4 Indiana Medicaid Waivers Explained: Which One Covers Family Caregiving?

The word "waiver" is doing a lot of quiet damage to Indiana families. People hear it, assume it's bureaucratic noise that doesn't concern them, and skip right past the thing that actually determines whether they can be paid to care for a loved one. Which Medicaid waiver your loved one qualifies for is the single biggest factor in whether family caregiving pay is available to you.

A "waiver," in plain terms, is a Medicaid program that "waives" the usual rule that long-term care has to happen in an institution. Instead, it lets the state pay for care at home or in the community. Indiana runs several, each serving a different population, and only some of them include the family caregiving services we're talking about.

This guide walks through the four waivers that matter most, who each one serves, and which ones actually open the door to getting paid as a family caregiver. Indiana reorganized these programs significantly in 2024, so a lot of older information online is now wrong — we'll flag what changed.

First, What Changed in 2024

If you've been researching this for a while, you may have read about the "Aged and Disabled Waiver," or A&D. Set that name aside. On July 1, 2024, Indiana retired the A&D Waiver and replaced it with two new waivers as part of a larger overhaul called PathWays for Aging.^[1]

The old A&D Waiver split by age. People 60 and older moved to the new PathWays for Aging Waiver. People 59 and younger moved to the new Health and Wellness Waiver.^[2] If you find a page that still talks about applying for the A&D Waiver as a current option, it's out of date. Here are the four that matter now.

Waiver 1: PathWays for Aging (Age 60+)

This is the big one for most families caring for an aging parent or spouse.

The PathWays for Aging Waiver serves Hoosiers aged 60 and older who need a nursing-facility level of care but want to stay at home or in their community.^[3] It's administered as part of Indiana's managed care system, meaning each member has a care coordinator who helps connect them to services.

Crucially for our purposes: PathWays for Aging includes Structured Family Caregiving as a covered service. If your aging parent qualifies for this waiver, the door to paid family caregiving is open.

Now, individuals need only one point of contact for assistance, making it easier for more Hoosiers to stay in their homes, surrounded by family and friends.

The catch is capacity. The waiver launched with 39,842 slots, most of which were already filled by people transitioning from the old A&D Waiver.^[4] As of early 2026, more than 11,000 seniors were on a waiting list, with the state inviting people from the list each month.^[5] People transitioning home from a nursing home or hospital get priority. The waiver is real and active — but the waitlist is real too.

Waiver 2: Health and Wellness (Age 59 and Under)

The Health and Wellness Waiver is the mirror image of PathWays, for a younger population. It serves Hoosiers aged 59 and younger who have disabilities and need a nursing-facility level of care.^[6]

Like PathWays, it includes Structured Family Caregiving. So an adult under 60 with a qualifying disability — or a family caring for one — can access paid family caregiving through this waiver.

It launched with 16,127 slots, again mostly filled by people transitioning from the old system.^[7] Advocates have raised concerns about wait times for new applicants; at the launch, one estimate suggested the Health and Wellness waiver could mean waiting around 30 months for services, because only about 125 people are targeted to transition per month.^[8] If you're applying fresh to this waiver, plan for a potentially long wait.

Waiver 3: Traumatic Brain Injury (TBI)

The Traumatic Brain Injury Waiver serves people who have a qualifying brain injury and need a level of care they'd otherwise receive in an institution.^[9] As part of the 2024 reorganization, the TBI Waiver moved from the Division of Aging to the Division of Disability and Rehabilitative Services.^[10]

The TBI Waiver also includes Structured Family Caregiving among its services. For families caring for a loved one whose primary qualifying condition is a traumatic brain injury, this is often the relevant pathway rather than the age-based waivers.

Waiver 4: The Developmental Disability Waivers (FSW and CIH)

This is where we have to be honest about a hard reality.

Indiana runs two waivers for people with developmental disabilities: the Family Supports Waiver (FSW) and the Community Integration and Habilitation Waiver (CIH).^[11] These serve a different population from the aging and disability waivers above, with their own services.

The hard part: as of late 2025, both the FSW and CIH waivers hit their maximum approved capacity, and no new slots are expected to be released until at least July 2026.^[12]

If your loved one's needs fall under the developmental disability waivers specifically, the realistic picture right now is a wait. We'd rather tell you that than let you assume a slot is available when it isn't.

A Quick Map of the Four

For most families reading this — those caring for an aging parent or a disabled adult — the relevant door is PathWays for Aging or Health and Wellness, and both include the family caregiving services that make paid caregiving possible.

How to Find Out Which One Applies to You

You don't have to decode this entirely on your own. The practical first step for the aging and disability waivers is to contact your local Area Agency on Aging (AAA), which handles the initial level-of-care screening.^[13] For PathWays specifically, the state also runs an enrollment helpline.

What that screening looks at is whether your loved one needs a nursing-facility level of care — essentially, whether they need enough hands-on help with everyday activities like bathing, dressing, eating, mobility, and managing medications that, without support at home, they'd require the kind of care a facility provides. The AAA arranges the assessment that makes that determination, and it's also the point where financial eligibility gets reviewed. Two things are worth having ready before you start: documentation of your loved one's medical conditions and care needs, and a clear picture of income and countable assets — which we break down in our guide to Indiana Medicaid income and asset limits. Going in prepared is often the difference between a single clean screening and several frustrating rounds of follow-up.

A good provider agency can also help you figure out which waiver fits before you start, which saves you from applying to the wrong one — a common and costly application mistake — and losing weeks. The waiver determines everything downstream, so getting this right at the start is worth the phone call.

What This Means for Your Family

The waiver question feels like bureaucratic trivia until you realize it's the gatekeeper for everything else. PathWays for Aging and the Health and Wellness Waiver both include Structured Family Caregiving, which means most Indiana families caring for an aging or disabled loved one have a real path to getting paid — subject to eligibility and, often, a wait.

At Tender Home Care, we help Indiana families figure out which waiver applies, navigate the screening, and access Structured Family Caregiving once eligible. We'll be honest with you about waitlists and timelines rather than promising what we can't deliver. The conversation costs nothing.

For the full walkthrough of how paid family caregiving works once you're through the waiver door, see our guide on how to get paid to care for a family member in Indiana.

Sources

1. [1] Indiana FSSA. "FSSA announces launch of Indiana PathWays for Aging Medicaid managed care program." 2024. Link.

2. [2] Rep. Sue Errington. "FSSA's new Pathways for Aging and Structured Family Care programs now live." 2024. Link.

3. [3] Medicaid Planning Assistance. "Indiana Pathways for Aging Program." 2026. Link.

4. [4] Rep. Sue Errington. "FSSA's new Pathways for Aging and Structured Family Care programs now live." 2024. Link.

5. [5] Medicaid Planning Assistance. "Indiana Pathways for Aging Program." 2026. Link.

6. [6] Rep. Sue Errington. "FSSA's new Pathways for Aging and Structured Family Care programs now live." 2024. Link.

7. [7] Rep. Sue Errington. "FSSA's new Pathways for Aging and Structured Family Care programs now live." 2024. Link.

8. [8] Indiana Capital Chronicle. "PathWays for Aging launches for 123,000 eligible senior Hoosiers." 2024. Link.

9. [9] INARF. "CMS approves FSSA's Indiana's PathWays for Aging Program and Home and Community-Based Services Waivers." 2024. Link.

10. [10] INARF. "CMS approves FSSA's Indiana's PathWays for Aging Program and Home and Community-Based Services Waivers." 2024. Link.

11. [11] The Arc of Indiana. "Medicaid & Medicaid Waiver Updates." 2026. Link.

12. [12] The Arc of Indiana. "Medicaid & Medicaid Waiver Updates." 2026. Link.

13. [13] Medicaid Planning Assistance. "Indiana Pathways for Aging Program." 2026. Link.