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Medicaid Waiver vs. Nursing Home Medicaid

Indiana's PathWays Waiver and nursing-home Medicaid use similar financial eligibility tests but pay for completely different settings, and one is capped while the other is not.

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Short answer

Indiana's PathWays Waiver and long-term-care Medicaid for a nursing home use a similar Special Income Limit and asset test, but pay for very different settings -- the waiver pays for care services inside a licensed community or at home, while nursing-home Medicaid pays for 24-hour skilled nursing care in a Comprehensive Care Facility.

The waitlist difference

Nursing home Medicaid is an entitlement in Indiana -- if a person meets the clinical and financial criteria, coverage is available. The PathWays Waiver is capped and has carried a waitlist historically (9,015 people at its July 2024 launch); confirm current status with CICOA before assuming a short wait.

Room and board

Nursing-home Medicaid covers room and board as part of the facility's daily rate. PathWays does not -- room and board for assisted-living-style care runs through the separate RCAP program instead.

How families pay for care. Indiana's PathWays Waiver pays for care services, RCAP pays for room and board, and VA Aid and Attendance can help veterans and surviving spouses. Read the full explanation →

Questions families ask

What does a nursing home cost in Indiana?

CareScout's 2025 survey puts Indiana's nursing home median at $8,943 a month for a semi-private room and $10,326 for a private room. Semi-private figures are often Medicaid-weighted and lower than a private-pay quote you'd actually be offered.

What does in-home care cost in Indiana, and when does a community become cheaper?

Indiana's 2025 CareScout median for non-medical home care is $35 an hour. A 40-hour week already runs about $6,067 a month, above Indiana's assisted living median -- so once care needs push past roughly 40 hours a week, it is worth running the math against a community's monthly rate.

Does Indiana have a state program that pays assisted living rent directly?

No broad, non-Medicaid state subsidy pays a family's assisted-living rent directly in Indiana. Available help is narrower: the PathWays Waiver for care services, RCAP for room-and-board assistance paired with a facility's waiver agreement, and VA Aid and Attendance for eligible veterans and surviving spouses.

Which long-term care ombudsman office covers Indianapolis?

Region 8 of Indiana's Long Term Care Ombudsman Program, operated by Indiana Legal Services, covers Marion County and all five surrounding collar counties this site serves -- Hamilton, Hendricks, Johnson, Boone and Hancock -- plus Morgan and Shelby. Reach the regional office at 317-631-9424 or the statewide line at 800-622-4484.

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