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Medicaid Waivers and Assisted Living

Indiana runs two separate programs for care inside a licensed community: the PathWays Waiver for care services, and RCAP for room and board.

HomeCosts & PayingMedicaid Waivers and Assisted Living

Medicaid waivers and assisted living in Indiana

Short answer

Indiana pairs two separate Medicaid programs for care inside a licensed Residential Care Facility: the PathWays Waiver, which pays for care services, and the Residential Care Assistance Program (RCAP), which pays for room and board. Neither one alone covers the full monthly bill.

PathWays Waiver

Launched July 1, 2024 as part of Indiana PathWays for Aging, the PathWays Waiver serves Hoosiers 60 and older through the Office of Medicaid Policy and Planning, with CICOA Aging & In-Home Solutions handling local case management. It covers personal/attendant care, structured family caregiving, respite, case management, home modifications and adult day services -- including care services inside a licensed community that holds a provider agreement. It does not cover room and board.

RCAP

The Residential Care Assistance Program is Indiana's Medicaid-funded room-and-board assistance for RCF residents, paid alongside PathWays waiver care services rather than instead of them. A facility can hold a PathWays agreement, an RCAP agreement, both, or neither -- ask specifically which apply before assuming a waiver covers the whole bill.

In-home-only services

Most Indianapolis-area seniors needing in-home-only care also use the PathWays Waiver rather than a separate program. Younger Hoosiers with disabilities (59 and under) instead use the Health and Wellness Waiver, administered by DDARS's Bureau of Disability Services -- generally not the program families searching this site will need.

Free help in your area. CICOA Aging & In-Home Solutions is the Area Agency on Aging covering all six counties this site serves. Read the full explanation →

Questions families ask

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.

Is in-home care or assisted living cheaper in Indiana?

It depends on hours needed. At Indiana's 2025 median of $35 an hour, a 40-hour week of home care already costs more than Indiana's assisted living median of $5,639 a month. Below roughly 30-35 hours a week, home care is often cheaper; above it, a community usually wins.

What's the difference between a nursing home and assisted living in Indiana?

A nursing home is licensed in Indiana as a Comprehensive Care Facility, providing 24-hour skilled nursing care and carrying a federal CMS star rating. Assisted living is licensed as a Residential Care Facility, a lower level of care with no CMS rating.

What's the difference between hospice and palliative care?

Palliative care focuses on symptom relief and quality of life, and can run alongside curative treatment at any stage of an illness. Hospice is for a life-limiting illness when a physician expects six months or less if the disease runs its normal course, and generally means curative treatment has stopped.

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