Will my current home care services change with the Indiana PathWays for Aging transition?

The transition to a managed care model in Indiana has left many families wondering if the “peace of mind” they have built through existing care routines will be disrupted. Since the launch of PathWays for Aging, the landscape of Indiana senior services update has shifted toward a more coordinated, insurance-led approach. For those who were previously on the Aged and Disabled (A&D) waiver, the change was more than just a name update; it was a shift in how home care changes are approved and managed. Navigating this system in 2026 requires an understanding of how Managed Care Entities (MCEs) like Anthem, Humana, and UnitedHealthcare view medical necessity and care coordination. While the state promised a seamless experience, many families still feel the need to advocate for their existing service levels. This blog addresses the most common fears regarding service reductions and provider changes within the PathWays framework, ensuring you have the information needed to maintain your loved one’s independence in the Indianapolis area. For a deep dive into the regulatory framework, see our Indiana PathWays for Aging Guide.

Does PathWays for Aging reduce the number of hours I can receive?

One of the primary concerns for families is whether the move to managed care results in a loss of authorized hours. Under the previous fee-for-service model, hours were often determined by a case manager with a high degree of flexibility. Within the PathWays for Aging system, the number of hours is determined through a collaborative process led by your assigned Care Coordinator. It is important to know that the state of Indiana implemented continuity of care protections during the PathWays transition impact to prevent sudden drops in service. However, by 2026, most members have undergone at least one or two reassessments by their chosen MCE. These reassessments are based on “medical necessity” and the functional needs of the senior. If your loved one’s health status remains stable, their hours should theoretically remain consistent. Reductions typically occur only if a reassessment shows a significant improvement in the senior’s ability to perform activities of daily living (ADLs). To protect your current hours, it is vital to document every struggle your parent faces during their annual assessment. If a reduction is proposed that you disagree with, you have the right to file a grievance and request a clinical review through your MCE’s member services.

• Initial hours are based on the previous service plan authorized under the A&D waiver.
• Reassessments are conducted annually or whenever there is a significant change in health.
• Care Coordinators use a standardized state assessment tool to calculate daily needs.
• Families can appeal any decision that reduces care hours through a formal grievance process.
• Documentation from primary care physicians can support the need for higher hour levels.

What happens to my caregiver during the managed care transition?

For many seniors, the bond with their specific caregiver is the most critical element of their daily happiness. The good news is that the Indiana PathWays for Aging program emphasizes the importance of the caregiver-client relationship. If your caregiver works for an agency that is contracted with your specific MCE, there should be no change in who comes to your door. However, if your home care agency is not in-network with your new plan, you may face a difficult choice. During the initial rollout, there was a 90-day period where out-of-network providers were allowed to continue services to ensure safety. In 2026, those grace periods have expired. If your preferred agency has not joined your MCE’s network, the MCE may eventually require you to transition to an in-network provider. To avoid this, many families in Indianapolis choose their MCE based on which health plan their current agency accepts. If you are using an agency like Nana Cares, checking their network status is the first step in ensuring your caregiver remains a constant presence in your parent’s life.

• Caregivers can stay as long as their employing agency is in-network with the chosen MCE.
• Out-of-network exceptions are rare but can be requested for highly specialized care needs.
• Changes in health plans during open enrollment can help families align with their preferred providers.
• Consistent caregivers are recognized as a key factor in reducing anxiety for seniors with dementia.
• Managed care plans are required to maintain an adequate network of providers in every county.

Do I need a new assessment to stay in the PathWays program?

Yes, the requirement for regular assessments is a standard part of the Indiana PathWays for Aging program. Even if your loved one has been receiving services for years, the MCE must verify that they still meet the “Nursing Facility Level of Care” (NFLOC) requirement. This assessment is not just about keeping the care you have; it is also an opportunity to request more help if a senior’s condition has declined. In 2026, these assessments are typically conducted by a Care Coordinator who visits the home once a year. They will ask questions about mobility, cognitive function, medication management, and nutritional needs. This Indiana senior services update means that your care plan is a “living document” that can be adjusted as needs change. Families should treat these assessments with a high degree of preparation. Being able to describe a “worst-case day” rather than a “best-case day” is essential for ensuring the coordinator understands the true level of risk the senior faces without support.

• Annual assessments are mandatory to maintain eligibility for waiver-based services.
• Assessments determine if the senior still meets the state’s clinical criteria for home care.
• The Care Coordinator will evaluate both the physical and social needs of the member.
• Changes in the environment, such as a new fall risk, should be disclosed during the visit.
• Families have the right to participate in the assessment and provide additional context.

How do I ensure my home care agency is in-network with my new plan?

Ensuring your agency is in-network is the most proactive step you can take to prevent home care changes. Every MCE (Anthem, Humana, UnitedHealthcare) is required to provide a searchable online provider directory. You can search by agency name or by city to see who is currently contracted. However, these directories are not always updated in real-time. The most reliable way to confirm status is to call the home care agency directly and ask which PathWays plans they accept. In the Indianapolis metropolitan area, most large agencies try to contract with all three MCEs to provide maximum flexibility for their clients. If you find that your agency is not in-network with your current plan, you have the option to change your health plan during the annual open enrollment period, which typically runs from mid-October to mid-December. Keeping your agency and your MCE aligned is the only way to guarantee the PathWays transition impact remains positive and your care remains uninterrupted.

• Visit the MCE website and use their “Find a Doctor” or “Provider Search” tool.
• Call your home care agency’s administrative office to confirm their 2026 contract status.
• Contact the Indiana PathWays for Aging helpline for assistance with network questions.
• Review your health plan’s member handbook for a full list of covered home care partners.
• Consider switching plans during open enrollment if your preferred agency is out-of-network.

Maintaining the quality of care your loved one deserves requires a proactive approach to the managed care system. At Nana Cares, we understand that the home care changes brought about by PathWays for Aging can be stressful. Our team is dedicated to helping Indianapolis families navigate these transitions without losing the vital support they rely on. Whether you are worried about a reduction in hours or need to confirm if we are in-network with your new plan, we are here to provide the clarity you need. We believe that every senior deserves a consistent, compassionate caregiver who understands their unique journey. If you have questions about how the latest Indiana senior services update affects your specific care plan, we invite you to reach out to us. We offer a free 1-hour information session where we can review your current situation and help you build a strategy to ensure your care remains stable and high-quality. Let our family help you secure the peace of mind you deserve within the PathWays system. Contact Nana Cares today to schedule your session and keep your loved one’s care on the right path.