Two different Medicaid pathways
Indiana expanded Medicaid under the ACA through the Healthy Indiana Plan (HIP), effective February 1, 2015, for adults 19-64. This is a completely different eligibility pathway -- income-based (MAGI) -- from the non-MAGI aged/blind/disabled pathway seniors use for long-term-care Medicaid. The two are frequently and incorrectly conflated.
Why the distinction matters
HIP eligibility phases out once someone qualifies for Medicare at 65, and it was never designed to pay for assisted living or nursing home care. Long-term-care Medicaid for a senior in a licensed community runs through a separate application process, with its own asset limits, a Special Income Limit (approximately 300% of the SSI federal benefit rate), and spend-down rules.
If a hospital or facility mentions “Medicaid eligibility”
Ask specifically which pathway they mean. A parent who does not qualify for HIP based on income can still be eligible for long-term-care Medicaid, since the two use entirely different rules.
How families actually pay for care
Indiana expanded Medicaid under the ACA through the Healthy Indiana Plan (HIP), effective February 1, 2015, for adults 19-64 — a completely different, income-based eligibility pathway from the non-MAGI aged/blind/disabled Medicaid pathway seniors use for long-term care. Do not conflate the two.
For care inside a licensed community, Indiana pairs two separate programs: the PathWays Waiver (part of Indiana PathWays for Aging, for Hoosiers 60+) pays for care services, while the Residential Care Assistance Program (RCAP) pays for room and board. A facility can hold one agreement, both, or neither — ask specifically which apply before assuming a waiver covers the whole bill.
For in-home-only services, most seniors also use the PathWays Waiver, locally case-managed by CICOA Aging & In-Home Solutions. Nursing-facility Medicaid uses Indiana's own income/asset limits and spousal protections, which change annually — confirm current figures with FSSA before relying on a specific dollar amount.
Federal VA Aid and Attendance can add up to roughly $2,424/month for a qualifying veteran or $1,577/month for a surviving spouse (rates effective December 1, 2025), on top of any of the above.
