If already enrolled in PathWays, use PathWays contacts. The enrollment broker is 1-877-284-9294, and Member Support Services is 1-877-738-3511.
4. Keep contact information current. Missing an invitation or a document request can delay the case.

The GFS Indiana benefits portal guide explains how to use the state portal and manage common application tasks.

Indiana CHOICE for Non-Medicaid Help

CHOICE stands for Community and Home Options to Institutional Care for the Elderly and Disabled. It is one of Indiana’s strongest backup routes when a person needs help at home but Medicaid is not available for that need.

The CHOICE program is administered through Indiana’s Area Agencies on Aging. Applicants must be at least 60 or have a disability and must be at risk of losing independence. CHOICE may help with homemaker services, respite, attendant care, adult day services, home-delivered meals, skilled nursing, home health aide services, equipment, home modifications, emergency response systems, and transportation.

Indiana states that CHOICE has no income limit. However, there is a cost-sharing formula, and higher-income applicants may be asked to pay part of the cost. The state also says an individual may not have assets over $250,000 and that an additional $20,000 in countable assets is excluded when assets are determined. CHOICE cannot pay for a need when Medicare or Medicaid is already available to meet that same need.

Call your local AAA at 1-800-713-9023 or use the GFS Indiana AAA guide to find the correct regional office.

Can a Family Caregiver Be Paid?

Sometimes. Indiana’s PathWays waiver includes services such as Structured Family Caregiving, and Indiana’s provider guidance confirms that family members can be paid providers in that service when the program rules are met. This is not an automatic cash payment for any relative who provides care. The older adult must qualify for the service, it must be included in the care plan, and provider rules apply.

For non-Medicaid support, Indiana’s Family Caregiver Program can provide caregiver counseling, training, respite, support groups, access help, and limited supplemental services. Indiana says this program has no income or asset limit, although funding is limited and participants may be asked for voluntary contributions.

For a deeper explanation of caregiver-pay routes, use the GFS guide to paid family caregiving in Indiana.

PACE Can Bundle Home Care

PACE, the Program of All-Inclusive Care for the Elderly, can be a strong option for people with high care needs who live in a covered service area. Indiana says PACE generally serves adults age 55 or older who need nursing-home level care, can live safely in the community at enrollment, and live in the program’s service area.

Indiana PACE can include personal care at home, home health, adult day services, meals, transportation, prescriptions, therapies, medical care, respite, and nursing-home care when needed. PACE is an integrated care program, not a cash allowance. Participants generally receive covered services through the PACE organization.

Indiana’s current list includes programs serving parts of Indianapolis and surrounding counties, Evansville, Greenwood, Dyer, Lafayette, Michigan City, Jeffersonville, Kokomo, Fort Wayne, Richmond, and Mishawaka areas. Service areas are defined by county or ZIP code, so check the official list before assuming a nearby PACE program can enroll the person.

Veterans and Surviving Spouses

Veterans should check VA help before spending down savings. VA Aid and Attendance can add monthly payments to a qualifying VA pension when a veteran or eligible survivor meets the rules and needs help with daily activities or is housebound.

The VA also offers VA home aide care for enrolled veterans who meet clinical and community-care rules when the service is available locally. These services can help with personal care and can be used with other home- and community-based supports.

Indiana’s county veteran service officer directory is a good first stop for claims help. The GFS guide to Indiana veteran benefits adds state-specific routes.

Private Pay and Insurance

Some families need a private-pay bridge while waiting for public programs. Ask every agency for the hourly rate, minimum shift, weekend or holiday rate, cancellation rules, and whether the quoted price includes supervision, payroll, and backup staff. Get the answer in writing.

If the older adult has a long-term care insurance policy, call the insurer before hiring care. Ask what triggers benefits, whether there is an elimination period, which home-care providers qualify, whether informal caregivers can be reimbursed, and what records the insurer needs.

If home care is becoming too expensive or unsafe even with benefits, compare other care settings before a crisis. GFS has guides on home care vs assisted living and home care vs nursing.

Documents to Gather

• Photo identification and Social Security number.
• Medicare, Medicaid, and other insurance cards.
• Social Security, pension, and other income records.
• Recent bank and asset statements.
• Medication list and doctor contact information.
• Hospital discharge papers, therapy orders, or home-health orders.
• A written list of daily activities the person cannot do safely alone.
• Power of attorney, guardianship, or authorized-representative paperwork when someone else handles the case.
• Military discharge records when seeking veterans benefits.

Reality Checks for Indiana Families

• Medicaid can take time. Indiana says a complete health-coverage application can take up to 90 days.
• The PathWays waiver has a waitlist. Being in PathWays managed care does not mean waiver home-care services start immediately.
• Waiver invitations have deadlines. Respond quickly to an invitation and every document request.
• CHOICE is flexible, not unlimited. Service hours and availability depend on assessed need, local funding, and providers.
• PACE is geographic. A program in a nearby city may not serve the person’s ZIP code.
• Approval rarely means round-the-clock care. Most programs authorize a defined set of services and hours.

Common Mistakes to Avoid

• Assuming Medicare pays for long-term personal care.
• Applying for Medicaid but never contacting the AAA about waiver screening.
• Thinking CHOICE is only for people under a strict income limit.
• Assuming a relative can automatically be paid as the caregiver.
• Ignoring a PathWays waiver invitation, renewal notice, or document deadline.
• Paying privately for months before checking veteran benefits, PACE, respite, meals, or transportation.

Phone Scripts