Waiver Description
The Indiana Aged and Disabled Medicaid Waiver is intended to help elderly or disabled residents that need the type and level of care provided in nursing homes. By offering services and support to help these individuals live at home instead of in a nursing facility, the state can both improve the quality of life of the individual, as well as save money by decreasing its nursing home costs.
Services provided under this waiver are also extended to individuals in certain Medicaid-approved assisted living residences and adult family care homes, also referred to as adult foster care. This wavier can also assist individuals currently residing in a nursing home facility transition back into the community.
Associated with this waiver is a self-directed care option called the Consumer-Directed Attendant Care program, or CDAC. Individuals who choose this option are given the flexibility to select their own personal care providers, monitor them, as well as fire them.
Since no medical training is required to provide most forms of personal care, a broad range of individuals can be hired to provide these services, including friends and some family members of the care recipient. To be clear, spouses cannot be hired to provide care.
The hourly rate that caregivers are paid is determined by the state Medicaid office. It is typically is between 50% and 60% of the average hourly rate private caregivers receive in Indiana.
What is a Medicaid Waiver?
Medicaid Waivers, also known as Home and Community Based Services (HCBS) Waivers, allow qualifying program participants to receive services outside of a nursing home. Medicaid’s standard benefit is to pay for nursing home care. However, those who wish to live at home, in assisted living or in adult foster care, sometimes Medicaid will pay for nursing-home-level care in those locations if it can be obtained at a lower cost than in a nursing home.
Eligibility Guidelines
Applicants must meet certain criteria for qualification:
General Requirements
Residency – Must be a resident of the state of Indiana.
Place of Residence – Must be willing to live in an approved assisted living residence, adult foster care home, home of a family member, or one’s own home, instead of in a nursing home.
Functional – Must be assessed and found to require at least the level of care provided in a nursing home, which includes assistance with three activities of daily living, such as bathing, grooming, and mobility.
Financial Requirements
Income Limits
To be eligible for the Aged & Disabled Waiver, the candidate must fall within the financial guidelines for Indiana Medicaid long term care. In 2023, single applicants are allowed monthly income up to $2,742. If married and the applicant’s spouse is not seeking Medicaid services, the non-applicant’s income is not counted toward the applicant spouse’s eligibility.
When the non-applicant spouse has low income, some of the applicant’s income can be allocated to the non-applicant spouse as a living allowance. As of 2023, this spousal income allowance may be as much as $3,716 a month. Candidates should be aware that reallocation of income is a complicated process and may require the assistance of a Medicaid planning professional.
Asset Limits
Also referred to as “resources,” a single applicant’s countable assets must not exceed $2,000 in value for 2023. However, some assets are exempt (not counted toward the $2,000 limit). Exempt assets include one’s home as long as the equity is below $688,000, a vehicle, home furnishings, and personal items.
Married couples with only one applicant can allocate joint assets to the non-applicant spouse up to a value of $148,620. This is called a community spouse resource allowance. Again, the reallocation process is fraught with potential ways to violate Medicaid’s strict eligibility rules. So one should consider working with an outside professional.
Benefits and Services
The range of services that are paid for by this waiver have been specifically chosen to help individuals remain living outside of a nursing home. Applicants are evaluated individually. And in addition to case management, their customized plan of services may include any of the following. Certain services listed below can be consumer-directed, most notably attendant / personal care.
- Adult Day Services / Adult Day Care
- Adult Family Care / Adult Foster Care – Caregivers cannot be related to the care recipient
- Structured Family Caregiving – Caregiver can be related to the care recipient
- Assisted Living Services
- Attendant Care – Assistance with activities of daily living, such as mobility, dressing, toileting, etc.
- Case Management
- Community Transition
- Home Modifications and Assessment – Addition of walk-in tubs, grab bars, widening of doorways, etc.
- Home Delivered Meals
- Homemaker Services – Laundry, housecleaning, meal preparation, etc.
- Specialized Medical Equipment and Supplies
- Personal Emergency Response System (PERS)
- Respite Care – In-home and out-of-home
- Transportation Assistance
- Vehicle Modifications
- Nutritional Supplements
- Pest Control
- Health Care Coordination
How to Apply / Learn More
To apply for the Aged & Disabled Waiver, one should contact their local Indiana Area Agency on Aging. The AAA will start the application process with a telephone interview.
Although this waiver is available throughout the state, it is not an entitlement. This means there are limited participant enrollment slots, and a waitlist may exist.
More information about the Aged & Disabled Waiver can be found here.
