Indiana Medicaid respite care may help an eligible person remain at home while giving an unpaid family caregiver temporary relief. Coverage is not automatic. The person must qualify for an applicable Medicaid Home and Community-Based Services program, have respite or another appropriate support authorized in a service plan, and use a provider approved for the authorized service.
This guide explains the process for families in Indianapolis and Central Indiana, including PathWays for Aging, the Health & Wellness Waiver, and the Traumatic Brain Injury Waiver.
Indiana Medicaid respite care is temporary or periodic support provided in place of a person’s usual caregiver. Its purpose is to support the waiver participant while allowing the unpaid caregiver to rest, work, attend appointments, handle family responsibilities, or step away from caregiving for an approved period.
Home and Community-Based Services, commonly called HCBS, allow eligible Medicaid members to receive services in their homes or communities rather than in an institution. These programs serve targeted populations, including older adults and people with disabilities. (Medicaid)
Respite may be relevant when an unpaid caregiver regularly assists with:
Indiana’s official PathWays provider guidance defines respite as care provided temporarily or periodically in place of the usual caregiver. It also states that the approved professional level of care depends on the participant’s assessed needs.
Families beginning their research can also review caregiver respite in Indianapolis) to understand how non-medical relief may fit into everyday family caregiving.
Indiana Medicaid may pay for authorized in-home respite care through an applicable HCBS waiver, but having a Medicaid card does not automatically provide respite coverage.
Indiana requires a person to meet both general Medicaid requirements and the eligibility requirements of the specific HCBS program. The requested service must then be identified as appropriate, approved, and documented in the member’s service plan or Plan of Care. Indiana lists Respite Care Services among the services that may be authorized under its relevant aging and disability waivers. (Government of Indiana)
Several separate decisions are involved:
Medicaid payment is therefore different from private-pay respite care. With private pay, a family may contact an agency directly and request services subject to the agency’s assessment, scope, minimums, and availability. Medicaid-funded services must follow the authorization and billing rules of the applicable program.
For a broader explanation of the funding system, families can review Indiana Medicaid waiver home care and the supporting guide about Indiana Medicaid respite coverage.
Three Indiana waiver pathways are especially relevant to the populations served by Nana Cares: PathWays for Aging, the Health & Wellness Waiver, and the Traumatic Brain Injury Waiver.
Indiana PathWays for Aging Waiver
PathWays generally serves qualifying Indiana Medicaid members age 60 and older. Indiana’s official materials list Respite Care Services among the waiver services that may be authorized for an eligible member. PathWays is administered through managed care, so members may work with both care and service coordinators and their assigned health plan. (Government of Indiana)
Families can explore the planned PathWays for Aging respite care guide for program-specific information.
Health & Wellness Waiver
The Health & Wellness Waiver generally serves qualifying people age 59 and younger who have a disability and would require nursing-facility care without waiver or other supports. Indiana identifies respite services as one example of the services available through this waiver. (Government of Indiana)
More detail will be available in the Health & Wellness Waiver respite care guide.
Traumatic Brain Injury Waiver
The TBI Waiver supports eligible individuals with a qualifying traumatic brain injury who would otherwise require institutional care. Respite Care Services are included among the services that may be authorized, based on the member’s needs and approved Plan of Care. (Government of Indiana)
Families supporting an adult with a brain injury can review the planned TBI Waiver respite care guide.
These programs have different eligibility criteria, administration, assessments, and service rules. A family should not assume that a benefit available under one waiver works identically under another.
A person may qualify for Medicaid-funded respite care if they meet Indiana Medicaid requirements, qualify for an applicable HCBS waiver, satisfy the program’s functional or level-of-care standards, and have respite approved as part of an individualized service plan.
Indiana’s former Aged and Disabled Waiver was divided in July 2024 into the Health & Wellness Waiver for people age 59 and younger and the PathWays for Aging Waiver for people age 60 and older. Both require Medicaid and HCBS waiver eligibility. The TBI Waiver has separate requirements related to traumatic brain injury and the applicable institutional level-of-care standard. (Government of Indiana)
Eligibility may involve reviewing:
Qualifying for a waiver does not mean every listed service will be approved. The case manager, service coordinator, health plan, or state decision-maker identifies which services meet the member’s assessed needs and submits them for authorization.
Families should rely on Indiana Medicaid and their assigned program representatives for individual eligibility decisions. The supporting Medicaid respite eligibility in Indiana guide can help families prepare for that conversation without attempting to predict an approval.
To apply for Medicaid waiver respite care in Indiana, a family generally needs to address both Medicaid eligibility and entry into the appropriate HCBS waiver program.
A practical starting process is:
Families should describe their circumstances accurately. Helpful information may include when the caregiver provides support, which tasks are involved, how often relief is needed, what happens when the caregiver is unavailable, and whether daytime, weekend, or overnight coverage is being considered.
Do not send Social Security numbers, Medicaid identification numbers, full medical histories, or other sensitive information through ordinary website forms or unsecured email. Detailed records should be shared only through the appropriate secure process.
Respite care is added to an Indiana Medicaid service plan when the planning team identifies an assessed caregiver-relief need, determines that respite is an appropriate covered service, defines the service details, and receives the required authorization.
Federal HCBS rules require covered services to be documented in a person-centered service plan. The participant directs the planning process, with support from people they choose, and the plan should reflect the individual’s needs, strengths, goals, preferences, services, and responsible providers. (Centers for Medicare & Medicaid Services)
For respite, the planning discussion may address:
Indiana’s PathWays guidance states that the service coordinator or case manager must identify the primary caregiver being relieved and document the needs and activities requiring the authorized respite service. It also prohibits duplication of another service already provided through the participant’s plan.
A family can request a service-plan review when needs meaningfully change, but a request is not the same as an approval. The authorized decision-maker must determine whether the proposed change meets current program rules.
Medicaid respite care hours in Indiana are determined individually through assessment, service planning, authorization, and applicable waiver limits. There is no single schedule that applies to every family.
Decision-makers may consider:
Official PathWays guidance requires the respite provider to track authorized hours and report hours used and remaining. It also states that limits on the amount, frequency, or duration of respite must be reflected in the documentation when applicable.
Families should not arrange a schedule based only on what they requested verbally. They should confirm the final authorization, service code or category, approved tasks, dates, hours, and provider before assuming Medicaid will pay.
An agency may also have operational requirements that are separate from Medicaid authorization. Nana Cares currently lists a four-hour minimum per hourly visit and a 20-hour weekly minimum for its hourly services. Availability, waiver authorization, and the agency’s scheduling requirements must all align before care begins. (Nana Cares LLC)
In-home Medicaid respite care can include only the activities approved under the member’s waiver, assessment, service plan, and authorized service category. Families should not assume that every form of non-medical home care is automatically billable as Medicaid Respite Care Services.
Indiana’s current PathWays provider guidance describes formal Respite Care Services as temporary replacement care and identifies home health aide and nursing respite categories. The required professional level depends on the participant’s assessed needs.
That distinction matters because “respite” is also used more broadly by families to describe any temporary caregiver relief. Depending on the authorization, practical support may instead fall under another waiver category, such as attendant care or home and community assistance.
Nana Cares provides non-medical respite care that may include, when appropriate and included in the care plan:
Nana Cares does not provide skilled nursing, medical treatment, wound care, injections, IV therapy, clinical assessments, therapy, or medication administration. Families should confirm which Nana Cares service, if any, matches the exact Medicaid authorization. (Nana Cares LLC)
Readers who need hands-on daily support can review personal care services in Indianapolis. Families primarily seeking social engagement and routine support may also review companion care in Indianapolis .
To find an Indiana Medicaid respite care provider, first confirm the exact authorized service and then verify that the agency is approved to deliver that service under the member’s waiver, plan, and location.
Indiana’s provider process involves multiple stages, including state HCBS certification, enrollment with the Indiana Health Coverage Programs, and completion of waiver-program enrollment. PathWays providers may also need applicable managed care contracting. (Government of Indiana)
Ask each prospective provider:
PathWays members should confirm provider participation with their current health plan or official program resources. Indiana currently distinguishes provider certification from health-plan participation, so one should not be assumed from the other. (Government of Indiana)
The supporting article about finding a Medicaid respite provider provides a focused provider-selection checklist.
Families can start by contacting Nana Cares for an intake conversation and free non-medical needs assessment. The assessment helps the agency understand the person’s routines, requested schedule, care needs, preferences, service location, payer source, and current authorization.
Nana Cares is an Indianapolis-based Personal Services Agency providing non-medical Personal/Attendant Care, Companion Care, Homemaker Services, Respite Care, and Overnight Care for seniors and adults with disabilities age 18 and older. (Nana Cares LLC)
The usual intake process includes:
For Medicaid inquiries, Nana Cares will also need to confirm whether the agency is approved for the specific authorized service, county, waiver arrangement, and health-plan requirements. Certification as a waiver provider does not mean every service authorization can be accepted.
Families considering nighttime caregiver relief can also review overnight care in Indianapolis. Those ready to begin a conversation can use contact Nana Cares.
You do not need to understand every Medicaid term before asking for help. Nana Cares can listen to your family’s current caregiving situation, explain its non-medical intake process, and discuss whether its services may fit the authorized care needs.
Book a free needs assessment to discuss:
Medicaid eligibility, waiver enrollment, covered services, approved hours, provider-network participation, caregiver availability, and start dates must be confirmed before services begin. Nana Cares cannot guarantee Medicaid approval, payment, a particular caregiver, or immediate staffing. (Nana Cares LLC)
Compassionate, non-medical in-home care for seniors and adults with disabilities across Central Indiana.
Nana Cares provides personal care, homemaker services, companion care, respite care, and overnight support with a warm, professional approach.