Can the PathWays for Aging Medicaid Waiver Program Cover Assisted Living in Indiana?

The most common questions people have about assisted living in Indiana are how much it costs, how to pay for it, and whether Medicaid covers it. Senior living costs vary based on the local cost of living, community amenities, and services. In Indiana, Medicaid and the Indiana PathWays for Aging Medicaid Waiver Program can help offset some assisted living costs.

However, Medicaid may not be accepted at all assisted living communities in Indiana and may only cover specific services. Keep reading for more information on Medicaid, what it covers, and how to pay for assisted living.

In this guide, we'll discuss:

• What Medicaid is
• Indiana’s PathWays for Aging Medicaid Waiver Program
• WHAT ASSISTED LIVING is and how to pay for it
• your next steps
  
  

What Is Medicaid?

Medicaid is a state-funded public insurance program that covers medical care and some long-term care services. It can often get confused with Medicare, which provides health insurance for people 65 years of age or older.

In Indiana, Medicaid covers all necessary senior living care services. The care level and services a person receives are determined by an Indiana PathWays for Aging MEDICAID Program assessment.

Care services are included in assisted living services supported by PathWays for Aging. However, the monthly rate doesn’t include assisted living room and board, which are the resident’s responsibility.

Indiana’s PathWays for Aging Medicaid Waiver Program

The state-funded PathWays for Aging Medicaid Waiver Program provides essential care services for qualified individuals. It allows Indiana’s Medicaid program to provide the necessary support services for a person to live as independently as possible in their home or other community setting. Some federal rules that usually apply to Medicaid services are set aside to provide more flexible care options.

To be eligible for PathWays for Aging, individuals must qualify based on the following criteria:

• Be at least 60 years of age
• Be a member of the Indiana Medicaid program
• Be eligible for full Medicaid coverage under the aged, disabled, or blind category, with or without Medicare
• May be receiving long-term care services, including:
  • Residing in a long-term care community or receiving support at home
  • Approval for an Aged and Disabled Waiver
• May be in the Behavioral and Primary Health Coordination program
• Not be a member of the Healthy Indiana Health Plan or Hoosier Healthwise Plan
• Not be a member of any of the following waivers:
  • Family Support
  • Community Integration and Habilitation
  • Traumatic Brain Injury
  • End Stage Renal Disease
• Not qualify for Emergency Services Only due to citizenship
• Not be a Breast and Cervical Cancer Program member on MA12
• Not be a resident with an intellectual or developmental disability in an immediate care community

In addition to the above, the following income requirements apply for the PathWays for Aging Medicaid Waiver program:

• Family size of 1: $1,304.17 income maximum per month
• Family size of 2: $1,762.50 income maximum per month

Family size for this program is based on your tax household. To qualify for the program, you must not have more than $2,000 (if single) or $3,000 (if married) in assets. Assets can include stocks, property other than your house, bank accounts, and cash.

Check full eligibility requirements for the PathWays for Aging Medicaid Waiver program here.

What Is Assisted Living?

For those who need some extra help, assisted living communities offer a homelike environment while also providing necessary support. Residents have easy access to meals, housekeeping, social events, and 24/7 support from care staff. 

Communities offer many different care options to provide the right balance of support and independence to residents, whether that’s minimal support to make sure daily habits are maintained or personalized care. No matter what the care level is, services are tailored to each person to make sure their unique needs are met.

Assisted living is ideal for those who need assistance with activities of daily living (ADLs) or instrumental activities of daily living (IADLs). ADLs include personal care activities, such as eating, personal hygiene, grooming, and toileting. IADLs cover complex activities, such as doing laundry, housekeeping, preparing meals, and managing finances and medications.

How to Pay for Assisted Living

There are plenty of ways to help offset the cost of assisted living. It’s important to explore all options that may be available to you to cover room and board and other services that Medicaid may not cover in Indiana. These resources include:

• Private funds: Many people pay senior living costs out of pocket from private funds. This includes savings accounts, retirement plans, investments, an inheritance, or money from selling the family home.
• Long-term care insurance: These policies cover specific things for a fixed period, but it can be hard to know how much coverage is needed. To make an informed decision, it’s best to talk with a financial advisor or insurance provider to discuss your options.
• Life insurance: You have several options for accessing the cash in your life insurance policy. You generally won’t get face value for the policy, but it will usually be more than the surrender value.
• Veterans’ benefits: The Department of Veterans Affairs offers a VA Aid and Attendance pension to eligible veterans, which can offset the cost of assisted living by a considerable amount.

Get More Answers

Understanding Medicaid, what it covers, and how to pay for senior living can be hard. But you don’t have to do this alone—nor should you. Assisted living communities, such as Cedarhurst^®, have many years of experience helping families navigate senior living, from easy questions about dining hours to complex topics, such as how to pay for senior living. We recommend connecting with the local experts at one of our communities to discuss paying for senior living and ask any questions you may have.

Your Next Steps

Finding out what you can use to pay for senior living in Indiana can be confusing, but we’re here to help. Cedarhurst has many years of experience helping families with the senior living process. Cedarhurst accepts the Indiana PathWays for Aging Medicaid Waiver Program at select communities in Indiana. To learn more about assisted living costs, explore our senior living pricing resources. 

Please be advised that the information provided in this blog is for general informational purposes only. Cedarhurst makes no representations or warranties of any kind, express or implied, regarding the completeness, accuracy, reliability, suitability, or availability of the information contained on this page. For the most accurate and up-to-date information regarding PathWays for Aging and related resources, we strongly recommend visiting Indiana's official PathWays for Aging Medicaid Waiver Program website.