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The money is running out

Spend-down, Medicaid waiver waitlists, and why waiting makes this harder.

Quick answer

Spend-down, Medicaid waiver waitlists, and why waiting makes this harder.

HomeBy SituationThe money is running out

This is the situation families delay talking about longest, and delay is the one thing that reliably makes it worse.

Short answer

Spend-down, Medicaid waiver waitlists, and why waiting makes this harder.

What to do, in order

  1. Work out the actual runway. Current balance, monthly burn including care-level charges, and expected increases.
  2. Contact the Area Agency on Aging about waiver waiting lists now. Indiana's PathWays Waiver has carried a waitlist historically -- ask CICOA where an application would currently stand before assuming there is time to wait.
  3. Find out whether the current community holds a waiver provider agreement. Ask directly, and ask how many current residents actually use it.
  4. Check for benefits already on the table. VA Aid and Attendance is heavily under-claimed; unreimbursed care costs reduce countable income.
  5. Talk to an elder law attorney before moving money. Transfers carry look-back consequences.

Questions families ask

What license does Indiana require for assisted living?

Indiana licenses assisted-living-type communities as Residential Care Facilities (RCF) under 410 IAC 16.2-5 and Indiana Code 16-28-2, issued by the Indiana Department of Health. It is a single license type -- Indiana does not tier assisted living into Type A/Type B categories the way Texas does.

Does Indiana require every assisted living community to be licensed?

No. Under 410 IAC 16.2-5-0.5(c), a community that provides only room, board, housekeeping and activities -- without administering medication or providing nursing care -- is not required to hold a Residential Care Facility license at all. Some buildings marketed as assisted living in Indiana may carry no state license, so always confirm directly.

Does Indiana require a separate license for memory care?

No. Indiana requires a written Alzheimer's and Dementia Special Care Disclosure under Indiana Code 12-10-5.5, not a separate state certification. Communities must file the disclosure and meet training requirements, but there is no distinct 'certified memory care' license to check for.

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