For many Indiana families, long-term care does not fit neatly into two categories. A loved one may no longer be able to live safely at home without significant help, but they may not need the level of care provided in a nursing facility either. Assisted living can feel like the right middle ground. The problem is that paying for it can be difficult. That is why a new Indiana Medicaid development is worth watching closely.
The Indiana Family and Social Services Administration (FSSA) has posted an Assisted Living 1915(c) Waiver September 2026 Application on its public-notice page. This signals that Indiana is moving forward with a Medicaid waiver specifically focused on assisted-living services.
This does not mean Medicaid will suddenly pay the assisted-living bill for every Indiana senior. It does mean families planning for long-term care should keep an eye on what happens next.
What does Indiana Medicaid currently cover in assisted living?
Indiana already allows assisted-living services to be provided through certain Medicaid Home and Community-Based Services programs. For people age 60 and older, Indiana's PathWays for Aging Waiver currently lists assisted living among the services that may be authorized for eligible participants. Other available waiver services can include attendant care, home-delivered meals, respite care, transportation, home modifications and structured family caregiving.
But qualifying for Medicaid does not automatically mean every service is immediately available.
Indiana states that a person seeking an HCBS waiver generally must meet both Medicaid financial eligibility requirements and waiver eligibility requirements, including meeting a nursing-facility level of care.
That means families may need to work through several different questions:
- Does the person financially qualify for Medicaid?
- Does the person meet the required level of care?
- Which waiver applies?
- Is assisted living an authorized service for that person?
- Is there an available waiver opportunity?
- Is there an assisted-living provider that participates in the program?
These distinctions matter. A family may hear that a parent “qualifies for Medicaid” and understandably assume that means Medicaid will immediately begin paying for assisted living. In reality, Medicaid eligibility and access to a particular long-term-care service are not always the same thing.
So what is changing?
The development to watch is Indiana's new Assisted Living 1915(c) Waiver application. FSSA's current public-notice page specifically lists an “Assisted Living 1915(c) Waiver September 2026 Application.”
A Section 1915(c) waiver allows states to provide Medicaid-funded long-term services and supports in home and community settings rather than requiring eligible individuals to receive care in an institution. That concept is already central to Indiana's HCBS system. Indiana explains that HCBS waiver services are intended to help eligible individuals remain in their homes or other community settings instead of receiving care in a Medicaid-funded institution.
Assisted-living communities can qualify as one of those community settings. The important question now is how Indiana's proposed standalone assisted-living waiver will differ from the assisted-living services already available through PathWays.
Why should Indiana families pay attention?
Because assisted living is often where families face one of their hardest financial decisions. A parent may need help with medication, meals, bathing, mobility or other daily activities but still prefer a residential setting that provides more independence than a nursing facility. Then the family starts looking at the cost.
Medicare generally is not designed to pay indefinitely for custodial long-term care simply because someone needs help with daily activities. Families often end up using savings, income, long-term-care insurance or Medicaid-related options to help address those costs.
Indiana's current PathWays system already recognizes assisted living as a covered waiver service for qualifying individuals. A separate assisted-living waiver could potentially create a more defined pathway for this particular level of care. However, we do not want families making significant financial decisions based on assumptions about what the new waiver will ultimately provide.
What details should families watch for?
The application itself is only the beginning. As Indiana moves through the federal waiver process, several details will determine how useful the program ultimately becomes. We will keep an eye out for answers to these questions:
- Who will qualify?
- What financial eligibility rules will apply?
- What level of care will be required?
- What assisted-living services will Medicaid cover?
- Will there be a separate waiting list?
- How many waiver slots will be available?
- Will there be priority or reserved-capacity categories?
- Which assisted-living communities will participate?
- How will room and board be handled?
- When will the new waiver actually begin operating?
Those details can dramatically change what the program means for an individual family.
What about the current PathWays waiting list?
This is another reason the new waiver deserves attention. Indiana currently acknowledges that people seeking assisted-living waiver services may spend time on a waiting list. FSSA's PathWays provider guidance specifically explains that a person who comes off the assisted-living waitlist must then complete the applicable Medicaid eligibility and enrollment process.
In other words, assisted-living access involves more than simply determining whether someone owns too many assets. That is important when families are trying to plan several months or even years ahead. A new assisted-living waiver could change how Indiana manages this process, but we will need to see the final rules before knowing exactly what that will look like.
Will Medicaid pay the entire assisted-living bill?
Families should be particularly careful with this question. When someone says, “Medicaid pays for assisted living,” that can sound like Medicaid simply pays the entire monthly bill charged by an assisted-living community. That is not necessarily how the system works.
Medicaid HCBS programs generally authorize particular care and support services. Housing expenses, room and board, personal expenses and Medicaid-covered services can be treated differently. Indiana's current PathWays waiver identifies assisted living as an authorized waiver service, but the specific services a member receives must be identified and authorized through the person's care planning process. The proposed waiver's treatment of these costs will therefore be one of the most important areas to watch.
Should families change their Medicaid planning now?
This is something to watch, not a reason to abandon current planning. Long-term-care planning should still be based on the laws, regulations and Medicaid programs that are actually available today. For families concerned about future assisted-living or nursing-home costs, that planning may include reviewing:
- Current assets and income
- Long-term-care insurance
- Medicaid eligibility
- Existing PathWays benefits
- Powers of attorney
- Trust planning
- Whether remaining at home is realistic
- Assisted-living costs
- Nursing-home costs
- Asset-protection strategies where appropriate
One of the biggest mistakes families can make is waiting until a health crisis forces an immediate decision. Earlier planning often gives families more time to understand their choices.
This is One to Keep an Eye On
Indiana's proposed assisted-living waiver may ultimately become an important new option for seniors who need substantial support but would prefer assisted living over nursing-facility care. The true usefulness may depend heavily on enrollment limits, provider participation, eligibility requirements and available waiver slots.
We simply do not know all of those answers yet. What we do know is that Indiana has formally posted the new Assisted Living 1915(c) Waiver application, and that makes this an important development for families considering long-term-care planning. We will continue watching as Indiana releases additional guidance.
How Vick Law Can Help
Medicaid planning involves much more than completing an application. At Vick Law, P.C., we help Indiana families understand how Medicaid, estate planning, long-term-care costs and asset-protection strategies can work together.
If you are concerned about paying for assisted living, home care or nursing-home care for yourself, a spouse or a parent, it is often better to explore your options before the need becomes urgent. As Indiana's new assisted-living waiver develops, we will continue monitoring the program and explaining what those changes may mean for local families.
To schedule a consultation with Vick Law, P.C., call (317) 884-3133 or book a call online.
Sources
Indiana Family and Social Services Administration, Public Notices: Assisted Living 1915(c) Waiver September 2026 Application.
Indiana Medicaid, Aged and Disabled Waiver / Indiana PathWays for Aging Waiver.
Indiana Office of Medicaid Policy and Planning, Home- and Community-Based Services Waiver: Indiana PathWays for Aging.
Indiana Medicaid, Home- and Community-Based Services.
Indiana PathWays for Aging, HCBS Provider Frequently Asked Questions.
