By Indy Senior Advisor Care Team · June 1, 2026
On July 1, 2024, Indiana split its long-standing Aged & Disabled Waiver into two new programs. For Indianapolis-area families already confused by Medicaid terminology, here is what actually changed and what didn't.
A waiver most families had never heard of, replaced by two more
If your family started researching Medicaid help for senior care more than a year or two ago, you may still be picturing Indiana's old Aged & Disabled Waiver. That program no longer exists in that form. On July 1, 2024, the state split it into two separate waivers as part of a broader restructuring called Indiana PathWays for Aging.
The split itself is simple to state and easy to get wrong in practice: the new PathWays Waiver serves Hoosiers age 60 and older, while the Health and Wellness Waiver serves people under 60 with disabilities. Almost every family reading this from the Indianapolis metro, searching for help for a parent, will land in the PathWays population, not the Health and Wellness one.
The name change alone causes real confusion. Families who started researching Medicaid options for a parent two or three years ago, perhaps after a first conversation with a hospital social worker, often bookmarked information about the Aged & Disabled Waiver that is now out of date. If you find an old article, a saved PDF, or notes from an earlier conversation referencing that program by name, treat it as a starting point for questions rather than current fact.
What PathWays actually pays for
The PathWays Waiver, administered through Indiana's Office of Medicaid Policy and Planning, covers personal and attendant care, structured family caregiving, respite for family caregivers, case management, home modifications, and adult day services. It can also pay for care services delivered inside a licensed Residential Care Facility, if that facility holds a current PathWays provider agreement.
What it does not pay for is room and board. That distinction trips up more families than any other piece of this system, so it is worth repeating: a facility can be a strong fit for care needs and still leave a family with the full rent bill if it does not separately participate in Indiana's room-and-board program.
Structured family caregiving is one of the more valuable, and less understood, pieces of what PathWays can cover. It allows an eligible family member who is already providing significant care to be compensated for it, under a formal arrangement with training and oversight requirements, rather than assuming unpaid caregiving is the only option once a family decides against a facility move.
Case management is built into the program as well, meaning an eligible household is assigned someone whose job is to help coordinate the various services and providers involved -- valuable for families who find the sheer number of moving pieces in senior care overwhelming on top of everything else they're managing.
RCAP: the other half of the equation
The Residential Care Assistance Program, RCAP, is Indiana's Medicaid-funded room-and-board assistance for residents of licensed Residential Care Facilities. It runs alongside the PathWays Waiver rather than replacing any part of it -- a facility can hold a PathWays agreement, an RCAP agreement, both, or neither.
Before assuming a community's Medicaid relationship covers the full monthly bill, ask two separate, specific questions: does this community hold a current PathWays Waiver provider agreement, and does it separately hold an RCAP agreement? A confident answer to only one of these questions is a signal to keep asking, not a reason to stop.
RCAP's room-and-board coverage functions differently than a typical rent subsidy. It generally sets a rate the program will pay toward a resident's room-and-board charges at a participating facility, with the resident's own income (primarily Social Security) applied first and RCAP covering the remaining gap up to the program's limit. That structure means the specific numbers can vary by household income, which is one more reason a direct conversation with CICOA, rather than an assumption based on a friend's experience, is worth having early.
Who administers this locally
For families across Marion, Hamilton, Hendricks, Johnson, Boone and Hancock counties, CICOA Aging & In-Home Solutions handles local PathWays Waiver case management. CICOA's Resource Center can walk a family through where an application currently stands, what documentation is needed, and which facilities in the metro currently hold active provider agreements.
This is also the right first call for a family that isn't sure yet whether Medicaid will be part of the picture at all. CICOA's information and referral services are free regardless of whether a family ultimately qualifies for the waiver.
The waitlist reality
At the program's July 2024 launch, 9,015 people were on the PathWays waiting list statewide, out of 39,842 total slots. That is not a small number, and it is part of why elder law attorneys and case managers consistently advise applying well before a crisis, rather than waiting until private funds are nearly exhausted.
Current 2026 waitlist figures were not available as part of this article's research, and they shift over time as the state opens additional slots. The only reliable way to know where an application currently stands is to ask CICOA directly.
What this means for a family planning right now
If a parent is likely to need Medicaid help for assisted-living-style care within the next one to three years, the practical advice is to start the PathWays Waiver application now rather than waiting for a discharge deadline or a financial cliff to force the timeline. Applying early does not commit a family to anything -- it simply gets a name into the process while other options, private pay, VA benefits, or a temporary in-home arrangement, run in parallel.
It is also worth asking any community under consideration, in writing, exactly which of the two programs it participates in today, since provider agreements can change. A facility's Medicaid status two years ago is not proof of its status now.
None of this replaces a conversation with an elder law attorney if the family's finances are complex -- particularly around asset transfers, trusts, or a spouse who will remain in the home. Medicaid planning has real look-back rules and irreversible consequences for money moved at the wrong time, and a benefits counselor at CICOA, while extremely useful for navigating the waiver application itself, is not a substitute for legal advice on asset structuring.
A realistic timeline
Applying for the PathWays Waiver is not a same-week process. Between the financial and functional-need assessments, documentation gathering, and the waitlist itself if one is active, families should expect the process to take weeks at a minimum and sometimes several months. That is exactly why elder law attorneys and CICOA's own case managers consistently recommend starting the application well before a family expects to need it, rather than treating it as a step that begins only once a crisis forces the issue.
In the meantime, it is worth having a parallel, private-pay plan in place -- even a temporary one -- so that a slow-moving Medicaid process does not become the single point of failure in an urgent housing decision.
