How to Pay for Home Care in Indiana

Start with what kind of help you need

Before you worry about who pays, get clear on the type of care. Families often mix up skilled medical care with everyday help at home. Medicare, Medicaid, the VA, and private insurers each cover different pieces—and often not the same ones.

Skilled or medical home health usually means intermittent nursing, therapy, or a home health aide tied to a doctor’s plan of care. Non-medical home care means help with bathing, dressing, meals, light housekeeping, companionship, and respite for family caregivers. Many Indiana households need non-medical help for months or years, which is where Medicaid home- and community-based services (HCBS) waivers, VA Aid & Attendance, long-term care insurance, and private pay come in.

Indiana Medicaid and HCBS waivers

If the person who needs care has limited income and assets—or may qualify under special waiver financial rules—Indiana Medicaid can be the most important payer for long-term home care. On July 1, 2024, the former Aged and Disabled Waiver split into two programs: the Indiana PathWays for Aging Waiver (generally age 60+) and the Health & Wellness Waiver (generally age 59 and under).

Waiver services can include attendant care, home and community assistance (help with housework and errands), respite, home-delivered meals, home modifications, and other supports listed on the member’s approved service plan. Exact services depend on assessed need and what the case manager and state approve—not on a fixed menu you pick yourself.

Important: waiver slots are limited. FSSA has used waiting lists when capacity is full. Apply early through your local Area Agency on Aging (AAA), and also complete a Medicaid application. Confirm current waiting-list and invitation rules with your AAA or case manager; do not rely on informal timelines.

• Find your AAA: in.gov FSSA Area Agencies on Aging directory, or call 800-713-9023.
• Apply for Medicaid coverage through official FSSA / Medicaid channels.
• Ask specifically about PathWays for Aging (60+) or Health & Wellness (59 and under).

Indiana PathWays for Aging (60+)

PathWays for Aging is Indiana’s Medicaid managed care program for many members age 60 and older who qualify for full-coverage aged, blind, or disabled Medicaid (with or without Medicare). PathWays members can receive medical care through a PathWays health plan and, if approved for the PathWays Waiver, home- and community-based supports as an alternative to nursing facility care.

PathWays health plans have included Anthem, Humana, and UnitedHealthcare (confirm current plans on in.gov/pathways). Being in PathWays is not the same as having an active waiver slot. Ask your care coordinator or AAA which steps apply to you.

Medicare home health (usually short-term and skilled)

Original Medicare can cover home health services when you are homebound, need intermittent skilled nursing or therapy, and a Medicare-certified agency provides care under a physician or allowed practitioner’s order. Covered services can include skilled nursing, physical/occupational/speech therapy, and home health aide services when they are part of that skilled plan.

Medicare generally does not pay for 24-hour care, custodial-only personal care, or homemaker services unrelated to a skilled plan. If Mom mainly needs help bathing and cooking for the long haul, Medicare alone is usually not enough—look at Medicaid waivers, VA benefits, insurance, or private pay.

VA benefits, including Aid & Attendance

Eligible wartime Veterans and some surviving spouses may qualify for VA pension benefits. Aid & Attendance and Housebound allowances can increase that pension when the person needs help with daily activities or is largely housebound. Those extra monthly payments can help families pay for in-home care, assisted living, or nursing home care—but they are not a direct “VA home care agency” benefit for everyone.

Eligibility and rates change; apply through VA.gov or an accredited Veterans Service Organization. You generally cannot receive Aid & Attendance and Housebound at the same time. Confirm details with the VA—do not rely on third-party rate quotes.

Long-term care insurance and private pay

If the person has a long-term care insurance policy, call the insurer early. Ask what triggers benefits (elimination period, ADLs, cognitive impairment), which providers they will pay, and whether home care is covered at the same daily rate as facility care. Keep claim notes and care logs.

Private pay means the family or individual pays the agency directly. Rates vary by county, hours, and whether care is needed nights or weekends. Ask agencies for a written rate sheet, caregiver screening practices, and backup coverage if a caregiver calls off. Private pay can also bridge time while a Medicaid waiver application or waiting list moves forward.

A practical order of steps for most Indiana families

You do not have to finish every step before getting help. Many families start private-pay or family caregiving while applications are pending.

• Write down the help needed (ADLs, IADLs, nights, dementia support, skilled nursing).
• Call your local AAA (or 800-713-9023) about Options Counseling and waiver screening.
• Start or update the Medicaid application if income/assets may qualify.
• Ask about Medicare home health if there is a recent hospital stay or skilled need.
• Check VA pension / Aid & Attendance if the person (or spouse) is a wartime Veteran.
• Review any long-term care insurance policy and gather claim paperwork.
• Use this site’s match form to hear from licensed home care agencies in your county while funding is sorted out.

What this site will and will not do

Indiana Home Care Guide is an independent information site. We are not FSSA, Medicaid, Medicare, or the VA. We do not determine eligibility, approve service plans, or guarantee waiver openings. Always confirm rules, phone numbers, and next steps with your case manager, AAA, or the official agency links listed in each guide.

Frequently asked questions