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Managed Care for Medicare/Medicaid Dual-Eligibles in Indiana

Indiana coordinates long-term services and supports for seniors through managed care under the PathWays for Aging program, launched July 1, 2024.

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How Indiana coordinates care for dual-eligibles

Short answer

Indiana restructured how it coordinates Medicare and Medicaid long-term services and supports for seniors on July 1, 2024, when the Indiana PathWays for Aging program launched and split the former Aged & Disabled Waiver into the PathWays Waiver (60+) and Health and Wellness Waiver (under 60).

What PathWays for Aging coordinates

The program is designed to bring managed-care coordination to long-term services and supports for Hoosiers 60 and older, working alongside Medicare rather than replacing it. Because this is a relatively new structure (launched mid-2024), families should confirm current plan details and any further changes directly with FSSA or CICOA rather than relying on older descriptions of Indiana's Aged & Disabled Waiver, which PathWays replaced.

Where to get current, local answers

CICOA Aging & In-Home Solutions provides local PathWays case management for every county this site covers and is the most reliable source for how the program is actually functioning in this metro right now.

Questions families ask

Does Indiana require a separate license for memory care?

No. Indiana requires a written Alzheimer's and Dementia Special Care Disclosure under Indiana Code 12-10-5.5, not a separate state certification. Communities must file the disclosure and meet training requirements, but there is no distinct 'certified memory care' license to check for.

How do I check a facility's Indiana license and inspection history?

Use the Indiana Long Term Care Survey & Inspection Public Search at hoosierusa.isdh.in.gov, run by the Indiana Department of Health. Nursing homes also carry a federal CMS Care Compare star rating; assisted living (Residential Care Facilities) does not.

What's the difference between Indiana's Residential Care Facility and Comprehensive Care Facility licenses?

A Residential Care Facility (RCF) is Indiana's assisted-living-type license, covering personal care, medication administration and ADL help, not 24-hour skilled nursing. A Comprehensive Care Facility is Indiana's nursing-home license, for residents who need 24-hour licensed nursing care.

What Medicaid waiver pays for assisted living in Indiana?

Indiana's PathWays Waiver, part of the Indiana PathWays for Aging program launched July 1, 2024 for Hoosiers 60 and older, can pay for care services inside a licensed Residential Care Facility that holds a waiver provider agreement. It does not cover room and board -- that runs through a separate program, RCAP.

What is RCAP and how is it different from the PathWays Waiver?

The Residential Care Assistance Program (RCAP) is Indiana's Medicaid-funded room-and-board assistance for RCF residents. It pairs with, but is separate from, the PathWays Waiver, which pays for care services. A facility can hold a PathWays agreement, an RCAP agreement, both, or neither -- ask specifically which apply.

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