Understanding Indiana's Medicaid Waiver Waiting List

In April 2024, FSSA, Indiana's state Medicaid agency, reached its federally approved waiver capacity. This led to the introduction of a waiting list for its in-home Pathways waiver services. Currently, waiting times may range from 1 to 2 years, but they can vary based on individual circumstances.

To get assessed for the Medicaid Waiver, contact Maximus at 833-597-2777. More information is available here: FSSA: DDARS: HCBS Medicaid Waiver Waiting List Information.

Priority for Waiver Invitations

Individuals are invited from the waiting list each month in a specific order. Here’s how it works:

1. Priority Individuals

Discharge from a Hospital

If someone on the waiver waiting list is hospitalized, they may qualify for priority placement. Contact Aging & In-Home Services or our office as soon as possible to discuss eligibility for priority processing.

Money Follows the Person (MFP)

MFP assists nursing home residents who have been there for at least 60 days to transition to in-home care. This program can expedite access to in-home waiver services and follows the same eligibility guidelines as the Pathways waiver. Learn more at in.gov/fssa/ddars/bba/medicaid-hcbs/money-follows-the-person.

CHOICE Program

The CHOICE (Community and Home Options to Institutional Care for the Elderly and Disabled) program is for individuals aged 60 and older or those with disabilities at risk of losing their independence. Eligibility requires assets below approximately $270,000 (excluding home). Services include attendant care, case management, transportation, home health aide, and home-delivered meals. Wait times are similar to those of the Pathways waiver. More details are available at CHOICE Program.

2. Remaining Waiver Invitations

Individuals on the waiting list without priority status receive the remaining waiver invitations based on the date they were assessed for a nursing facility level of care.

Alternative Services While You Wait

If you’re on the waiting list or considering applying, there are alternative services and options to explore while you wait:

PACE of Northeast Indiana

The PACE (Program of All-Inclusive Care for the Elderly) is currently available in Allen County. It provides comprehensive services, including care coordination, medical care, therapy, and transportation. This program is a partnership between Aging & In-Home Services and Parkview. It’s open to individuals who meet the same eligibility criteria as the Pathways waiver. For those on Medicare, there is an option to privately pay ($4,500 per month). For more information, visit www.pacenein.org.

GUIDE Program

The GUIDE (Guiding an Improved Dementia Experience) program is available at no cost to those on Medicare A & B with a dementia diagnosis or signs of cognitive impairment. This program helps manage symptoms, offers caregiver support, and connects participants with community resources. GUIDE ensures that those living with dementia receive the care and attention they deserve. To learn more, call Aging & In-Home Services at 260-999-4106 or visit GUIDE: Dementia Support Covered by Medicare | agingihs.

Veteran-Directed Care Program

The Veteran-Directed Care (VDC) Program is a VA initiative that gives Veterans greater control over their long-term care. This program helps Veterans stay in their homes and communities by providing a flexible budget to purchase the goods and services they need to maintain independence. It includes the option to hire, train, and supervise their own caregivers. More details can be found at Veteran-Directed Care.

Conclusion

Navigating the Medicaid Waiver waiting list can be challenging. However, understanding the process and knowing your options can make a significant difference. Whether you are seeking immediate assistance or planning for the future, resources are available to support you.

If you have any questions or need further assistance, please feel free to reach out. I am here to help you navigate these complex matters and ensure your wishes are honored.