The Indiana Health and Wellness Waiver provides long-term care services to individuals who prefer to live at home rather than in institutional settings. Ahead, we explore the key aspects of the waiver, from its transition from the Aged and Disabled Waiver, eligibility requirements, services offered, and the application process to understanding waitlist status and how priority is determined.
The Indiana Health and Wellness Waiver is an Indiana Medicaid program that provides Home and Community-Based Services (HCBS) to people who require long-term care but prefer to live in their own homes or communities rather than institutional settings, such as nursing facilities.
The transition from the Aged and Disabled (A&D) Waiver to the Indiana Health and Wellness Waiver is a shift in how Medicaid provides long-term care services. While the A&D Waiver historically supported older adults and people with disabilities, the Health and Wellness Waiver offers more modernized and flexible home and community-based services (HCBS).
Current A&D Waiver recipients who qualify may be automatically transitioned to the Health and Wellness Waiver, allowing them to continue receiving similar services with additional supports.
The Aged and Disabled (A&D) Waiver in Indiana split in July of 2024 into two separate waivers: the Health and Wellness Waiver and the PathWays to Aging Waiver to better address the unique needs of different populations. The PathWays Waiver focuses primarily on aging individuals, while the Health and Wellness Waiver supports individuals with disabilities who need home and community-based services.
To qualify for the Indiana Health and Wellness Waiver, applicants must meet specific Medicaid eligibility requirements. Generally, individuals must demonstrate a need for long-term care services and meet income and asset limits set by Medicaid. Additionally, applicants must require assistance with activities of daily living (ADLs), such as bathing, dressing, or mobility. A medical evaluation is often required to confirm that the individual needs the level of care provided by the waiver.
For minor children, the waiver takes into account not only their medical needs but also the availability of family or community support. While minors may qualify for waiver services, eligibility is assessed differently from adults, focusing on the child's developmental and medical needs. Parental income may not be counted toward eligibility in certain circumstances, depending on the severity of the child's condition and specific Medicaid guidelines.
Spouses of eligible individuals may also qualify for services, but they must meet the same general Medicaid criteria, including financial requirements. In some cases, if both spouses require long-term care, each spouse must individually qualify for the waiver. However, Indiana allows for certain protections of income and assets for the non-institutionalized spouse, ensuring they can retain a portion of the household's resources while their partner receives waiver services.
The Indiana Health and Wellness Waiver offers services and supports to help eligible individuals remain in their homes or communities, rather than moving to institutional care.
The split from the previous Aging and Disabled Waiver allows for more targeted Home and Community-Based Services (HCBS), improving service delivery by tailoring care to the needs of aging individuals and those with disabilities while expanding access to services like structured family caregiving, respite care, and in-home support.
Structured Family Caregiving, in particular, is an important feature of this waiver, allowing family members to be paid for the care they provide. Learn more >>
The application process begins by contacting your local Area Agency on Aging (AAA) or the state's Division of Aging who will guide you through an initial screening to assess your eligibility based on medical and financial criteria.
After the screening, you'll need to complete a formal application, which includes submitting the necessary documentation to Medicaid for review. A case manager will be assigned to assist in this process, helping to arrange for any required medical evaluations and coordinating your care plan.
When applying for the Health and Wellness Waiver, you will need to provide several key documents, including:
The Indiana Health and Wellness Waiver program has a large waitlist due to the high demand for services. As of October 2024, approximately over four thousand Hoosiers are on the waiting list for the Health and Wellness Waiver, with another nine thousand waiting for services under the Pathways program. While the state will invite 925 individuals off the waitlists each month—800 for PathWays and 125 for Health and Wellness—demand for the waiver programs continue to grow.
Applicants are prioritized based on the severity of their needs, with those requiring immediate care or having urgent medical conditions more likely to be invited off the waitlist sooner.
Though the waitlist continues to grow, applicants with the most urgent needs may be prioritized. You can use our free program matching tool to see if you qualify.
