The shift in Indiana’s approach to elderly care represents one of the most significant overhauls in the state’s Medicaid history. For decades, the system relied on a fee for service model that often felt fragmented to the families navigating it. In 2024, the Indiana Family and Social Services Administration (FSSA) launched PathWays for Aging, a managed care program designed to weave medical services and long term supports into a single, cohesive experience. For families in the Indianapolis area, this transition is not just a change in paperwork; it is a fundamental change in how companion care and clinical support are authorized and delivered. Understanding the mechanics of this program is essential for any family seeking to maintain their loved one’s independence while utilizing the Indiana care systems guide for maximum benefit. As of 2026, the program has matured, integrating even more closely with Medicare benefits to ensure that Hoosiers aged 60 and older receive high quality care that is both sustainable and person centered. This sub-pillar provides the regulatory depth needed to navigate the managed care landscape with confidence and clarity.
The primary objective of the PathWays for Aging program is to empower Hoosiers to age in place by shifting the focus of Medicaid from institutional care to home and community based services (HCBS). Historically, Medicaid systems were heavily weighted toward nursing home placement because the funding mechanisms made it easier to manage. PathWays for Aging reverses this by creating a managed care environment where the health of the member is prioritized in the setting of their choice. By partnering with private Managed Care Entities (MCEs), the state aims to achieve several key outcomes: improved health results through better coordination, greater budget predictability for the state, and enhanced quality of life for seniors. The program recognizes that companion care and social support are just as vital to health as medical prescriptions. By integrating these services, PathWays ensures that a senior’s nutritional, social, and physical needs are addressed under one umbrella. This holistic approach is designed to reduce emergency room visits and delay the need for nursing home admission, which aligns with the desires of over 75 percent of older adults who wish to remain in their own communities. For a broader look at how this fits into the state’s vision, you can refer to the Indiana care systems guide.
The transition for individuals previously enrolled in the Aged and Disabled (A&D) waiver was designed to be as automatic as possible to prevent gaps in service. When the program went live on July 1, 2024, most waiver recipients were transitioned directly into the PathWays program based on their age and eligibility status. If your loved one is currently aging into the program (turning 60) or is new to the Indiana care systems guide, the process begins with an eligibility determination through the Division of Aging and the local Area Agency on Aging (AAA). Once financial and functional eligibility (Nursing Facility Level of Care) is confirmed, the family receives a choice of health plans. If no plan is selected within the allotted timeframe, the state automatically assigns one to the member. However, it is highly recommended that families take an active role in this choice to ensure their preferred companion care providers are in network. The transition involves a comprehensive health screening to establish a baseline for the new managed care plan. This screening is the first step in moving from the old waiver system to a more integrated, managed model that oversees both the medical and social determinants of health.
While all three Managed Care Entities (MCEs) provide the same core Medicaid benefits required by the state, they differentiate themselves through “extra” or “value added” benefits. These extras are designed to attract members and promote overall wellness beyond basic medical care. For instance, some plans offer significant allowances for over the counter (OTC) medications, healthy food, and even utility assistance. As of 2026, these allowances have become a major factor in plan selection. Anthem PathWays might focus on robust wellness rewards and caregiver support programs, while Humana PathWays often emphasizes vision and dental extras, such as higher allowances for glasses or hearing aids. UnitedHealthcare PathWays is frequently recognized for its integrated “Dual Care” options for those who also have Medicare, providing a seamless experience across both insurance types. When comparing plans, families should look at the “Value-Added Services” chart provided on the official IN.gov PathWays site. Key factors to consider include the availability of gym memberships, gift cards for groceries, and the specific network of companion care agencies each plan contracts with in Marion, Hamilton, and Hendricks counties.
The Care and Service Coordinator is perhaps the most important new role introduced by the PathWays for Aging program. In the old fee for service model, families often had to act as their own case managers, coordinating between doctors, pharmacies, and home care agencies. In the PathWays system, the MCE provides a dedicated coordinator who acts as the “glue” for the entire care team. This individual is responsible for conducting the initial and annual comprehensive assessments, developing the Person-Centered Service Plan, and authorizing the hours for companion care. They are the primary point of contact for the family if the senior’s health changes or if more support is needed at home. This coordinator also ensures that the medical side of the plan (like specialist visits) is communicating with the social side (like meal delivery or home modifications). By having a single person oversee the integration of all services, the PathWays program aims to simplify the Indiana care systems guide and reduce the administrative burden on family caregivers. Their goal is to ensure that the care being delivered is truly meeting the member’s personal goals and health needs.
One of the top concerns for families during the PathWays transition is the ability to maintain relationships with trusted caregivers. The answer generally depends on whether the companion care provider is “in network” with the chosen health plan. When PathWays launched, the state prioritized “continuity of care,” which required MCEs to honor existing service authorizations for a specific period. However, for long term stability, the provider must be enrolled in the health plan’s network. Families should explicitly ask their current agency which MCEs they are contracted with: Anthem, Humana, or UnitedHealthcare. If an agency like Nana Cares is in network, the transition is seamless. If the provider is not in network, the member may eventually be required to switch to a provider that is, unless an out of network exception is granted by the MCE based on specialized medical needs. This is why the plan selection period (mid-October to mid-December annually) is so critical. It allows families to align their health plan with the Indiana care systems guide and their preferred local providers to ensure that the “quality care from our family to yours” promise is never interrupted.
To protect members during transitions: such as moving from one MCE to another or the initial launch of the program: Indiana enforces a 90 day continuity of care period. This means that for the first 90 days after enrollment in a new PathWays plan, the MCE must honor all existing service authorizations and allow the member to continue seeing their current providers, even if those providers are not in the new plan’s network. This period is intended to give the MCE time to conduct a new assessment and for the provider to potentially join the network or for a safe handoff to occur. This rule is a vital safety net for seniors with complex conditions like MS or TBI, where a sudden change in companion care could lead to physical or emotional distress. Additionally, members have the right to change their MCE for any reason within the first 90 days of their initial enrollment. This “trial period” ensures that if a family finds that their chosen plan is not meeting their needs or that their preferred provider in the Indiana care systems guide is unavailable, they have the flexibility to make a correction without waiting for the next open enrollment period.
Under the PathWays program, transportation and meal assistance are no longer just “add-ons” but are integrated benefits designed to support independence. All PathWays plans are required to provide non-emergency medical transportation to and from doctor appointments, pharmacies, and even eligibility redetermination meetings with the state. This is especially important for seniors in the Indianapolis suburbs who may no longer be able to drive. Furthermore, PathWays expanded the availability of home delivered meals. For seniors returning home from a hospital or nursing facility stay, these plans often provide a specific number of “transition meals” to ensure they have proper nutrition during recovery. On an ongoing basis, the Care and Service Coordinator can include meal delivery in the service plan if a senior is unable to safely prepare food. These benefits directly complement companion care by handling the logistical and nutritional hurdles that often lead to health declines. By removing the stress of how to get to the doctor or what to eat for dinner, PathWays allows the senior and their Indiana care systems guide support team to focus on meaningful engagement and daily safety.
Navigating a managed care system can occasionally lead to disagreements over authorized hours or service denials. If a family encounters an issue with their PathWays MCE, the first step is to contact the MCE’s Member Services department to file a formal grievance or appeal. Each plan has a clear process for reviewing these complaints. If the issue is not resolved through the MCE, families can reach out to the PathWays Member Support Services (MSS) at 877-738-3511. This service, managed by Maximus, provides independent support to help members resolve disputes and understand their rights. Additionally, the Long Term Care Ombudsman is available to advocate for seniors’ rights in both home and facility settings. For general program questions or help changing plans, the Indiana PathWays for Aging Helpline at 877-284-9294 is the primary resource. Having these numbers readily available is a core part of elder care advocacy and ensures that the family remains in control of the care journey. No family should feel like they are fighting the system alone; these oversight bodies are in place to ensure that the promise of PathWays: quality, coordinated care: is kept for every Hoosier.
The transition to PathWays for Aging is a journey toward a more integrated and compassionate future for Indiana’s seniors. While the terminology and the structures of managed care may seem daunting at first, the underlying goal is to give your family more tools to keep your loved one safe at home. At Nana Cares, we have been closely monitoring every regulatory update to ensure our companion care services remain perfectly aligned with the PathWays model. We believe that the best care happens when medical coordination meets the heart of a dedicated caregiver. If you are currently navigating the Indiana care systems guide and need help understanding how PathWays for Aging affects your specific situation, our team is here to walk alongside you. We offer a free 1-hour information session where we can help you decode your health plan benefits and discuss how our personalized services can provide the continuity and peace of mind your family deserves. Let us help you turn the complexity of state programs into a clear, supportive path forward for your loved one. Connect with Nana Cares today to learn how we can support your journey through the PathWays transition.
Compassionate, non-medical in-home care for seniors and adults with disabilities across Central Indiana.
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