When Medicaid in Indiana Will Pay for a Nursing Home, Assisted Living, or Home Health Care

With the average monthly cost of a private room in a nursing home in Indiana surpassing $9,700 in 2024, seniors who are likely to need long-term care (LTC) need to plan ahead to ensure they have a way to pay for that care. Long-term care is usually paid for using one of the following:

• private funds (your own money)
• nursing home insurance, or
• Medicaid.

If you need nursing home care, but can't afford to pay privately and don't have long-term care (LTC) insurance, Indiana Medicaid might cover the cost of your care.

Medicaid is a medical assistance program funded by the federal and state governments to pay for, among other things, long-term care for people who are over 65, have a disability, or are blind.

Other types of Medicaid services have eligibility guidelines that are different from the rules for long-term care. To qualify for Medicaid LTC benefits, you must:

• live in a skilled nursing facility, intermediate care facility, or hospital for 30 days or more
• meet specified income and resource qualifications, and
• need this level of care (as determined by Medicaid).

Indiana also operates a Medicaid waiver plan, known as a Home and Community-Based Services (HCBS) waiver, that allows seniors who need assistance living independently to stay in their homes and communities instead of in nursing homes.

Medicaid Coverage for Nursing Homes in Indiana

Indiana Medicaid, administered by the Indiana Family and Social Services Administration (FSSA), provides coverage for nursing home residents who are 65 or older, blind, or disabled and who meet income and resource requirements.

To qualify for nursing home Medicaid, you must be financially eligible and need the kind of care nursing homes provide, such as:

• 24-hour supervised nursing care
• therapy, and
• nutrition management.

Medicaid Income Rules for LTC Benefits in Indiana

In Indiana, a single person can have a monthly income up to $2,901 in 2025 and qualify for Medicaid-paid nursing home care. (This is 300% of the SSI individual payment level.)

The Medicaid income limit for a married couple, with both spouses applying, is twice as much—$5,802 per month in 2025. These LTC income limits can be higher than the income limit for those applying for other health care benefits from Medicaid.

For purposes of determining Medicaid LTC eligibility, any income an applicant receives from any source is considered. But when only one spouse of a married couple applies for Medicaid, the income of the non-applicant spouse doesn't count toward the limit. This is to ensure the non-applicant spouse has enough funds to live on.

Additionally, if the non-applicant spouse doesn't have much income in their own name, they're entitled to a minimum monthly needs allowance, which can range from $2,555 to $3,948. So, if you're applying for LTC Medicaid, and your non-applicant spouse has less than $2,555 in monthly income, some of your income can be transferred to help support your spouse.

Otherwise, if you qualify for Medicaid and live in a nursing home, you'll have to spend almost all your income on your care. Indiana Medicaid allows nursing home residents receiving Medicaid to keep only $52 per month as a personal needs allowance.

Indiana Medicaid Asset Rules for Long-Term Care Benefits

Indiana Medicaid has resource rules, which you must satisfy to be eligible for coverage, that can be different from those for other Indiana Medicaid programs. Resources are assets like:

• real estate
• life insurance with a cash value
• vehicles
• motorhomes
• bank accounts, and
• cash.

You'll have to total up all of your non-exempt, countable assets to determine how much you have in resources. But not all assets count toward the limit.

If you're single, you can have only up to $2,000 in assets with a few allowable exclusions such as a car and your home (up to $730,000 in equity value in 2025). If you're married, your non-applicant spouse at home can keep up to $157,920 worth of joint assets.

Indiana Medicaid HCBS Waiver, Assisted Living, and Home Care Options

Indiana residents can qualify for Medicaid long-term care services delivered outside of the nursing home facility setting. The state has programs with different eligibility requirements that offer other benefits to help seniors living at home or in the community to obtain needed services.

PathWays for Aging Replaces Aged & Disabled Waiver for Seniors

Indiana offers a Home and Community-Based Services (HCBS) Medicaid waiver program that provides LTC services in their homes. The HCBS waivers are designed to help Medicaid recipients live independently—in their homes or community settings—rather than in nursing homes.

In 2024, Indiana launched the PathWays for Aging Waiver program, replacing the Aged & Disabled Waiver program. Through managed care organizations, PathWays covers Medicaid home and community-based waiver services for Medicaid-eligible individuals 60 and older who need nursing home-level care, such as:

• adult day care
• assisted living
• home and vehicle modifications
• attendant care (including self-directed attendant care)
• transportation services
• home-delivered meals, and
• personal emergency response systems.

For more information about Indiana PathWays for Aging Medicaid waivers, visit the FSSA PathWays information page. You can also go to your local Area Agency on Aging or call the PathWays information line at 877-284-9294.

Indiana's Program of All-Inclusive Care for the Elderly (PACE)

Indiana has also designed and implemented a Program of All-Inclusive Care for the Elderly (PACE) to provide community-based care to eligible individuals. To qualify for PACE, you must:

• be 55 or older
• live in an area served by a PACE provider
• require nursing home-level care, and
• be able to live safely in the community with PACE services.

PACE participants receive their services from an interdisciplinary team of professionals, including physicians, nurses, and social workers, who coordinate individualized care and services to keep seniors in their own homes and communities. Under this model, Indiana Medicaid pays for services offered in the PACE program through its managed care partners.

If you're interested in a PACE program, apply directly to the one you're interested in, and the program will help determine your eligibility. Check the FSSA PACE page for more information and to find the PACE provider serving your area.

Indiana Structured Family Caregiving Program

Structured Family Caregiving (SFC) is a related state benefit that can provide a caregiver to a waiver participant in the home of either the participant or the caregiver. Under this program, relatives of the individual in need—such as adult children—can serve as caregivers and be compensated for the services they provide to a person who would otherwise need care in an LTC facility.

You can receive SFC benefits through the PathWays for Aging program or PACE. But your spouse or legal guardian can only be paid as an SFC caregiver through PathWays. To learn more about SFC benefits in Indiana, visit FSSA online or contact your PACE program or managed care provider.

Getting Approved for Medicaid in Indiana

To apply for Indiana Medicaid, visit the Indiana FSSA benefits portal or request an application by mail. You can also visit your local FSSA Division of Family Resources (DFR) office and apply in person or call DFR for assistance at 800-403-0864.

Typically, your long-term care facility can also help you with the Medicaid application process.

For other questions about Indiana Medicaid and nursing home coverage, call the Indiana FSSA at 800-457-8283 or text 888-311-1846.