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What Happens When the Money Runs Out

Spend-down, Medicaid waiver transitions, and why you should ask a community about this before you move in.

HomeCosts & PayingWhat Happens When the Money Runs Out
Short answer

If private funds run out, the options generally are a Medicaid HCBS waiver for care inside a licensed community, Medicaid nursing facility coverage, or moving to a community that holds a waiver provider agreement. Confirm your state's specific programs before relying on this.

Ask before you move in, not after

This is the single most consequential question families skip. A community that does not hold a Medicaid waiver provider agreement will ask your parent to leave when private funds are exhausted — often with short notice, at the point when moving is hardest.

Ask directly: do you hold a Medicaid waiver provider agreement, and how many current residents use it? A community can technically hold an agreement and still have no waiver capacity available.

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 →
The local long-term care ombudsman. Indiana Legal Services' Region 8 Long Term Care Ombudsman covers this entire six-county metro: 317-631-9424, or the statewide line at 800-622-4484. Read the full explanation →

Questions families ask

What should I do after a parent's first fall?

Treat it as a signal, not an accident -- a first fall is one of the strongest predictors of the next one. Get the cause investigated (medications, vision, inner-ear issues), fix the immediate environment, and ask CICOA Aging & In-Home Solutions about equipment-lending programs.

What should I do right after a dementia diagnosis?

Slow down -- very little has to be decided the first month. Get the specific diagnosis type, since Alzheimer's, vascular dementia, Lewy body and frontotemporal dementia progress differently, and put power of attorney and medical power of attorney paperwork in place now, while capacity is clear.

I live out of state. How do I manage my parent's care from a distance?

Build a plan that survives a bad-weather week when you cannot fly in. Recruit local eyes such as a Meals on Wheels driver or trusted neighbor, get medical power of attorney and HIPAA authorization in place, and establish one local point of contact, such as CICOA or a geriatric care manager.

Which Area Agency on Aging covers Marion County?

CICOA Aging & In-Home Solutions, Indiana's Planning & Service Area 8, covers Marion County and all five surrounding collar counties this site serves. Reach CICOA at 317-254-5465 or its Resource Center at 317-803-6131.

Does Hamilton County have its own Area Agency on Aging?

No -- Hamilton County is covered by the same agency as Indianapolis, CICOA Aging & In-Home Solutions, so Carmel, Fishers and Noblesville families use the same regional resources as Marion County families.

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