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My spouse needs more care than I can give

Options that keep a couple together, and the spousal protections Medicaid provides.

Quick answer

Options that keep a couple together, and the spousal protections Medicaid provides.

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Home›By Situation›My spouse needs more care than I can give

Caring for a spouse is different from caring for a parent, financially and otherwise. Indiana's spousal impoverishment protections under federal Medicaid rules set a Community Spouse Resource Allowance and a Minimum Monthly Maintenance Needs Allowance -- confirm current figures with FSSA before relying on a specific dollar amount.

Short answer

Options that keep a couple together, and the spousal protections Medicaid provides.

What to do, in order

  1. Understand the spousal protections. Indiana's Community Spouse Resource Allowance and Minimum Monthly Maintenance Needs Allowance change annually -- confirm current figures with FSSA or an elder law attorney before assuming a specific dollar amount.
  2. Look at communities that keep couples together. Several campuses offer more than one level of care on one site.
  3. Be honest about your own health. Spousal caregivers routinely under-report their own decline.
  4. Get an objective assessment. The Area Agency on Aging serving your county can assess both of you at no cost.

Questions families ask

What is RCAP and how is it different from the PathWays Waiver?

The Residential Care Assistance Program (RCAP) is Indiana's Medicaid-funded room-and-board assistance for RCF residents. It pairs with, but is separate from, the PathWays Waiver, which pays for care services. A facility can hold a PathWays agreement, an RCAP agreement, both, or neither -- ask specifically which apply.

Is Indiana's Medicaid expansion (HIP) the same as long-term care Medicaid for seniors?

No. The Healthy Indiana Plan (HIP), Indiana's ACA expansion effective February 1, 2015, covers adults 19-64 based on income. Long-term-care Medicaid for seniors uses a separate, non-MAGI aged/blind/disabled eligibility pathway with different asset and income rules. The two are frequently and incorrectly conflated.

Is there a waitlist for Indiana's PathWays Waiver?

Yes, historically. At the program's July 2024 launch, 9,015 people were on the PathWays waiting list statewide out of 39,842 total slots. Current waitlist figures change; confirm today's status with CICOA Aging & In-Home Solutions, the Area Agency on Aging serving this region.

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