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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

How do I report suspected abuse or neglect in Indiana?

Call Indiana's statewide Adult Protective Services line at 1-800-992-6978, or file online. Indiana APS is state-run through five regional field teams under FSSA, not county-run, so there is no separate Marion County number to look up.

Is there a different number for a facility-specific licensing complaint versus abuse?

Yes. Adult Protective Services (1-800-992-6978) investigates suspected abuse, neglect or exploitation of an individual. A facility licensing complaint -- about conditions, staffing, or care quality broadly -- goes to the Indiana Department of Health at 1-800-246-8909 or through its online complaint form.

What should I do if someone is in immediate danger?

Call 911 first. Adult Protective Services is not an emergency responder and does not dispatch immediate help -- it investigates reports after the fact. Use 911 for anything urgent, then follow up with APS or the ombudsman as appropriate.

Who has to report suspected elder abuse in Indiana?

Indiana is a mandatory-reporting state: anyone who suspects neglect, battery, or exploitation of an endangered adult (18 or older, incapacitated, and harmed or threatened) is required to report it, not just healthcare or facility staff.

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