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Medicaid Waiver vs. Nursing Home Medicaid

Indiana's PathWays Waiver and nursing-home Medicaid use similar financial eligibility tests but pay for completely different settings, and one is capped while the other is not.

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Short answer

Indiana's PathWays Waiver and long-term-care Medicaid for a nursing home use a similar Special Income Limit and asset test, but pay for very different settings -- the waiver pays for care services inside a licensed community or at home, while nursing-home Medicaid pays for 24-hour skilled nursing care in a Comprehensive Care Facility.

The waitlist difference

Nursing home Medicaid is an entitlement in Indiana -- if a person meets the clinical and financial criteria, coverage is available. The PathWays Waiver is capped and has carried a waitlist historically (9,015 people at its July 2024 launch); confirm current status with CICOA before assuming a short wait.

Room and board

Nursing-home Medicaid covers room and board as part of the facility's daily rate. PathWays does not -- room and board for assisted-living-style care runs through the separate RCAP program instead.

How families pay for care. Indiana's PathWays Waiver pays for care services, RCAP pays for room and board, and VA Aid and Attendance can help veterans and surviving spouses. Read the full explanation →

Questions families ask

What senior care options exist in Boone County?

Boone County, anchored by Zionsville and the county seat Lebanon, has a smaller but growing set of verified communities, including standalone memory care and Trilogy Health Services campuses, with CICOA as the Area Agency on Aging.

What senior care options exist in Hancock County?

Hancock County, anchored by Greenfield, has several verified assisted living, independent living and skilled nursing options and is served by Hancock Regional Health and CICOA Aging & In-Home Solutions.

What's the difference between independent living and assisted living in Indiana?

Independent living is generally unlicensed housing -- apartments or cottages with dining and activities but no personal care. Assisted living communities in Indiana are licensed as Residential Care Facilities and provide medication administration and help with daily activities.

What's the difference between assisted living and memory care in Indiana?

Both can be licensed as Residential Care Facilities, but a memory care unit must also file Indiana's Alzheimer's and Dementia Special Care Disclosure under IC 12-10-5.5 and meet dementia-specific staff training requirements. There is no separate state cost median for memory care, unlike assisted living.

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