Indiana Medicaid Waiver Programs

What Is the Indiana PathWays for Aging Waiver?

The Pathways on Aging Waiver is part of Indiana’s Home and Community-Based Services (HCBS) initiative, designed to provide care outside institutional settings like nursing homes. The program focuses on enabling seniors 60 and older to live in their own homes or community environments by offering services that help with daily living and long-term care needs.

What Services Does It Cover? 

• Personal Care Assistance Help with bathing, dressing, and other daily activities.
• Homemaker Services Assistance with cleaning, laundry, and meal preparation.
• Transportation Services Rides to medical appointments and community activities. For more details about the program, https://www.in.gov/pathways/resources?utm

Eligibility for Indiana Pathways on Aging

To qualify for this program, applicants must meet the following requirements:

• Be 60 Years or Older: The program is exclusively for adults 60 years or older.
• Need Nursing Facility-Level Care: Applicants must demonstrate the same care needs as those eligible for nursing homes.
• Qualify for Medicaid Financially: Learn more about financial eligibility at https://www.in.gov/medicaid/members/apply-for-medicaid/eligibility-guide/?utm

How to Apply for Pathways

Locate your local AAA here: https://www.in.gov/fssa/da/area-agencies-on-aging?utm

The Area Agency on Aging will discuss Indiana Medicaid eligibility with you. If you appear to be eligible for Medicaid, the AAA will inform you and may assist you with this application.

The Indiana Health and Wellness Waiver is a Medicaid Home and Community-Based Services (HCBS) program designed to support individuals aged 59 and younger with disabilities or long-term care needs. This waiver allows participants to access vital services in their homes or community settings rather than institutional facilities, promoting independence and a higher quality of life.

What Is the Indiana Health and Wellness Waiver?

The Health and Wellness Waiver provides personalized care to younger individuals who require assistance with daily activities due to chronic illnesses, developmental disabilities, or other medical conditions. The program aims to reduce the reliance on nursing homes while enabling participants to thrive in their own environments.

What Services Does It Cover

Participants in the Indiana Health and Wellness Waiver program can receive a variety of services, including:

• Personal Care Assistance Help with bathing, dressing, and grooming.
• Homemaker Services Assistance with cleaning, laundry, and meal preparation.
• Respite Care Temporary relief for family caregivers
• Home Modifications Adjustments to improve mobility and safety in the home.
• Therapy Services Physical, occupational, and behavioral therapy to support recovery and independence.

For more details, visit https://www.in.gov/fssa/ddrs

Eligibility for the Health and Wellness Waiver

To qualify for this program, applicants must meet the following requirements:

• Age Limit: Be aged 59 or younger.
• Care Needs: Require nursing facility-level care as determined by state assessments.
• Medicaid Financial Eligibility: Meet Medicaid income and asset guidelines.

How to Apply for the Health and Wellness Waiver.

Contact your local Area Agency on Aging (AAA) 

To start the waiver application process, call your AAA or the toll-free support number (800-713-9023) to begin your preliminary Level of Care (LOC) screening.  The AAA will guide you through what’s needed to apply. You may be referred to a Level of Care Assessor (Maximus) to complete your LOC assessment. 

Locate your local AAA here: https://www.in.gov/fssa/da/area-agencies-on-aging?utm

Complete the Level of Care (LOC) Assessment

A Level of Care assessment determines if you meet nursing facility level of care, a requirement for the waiver. If you qualify, you’ll be asked if you want to be placed on the Health and Wellness waiver waiting list.

The Indiana Traumatic Brain Injury Waiver is a Medicaid Home and Community-Based Services (HCBS) program that provides essential care and support for individuals living with a traumatic brain injury (TBI). Designed to promote independence and enhance quality of life, this waiver allows participants to receive long-term care in their homes or communities rather than in institutional settings.

What Is the Indiana Traumatic Brain Injury Waiver?

This Medicaid waiver is tailored specifically for individuals who have sustained a TBI and require ongoing care to manage physical, cognitive, and behavioral challenges. It focuses on delivering personalized care plans that address the unique needs of TBI patients and their families.

Eligibility for the Traumatic Brain Injury Waiver

To qualify for the Indiana TBI Waiver, applicants must:

• Have a documented TBI Diagnosis: The condition must be verified by a medical professional.
• Require Nursing Facility-Level Care: Demonstrate the need for intensive, ongoing care as determined by state assessments.
• Meet Medicaid Financial Requirements: Learn more at https://www.in.gov/medicaid/members.

How to Apply for the Indiana TBI Waiver

• Apply for Indiana Medicaid (if not already enrolled)
• Contact your local BDDS office to request an application https://www.in.gov/fssa/ddars/bds/medicaid-hcbs-waivers/
• Submit the application online through the BDS Gateway or by paper form
• Provide Required Documentation
• If eligible, you may be placed on a waitlist until a waiver slot becomes available.

What is the Community Integration and Habilitation (CIH) Waiver

This waiver helps individuals with intellectual and developmental disabilities (IDD) receive services in their home or community instead of. Living in an institution. 

It is designed for individuals who:

• Meet Indiana’s level of care for institutional placement
• Qualify for Medicaid
• Have significant support needs 
• May be transitioning from a facility or group home
• Have complex medical or behavioral needs

What Services Does It Cover? 

The CIH Waiver may include:

• Residential Habilitation and Support (RHS)
• Supported Living services
• Day Services
• Respite Care
• Transportation
• Employment Services
• Therapies (when waiver-approved)

Services are based on the individuals assessed needs and included in their Individualized Service Plan (ISP)

How to Apply for the Indiana CIH Waiver

• Apply for Indiana Medicaid (if not already enrolled)
• Contact your local BDDS office to request an application https://www.in.gov/fssa/ddars/bds/medicaid-hcbs-waivers/
• Submit the application online through the BDS Gateway or by paper form
• Provide Required Documentation
• If eligible, you may be placed on a waitlist until a waiver slot becomes available.

What is Residential Habilitation and Support (RHS)

RHS is a service offered through Indiana’s Medicaid Waiver Program for individuals with Intellectual and developmental disabilities (IDD). It is provided under the Indiana Family and Social Services Administration (FSSA) through the Bureau of Developmental Disabilities (BDDS), primarily under the Community Integration and Habilitation (CIH) Waiver.  

Eligibility for Residential Habilitation and Support

To qualify for this program, applicants must meet the following requirements:

• Have a diagnosed intellectual or developmental disability (IDD).
• Meet the Level of Care required for an Intermediate Care Facility for Individuals with IDD
• Eligible for Medicaid/Approved for the CIH Waiver

What Services Does It Cover?

Services are individualized and based on each participant’s Individualized Support Plan (ISP). Depending on needs, RHS may include:

• Daily Living Support: Assistance with cooking/meal prep, cleaning, errands, and transportation
• Personal Care Assistance: Help with bathing, dressing, hygiene, and mobility
• Skill Development: Teaching independence, communication skills, and community involvement
• Health & Safety Monitoring: Supporting appointments, wellness oversight, and behavior support plans
• Community Participation: Encouraging employment, recreation, and social engagement

What is the Family Support Waiver (FSW)?

The FSW supports individuals with I/DD through home and community-based services that promote independence and quality of life.

What Services Does It Cover?

Participants in the Indiana Health and Wellness Waiver program can receive a variety of services, including:

• Respite care for family caregivers
• Personal assistance with daily activities
• Behavior support
• Day programs and community-based habilitation
• Speech, occupational, and physical therapy
• Transportation to medical or community activities
• Job coaching or pre-vocational services
• Assistive technology and home adaptations
• Case management

*Note: The current annual budget limit for FSW is $19,614 (as of April 2025).

Eligibility for Family Support Waiver

To qualify for this program, applicants must meet the following requirements:

• Be Medicaid eligible (or able to become eligible)
• Have a documented intellectual or developmental disability diagnosed before the age of 22 and expected to continue indefinitely.
• Meet the level of care typically provided in an intermediate care facility (ICF/IID).
• Receive services at home or in a community setting

There is no age limit — children and adults can qualify!

Structured Family Care is an Indiana Medicaid program that allows certain family members to be compensated for providing care to a loved one in the home. This program is designed for caregivers who live with the individual receiving care and are legally responsible for their well-being.

In many cases, this includes:

• Parents caring for children with special needs
• Spouses caring for their husband or wife
• Adult children caring for aging parents

Other living arrangements may qualify if the caregiver and the individual reside in the same home.

Through Structured Family Care, caregivers provide daily hands-on support with essential activities such as personal care, bathing and grooming, meal preparation, light housekeeping, mobility assistance, coordinating medical appointments, transportation, and overall supervision.

What Structured Family Caregiving Work is Reimbursable in Indiana?

• Personal care assistance, such as bathing, oral hygiene, hair care, shaving, hand and foot care, intact skin care, application of cosmetics, dressing, toileting, eating, etc.
• Homemaking, cooking, housekeeping.
• Transportation to appointments and community activities when they are therapeutic in nature.
• Mobility assistance.
• Accompanying the child to appointments such as doctor appointments

Absolute Golden Care Pays 80%

At Absolute Golden Care, we are proud to offer one of the highest Structured Family Care payout rates in Indianapolis. Your loved one’s level of care is determined by a case manager, and that assessment establishes the daily reimbursement rate. This daily rate is then shared between the family caregiver and the managing home care agency.

The Indiana Family and Social Services Administration recommends that agencies retain up to 35% of the daily reimbursement, leaving caregivers with approximately 65%.

At Absolute Golden Care, we do things differently.

We pay our Structured Family Caregivers 80% of the total reimbursement — which is 15% more than the standard recommendation and significantly higher than many agencies across the state.

The Indiana Family and Social Services Administration recommends the following split:

If you want to know your potential earnings based on your loved one’s level of care, contact Absolute Golden Care for current rates and eligibility details.

Lower levels of care receive proportionate rates. Please note that state reimbursement rates are subject to change over time.

*All Paid Structured Family Caregivers must complete all required training, pass background checks, follow documentation and compliance standards.

Ready to Switch Structured Family Care Agencies?

If you are currently enrolled in Structured Family Care and would like better pay and stronger support, you have the right to choose your provider.

No matter where you live in Indiana, state law gives you the freedom to switch to Absolute Golden Care at any time.

When you make the change, you can receive:

• One of the highest Structured Family Care payout rates in Indianapolis and across the state
• Reliable case management support
• Ongoing caregiver training
• A responsive team that truly advocates for families

We make the transition simple and guide you through every step of the process.

Is Your Structured Family Care Pay Really Tax-Free?

Yes! According to current IRS guidance, payments made to a family caregiver for Medicaid waiver services in the home are not considered taxable income.

While Absolute Golden Care cannot provide tax advice, we encourage caregivers to review IRS rules and Indiana state tax regulations (Indiana Code and Indiana Department of Revenue) to understand how these rules apply to their individual situation.

RHS allows certain relatives to serve as paid Direct Support Professionals (DSPs). This means trusted family members can provide daily support while helping their loved one build independence through structured habilitation services.

Who May Qualify as a Paid Caregiver?

• Parent of Adult Individuals (18+)
• Adult children and Adult Siblings
• Extended family members (aunts, uncles, grandparents)
• Guardians or spouses (hour limits may apply for legally responsible individuals)

*All Paid Family Caregivers must complete all required training, pass background checks, follow documentation and compliance standards.

How Compensation Works

Absolute Golden Care is committed to directing a significant portion of waiver reimbursement directly to caregivers. By operating efficiently and minimizing unnecessary overhead, we prioritize putting funding where it belongs — in the hands of those delivering care every day.

This approach strengthens families by offering financial recognition while maintaining consistency and trust in the caregiving relationship.

At Absolute Golden Care, we believe families should never have to choose between providing quality care and maintaining financial stability. Our model is built around family-centered, consumer-directed services, ensuring caregivers are supported, respected, and fairly compensated.

Why Choose Absolute Golden Care?

Families across Indiana choose Absolute Golden Care because we:

• Prioritize competitive caregiver compensation
• Promote consumer-directed service options
• Streamline administration to maximize caregiver funding
• Coordinate CIH Waiver services with clarity and responsiveness
• Provide dependable, relationship-based support

What Is Structured Family Caregiving?

Structured Family Caregiving is an Indiana Medicaid service available under certain Home and Community-Based Services (HCBS) waivers. This program allows eligible family members who live with an individual to receive compensation for providing daily care and supervision at home.

The program recognizes the essential role family caregivers play and offers financial support while helping individuals remain in a familiar, stable living environment rather than entering institutional care.

Official State Resource – Medicaid HCBS Programs: https://www.in.gov/fssa/da/medicaid-hcbs/

Who Can Be a Structured Family Caregiver?

Structured Family Caregiving is intended for live-in caregiving arrangements. Eligible caregivers may include:

• Parents caring for children with special needs
• Spouses caring for one another
• Adult children caring for aging parents
• Other legally responsible relatives, provided they live in the same household

Eligibility is determined by Indiana Medicaid and the individual’s assigned case manager.

Services Provided Through Structured Family Caregiving

Family caregivers provide daily support based on an approved care plan, which may include:

• Personal care assistance such as bathing, dressing, and grooming
• Meal preparation and nutritional support
• Household support and maintaining a safe living environment
• Mobility assistance and transfers
• Medication reminders and health monitoring
• Scheduling and transportation to medical appointments
• Supervision and support throughout the day

Care responsibilities are documented and monitored to ensure compliance with Medicaid requirements.

Payment Structure and Compensation

Compensation for Structured Family Caregiving is determined by the individual’s level of care, as assessed by a case manager. Daily reimbursement rates are established by the State of Indiana and vary based on care needs.

In many cases, payments for Structured Family Caregiving are considered tax-free under current IRS guidance; however, individuals should consult official IRS resources or a tax professional for confirmation.

SSI & Disability Tax Information: https://www.ssa.gov/ssi

Why Structured Family Caregiving Matters

This program allows families to continue caring for loved ones at home while receiving financial support for the care they already provide. It helps reduce caregiver burnout, supports household stability, and prevents unnecessary institutional placement.

For many families, Structured Family Caregiving makes long-term home care financially and emotionally sustainable.

Step 1: Determine Medicaid Eligibility

Before applying for a waiver, individuals must meet Indiana Medicaid financial eligibility requirements. This includes income and asset guidelines set by the state.

Indiana Medicaid Eligibility Information: https://www.in.gov/medicaid/members/

Step 2: Complete a Clinical Assessment

Applicants must demonstrate a level of care comparable to nursing facility care. This is determined through a state-approved clinical assessment conducted by a case manager or designated agency.

The assessment helps identify appropriate services and determine which waiver best fits the individual’s needs.

Step 3: Work With a Case Manager

Once eligibility is established, a case manager is assigned to coordinate services, develop a person-centered care plan, and authorize approved supports.

Absolute Golden Care works directly with case managers to ensure services are implemented correctly and without delays.

Step 4: Choose a Medicaid Provider

Indiana Medicaid participants have the right to choose their service provider. Once approved, individuals may select Absolute Golden Care to deliver authorized in-home services.

If already enrolled with another provider, participants may request a change without losing approved services.

Step 5: Begin Receiving Services

After provider selection and onboarding, approved services begin according to the care plan. Ongoing communication ensures services continue to meet the individual’s needs.

Medicaid Waivers vs. “Grants” for Care

Understanding Financial Support Options

Many families search for “grants” to help pay for long-term care. While direct cash grants for caregiving are limited, Indiana Medicaid waiver programs often function as an alternative by covering the cost of essential services at no out-of-pocket expense for eligible individuals.

How Medicaid Waivers Help Financially

Medicaid waivers can cover:

• Personal care and homemaker services
• Therapy and rehabilitation services
• Respite care for caregivers
• Home modifications and accessibility support
• Transportation and community services

Rather than providing one-time payments, these programs offer ongoing financial relief by paying for long-term care services.

Additional Financial Support Programs

Some individuals may also qualify for:

• Supplemental Security Income (SSI) https://www.ssa.gov/ssi

• Indiana Vocational Rehabilitation Services (for individuals returning to work) https://www.in.gov/fssa/ddrs/vr

These programs may complement Medicaid waiver services depending on eligibility.

How Absolute Golden Care Helps Families Navigate Medicaid

While Medicaid programs are governed by the State of Indiana, Absolute Golden Care supports families by:

• Explaining complex programs in plain language
• Assisting with provider transitions
• Coordinating with case managers and care teams
• Delivering approved in-home services reliably

Our goal is to make the process less overwhelming and ensure individuals receive the care they are entitled to.

Need Help Understanding Your Options?

Indiana Medicaid waiver programs can feel complex, but support is available. Absolute Golden Care is here to help you understand eligibility, explore available programs, and receive approved care at home.

Contact us to learn more about how Indiana Medicaid programs may support you or your loved one.