Medicaid Waivers
Helping older adults and people with disabilities to live independently in their communities and out of institutional care
Seniors and people with disabilities on Medicaid may be eligible for waivers that allow them to receive vital services in a home or community-based setting.
In the early 1980s a growing national trend moved away from institutional care for the elderly and persons with disabilities in favor of providing home and community-based services. In response, a new Medicaid program “waived” the federal requirement that services be provided in an institution. This allowed Medicaid recipients to receive non-traditional in-home and community-based services, so long as the cost was comparable.
Indiana began offering Medicaid Waivers in 1986 using federal and matching state dollars. Indiana Medicaid pays for home and community-based services for individuals who choose to remain in their home instead of an institution.
Indiana offers the following types of Medicaid Waivers:
Indiana PathWays for Aging Waiver for individuals who are 60 years of age or older and who meet the requirements for a nursing facility level of care.
Health & Wellness Waiver for individuals under 60 years of age who meet the requirements for a nursing facility level of care.
Traumatic Brain Injury Waiver for individuals of any age with a TBI diagnosis.
Community Integration and Habilitation (CIH) and Family Supports Waivers (FSW) for children and adults with intellectual or other developmental disabilities.
Since July 1, 2024, Managed Care Entities (MCEs) coordinate and approve medical care and waiver services for individuals on the PathWays for Aging Waiver.
Waivers are used to pay for services from qualified providers of attendant or nursing care services, home modifications (ramps), lifts for vehicles, residential and employment supports, etc., and are intended to help people with disabilities continue to live in their homes and communities instead of being moved to institutional care.
Every state has a maximum number of slots for Medicaid Waivers it can grant in a given year, filled on a first-come, first-served basis. When the maximum number of slots are filled, a wait list may be activated. Clients must meet eligibility requirements each year to continue receiving Medicaid and Waiver services.
Around the same time that Indiana began offering Medicaid Waivers, it also developed the CHOICE program. CHOICE — Community and Home Options for Institutional Care for the Elderly and Disabled — is a state-funded program under the Division of Aging that provides support to both seniors and people of any age with a disability to help them live at home or in community-integrated settings.
Medicaid Waivers in Central Indiana
CICOA is the single point of entry for people seeking PathWays, Health & Wellness and TBI Waivers or CHOICE funds in Boone, Hamilton, Hancock, Hendricks, Johnson, Marion, Morgan and Shelby counties. Access to Medicaid Waivers depends on the type of waiver sought and the individual’s eligibility for services.
Skilled Nursing Waivers
In Indiana, access to skilled nursing waiver services are initiated through the local Area Agency on Aging. CICOA is the Area Agency on Aging for Central Indiana.
Skilled nursing waivers include PathWays for Aging, Health & Wellness, and Traumatic Brain Injury waivers. To be eligible for these waivers, the individual must meet Medicaid requirements and eligible for nursing facility level of care. A CICOA options counselor will assess the potential client and determine whether the individual is eligible to receive services based on income, level of impairment, availability of funds, and waitlist status. For children with disabilities under the age of 18, parental income and resources are NOT counted when determining financial eligibility.
For Health & Wellness and TBI waivers, once the intake process is complete, ongoing case management can be provided through CICOA or handed off to an independent case manager, if the client so chooses.
For PathWays waivers, once the intake process is complete, the individual will be assigned to a Managed Care Entity (Anthem, Humana or UnitedHealthcare) to receive care coordination and service coordination.
Intellectual and Developmental Disability Waivers
Intellectual and Developmental Disability Waivers (CIH and FSW) are initiated through the local Bureau of Disability Services (BDS). Specifically, BDS manages the CIH and FSW waivers. Visit the Indiana BDS website to learn more or find your local office.
Get Started
Call the Aging & Disability Resource Center:
(317) 803-6131 or (800) 432-2422