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Learn how Indiana State Sponsored family caregiver programs work, including PathWays for Aging, the Health and Wellness Waiver, Structured Family Caregiving, and consumer-directed attendant care.
This guide explains how Indiana State Sponsored home care programs work, how Structured Family Caregiving and consumer-directed attendant care compare, who may qualify, and how FreedomCare helps families understand their next steps.
If you are caring for a parent, spouse, or family member in Indiana, helping with bathing, meals, mobility, medications, or daily supervision, you may be wondering whether State Sponsored Care can help compensate you for that work. The answer is yes. Indiana State Sponsored home care programs offer real pathways for eligible family members to get paid as caregivers while keeping their loved one safely at home.
Indiana's home care landscape changed significantly on July 1, 2024, when the state replaced its longstanding Aged and Disabled (A&D) Waiver with two new programs: PathWays for Aging (for Hoosiers 60 and older) and the Health and Wellness (H&W) Waiver (for adults under 60 with disabilities). Both programs offer Structured Family Caregiving and consumer-directed attendant care, the two primary ways Indiana families receive caregiver pay funded through State Sponsored Care.
FreedomCare helps Indiana families navigate these programs, understand what has changed, and start getting paid to care for someone they love. This guide explains every pathway, who qualifies, and how to apply.
Indiana State Sponsored Care is administered by the Family and Social Services Administration (FSSA). Long-term services and supports (LTSS) for seniors and adults with disabilities are delivered through a combination of HCBS waivers and the State Sponsored Care state plan. The key programs for family caregiver pay are the two waivers that replaced the A&D Waiver in 2024.
The Bottom Line: Indiana caregiver pay usually runs through PathWays for Aging or the Health and Wellness Waiver, not basic ABD State Sponsored Care.
What Indiana families need to know:
Indiana offers two distinct ways for family members to get paid through State Sponsored programs: consumer-directed attendant care and Structured Family Caregiving. Both are available under PathWays for Aging and the Health and Wellness Waiver, but they work very differently.
The Bottom Line: Indiana families usually compare two caregiver-pay paths: hourly consumer-directed attendant care or Structured Family Caregiving with a daily stipend.
Under consumer-directed attendant care, the care recipient acts as the employer. They select, hire, train, and supervise their own attendant for personal care and homemaker services. A financial management service (FMS) vendor handles payroll, tax withholding, and employment compliance.
Key facts about consumer-directed attendant care in Indiana:
In Indiana, Structured Family Caregiving provides a daily, tax-free stipend to a qualifying caregiver who lives with and provides care to a State Sponsored Care waiver member. SFC is delivered through a licensed SFC agency, which provides training, a Health Coach for ongoing support, and regular monitoring.
Key facts about SFC in Indiana:
Both SFC and consumer-directed attendant care allow family members to be paid for State Sponsored home care. Here is how they compare:
The Bottom Line: SFC is best for live-in caregiving with agency support, while consumer-directed attendant care is best for flexible hourly help from a trusted non-spouse caregiver.
| Feature | Structured Family Caregiving (SFC) | Consumer-Directed Attendant Care |
|---|---|---|
| How it works | Family member provides care under SFC agency oversight | Consumer hires and directs their own attendant |
| Payment type | Daily tax-free stipend (tiered by care level) | Hourly wages via financial management service (FMS) |
| Residency requirement | Caregiver must live in same home as care recipient | No live-in requirement |
| Employment restriction | Caregiving must be primary focus; outside work is permitted with restrictions | No employment restriction on caregiver |
| Eligible caregivers | Family members or trusted individuals (excludes spouses, legal guardians) | Adult children, siblings, grandchildren, friends (excludes spouses) |
| Agency oversight | Yes, SFC agency provides training, Health Coach, and monitoring | Minimal; FMS handles payroll only |
| Best for | Families with a live-in caregiver willing to make care the priority | Consumers wanting flexible hourly care from a trusted non-spouse |
The Bottom Line: PathWays serves seniors 60+, H&W serves adults under 60 with disabilities, and ABD State Sponsored Care does not provide the same family caregiver pay options.
PathWays for Aging is Indiana's managed care LTSS program for seniors 60 and older. Launched July 1, 2024, it replaced the Aged and Disabled Waiver for this age group. PathWays members choose from three managed care entities (Anthem, Humana, or UnitedHealthcare) and receive coordinated medical and long-term care services through their plan.
PathWays covers a wide range of home and community-based services, including attendant care (consumer-directed), Structured Family Caregiving, adult day services, home modifications, respite care, transportation, and skilled nursing. A care manager from the member's health plan develops a person-centered service plan based on assessed needs.
The H&W Waiver serves Indiana residents under 60 who have a qualifying disability and meet a nursing facility level of care. Unlike PathWays, the H&W Waiver operates on a fee-for-service basis with a state-approved case manager coordinating care. Services mirror those available under PathWays, including SFC and consumer-directed attendant care.
ABD State Sponsored Care is an entitlement program that provides healthcare coverage and limited home care benefits to aged, blind, and disabled Hoosiers. While it includes some personal care assistance, it does not offer Structured Family Caregiving or consumer-directed attendant care with family caregiver pay. Families who need caregiver compensation should pursue PathWays or the H&W Waiver.
The Bottom Line: PathWays and H&W both support family caregiver pay, while ABD State Sponsored Care is an entitlement program but does not offer SFC or full consumer-directed caregiver pay.
| Feature | PathWays for Aging | Health & Wellness (H&W) Waiver | ABD State Sponsored Care (Hoosier Care Connect) |
|---|---|---|---|
| Waiver authority | 1915(c) HCBS Waiver (managed care) | 1915(c) HCBS Waiver (fee-for-service) | State Sponsored Care State Plan |
| Age requirement | 60 and older | 59 and younger (with disability) | 65+ or blind/disabled (all ages) |
| Delivery model | Managed care (Anthem, Humana, UnitedHealthcare) | Fee-for-service with case management | Managed care (Hoosier Care Connect) |
| Consumer-directed attendant care | Yes, with FMS vendor | Yes, with FMS vendor | Limited |
| Structured Family Caregiving | Yes (daily stipend, live-in caregiver) | Yes (daily stipend, live-in caregiver) | Not available |
| Spouse as caregiver | No | No | No |
| Family caregiver pay | Yes, through SFC or consumer-directed attendant care | Yes, through SFC or consumer-directed attendant care | No |
| Waitlist | Yes (approx. 10,400 as of early 2026) | Yes | No (entitlement) |
| Income limit (2026, single, waiver) | $2,982/month (300% FBR) | $2,982/month (300% FBR) | $1,305/month (100% FPL) |
Indiana operates several State Sponsored HCBS waivers in addition to PathWays and H&W. Here is a complete overview:
The Bottom Line: Indiana has several waivers, but PathWays, H&W, and TBI are the strongest caregiver-pay pathways for most families.
| Waiver / Program | Population | Family Caregiver Pay? | Consumer Direction? | Waitlist? |
|---|---|---|---|---|
| PathWays for Aging | Age 60+, nursing facility LOC | Yes (SFC + consumer-directed attendant care) | Yes | Yes (approx. 10,400) |
| Health & Wellness (H&W) | Under 60, disability, nursing facility LOC | Yes (SFC + consumer-directed attendant care) | Yes | Yes |
| Traumatic Brain Injury (TBI) | TBI diagnosis, nursing facility LOC | Yes (SFC + consumer-directed attendant care) | Yes | Yes |
| Family Supports Waiver (FSW) | I/DD, all ages | Limited | Limited | Yes (significant) |
| Community Integration & Habilitation (CIH) | I/DD requiring residential support | Limited | Limited | Yes (significant) |
| ABD State Sponsored Care (Hoosier Care Connect) | 65+ or blind/disabled, all ages | No | Limited | No (entitlement) |
The Bottom Line: Seniors usually start with PathWays, adults under 60 usually start with H&W, and families choose SFC or consumer-directed attendant care based on living arrangement and pay preference.
The Bottom Line: Indiana caregiver rules changed in 2024, consumer direction depends on the waiver and model, and waiver enrollment is not automatic.
If you've been told that spouses can't get paid to care for a loved one in Indiana, the full picture is more encouraging than you might think.
Through Indiana's Structured Family Caregiving (SFC) program, spouses are explicitly eligible to receive a tax-free daily stipend as live-in caregivers. Indiana actively uses SFC to support spouses who are already doing the hard work of caring for someone they love at home.
The confusion often comes from a mid-2024 change when Indiana transitioned spouses out of the hourly Attendant Care program. But they were moved into SFC so they could still be compensated. It was a change in how spouses get paid, not whether they get paid.
Under current State Sponsored waivers like PathWays for Aging, Health & Wellness, and Traumatic Brain Injury, spouses, legal guardians, adult children, siblings, and even close friends can participate in SFC.
If you're a spouse providing care in Indiana, financial support is available to you. FreedomCare can help you understand your options and walk you through the process step by step.
PathWays for Aging is a managed care program, which means your health plan coordinates services and provider networks. Consumer-directed attendant care is available within PathWays, but the managed care entity (MCE) must approve the arrangement. The H&W Waiver operates on fee-for-service, giving families somewhat more flexibility in choosing providers. In both cases, a financial management service handles payroll.
Both PathWays and H&W have enrollment caps. As of early 2026, approximately 10,400 individuals are on the PathWays waiting list. FSSA sends monthly invitation letters to applicants. Families should apply as early as possible and maintain contact with their local Area Agency on Aging to stay informed about their waitlist status.
The Bottom Line: Applying in Indiana starts with your Area Agency on Aging, then State Sponsored Care enrollment, waiver selection, caregiver enrollment, and FreedomCare support.
Here’s the general path families usually follow when applying for Indiana State Sponsored home care and caregiver pay.
Indiana's 16 AAAs coordinate all HCBS waiver applications. Call the Indiana Aging and Disability Resource Center at 1-800-986-3505 or visit in.gov/fssa to find your regional AAA.
The AAA care manager will conduct an Eligibility Screen (E-Screen) to determine whether the care recipient meets the nursing facility level of care required for PathWays or H&W.
If not already enrolled, submit a State Sponsored Care application through the Division of Family Resources (DFR) at in.gov/fssa/dfr or through your local DFR office. Income and asset documentation will be required.
Based on age and assessment results, you will be directed to PathWays (60+) or H&W (under 60). Work with your care manager to select Structured Family Caregiving, consumer-directed attendant care, or agency-based services.
For SFC, contact a licensed SFC agency in your area to begin caregiver training and enrollment. For consumer-directed attendant care, your caregiver enrolls through the FMS vendor. Payments typically begin within a few weeks of completed enrollment.
Get help understanding PathWays, H&W, SFC, consumer-directed attendant care, caregiver rules, and next steps.
The Bottom Line: These FAQs answer the main Indiana caregiver pay questions about family eligibility, spouse rules, waivers, and consumer-directed care.
Yes, through Structured Family Caregiving (SFC) or consumer-directed attendant care under the PathWays for Aging Waiver or Health and Wellness Waiver, eligible family members can receive State Sponsored payment for providing care at home. Adult children, siblings, grandchildren, and other non-spouse relatives are eligible. Spouses and legal guardians cannot be paid.
No, under current Indiana State Sponsored Care rules, spouses and legal guardians are not eligible for caregiver payment through consumer-directed attendant care or Structured Family Caregiving. Eligible caregivers include adult children, siblings, grandchildren, and trusted friends.
The PathWays for Aging Waiver (age 60+), the Health and Wellness Waiver (under 60), and the Traumatic Brain Injury (TBI) Waiver all allow family caregiver payment through Structured Family Caregiving and consumer-directed attendant care. The Family Supports and Community Integration and Habilitation (CIH) waivers for individuals with intellectual and developmental disabilities offer more limited family caregiver options.
Consumer-directed care allows the State Sponsored Care member to hire, train, and supervise their own attendant for personal care and homemaker services. A financial management service (FMS) handles payroll and taxes. Family members (except spouses and legal guardians) can serve as the attendant. This option is available under both PathWays for Aging and the Health and Wellness Waiver.
The Bottom Line: These resources help Indiana families compare pay, apply for caregiver programs, understand PathWays, and verify State Sponsored Care program rules.
Our guide explains how much family caregivers can get paid in Indiana, including typical pay ranges, program differences, and what affects compensation.
freedomcare.com/how-much-do-family-members-get-paid-for-caregiving-indianaLearn how Indiana residents can become paid family caregivers through State Sponsored programs and how FreedomCare helps guide families through the process.
freedomcare.com/how-to-become-a-paid-family-caregiver-in-indianaThis article explains the launch of Indiana PathWays for Aging, a State Sponsored managed care program introducing new waiver structures and expanded home care services.
ilcein.org/fssa-announces-launch-of-indiana-pathways-for-aging-medicaid-managed-care-program-new-waiversThe Indiana Family and Social Services Administration website provides information on State Sponsored Care, disability services, and support programs for residents.
in.gov/fssaIndiana’s Home and Community-Based Services (HCBS), which provide in-home care and support for individuals who would otherwise need institutional care.
in.gov/medicaid/members/home-and-community-based-servicesLearn more about Indiana PathWays for Aging, a program that coordinates State Sponsored long-term care services for older adults and individuals with disabilities.
in.gov/pathwaysRead more about Hoosier Care Connect, a State Sponsored managed care program for individuals with complex medical needs who are not eligible for Medicare.
in.gov/medicaid/members/member-programs/hoosier-care-connectThe Bottom Line: Indiana State Sponsored Care rules, waiver availability, managed care networks, and eligibility standards can change.
This content is for general informational purposes only and should not be relied upon as legal, medical, financial, or professional advice. Indiana State Sponsored programs, including PathWays for Aging, the Health and Wellness Waiver, and Structured Family Caregiving, are subject to changing state and federal rules, eligibility standards, and enrollment caps. FreedomCare does not guarantee eligibility or program approval. Waiver availability may vary by county. Managed care enrollment impacts provider choice. Verify current requirements with the Indiana Family and Social Services Administration (FSSA) or your local Area Agency on Aging before applying for benefits or making care-related decisions.
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Why Families Choose FreedomCare
We help families across Indiana every day.
We’ll help you find the right program for your family.
Why Families Choose FreedomCare
We help families across Indiana every day.
Get clear answers about PathWays for Aging, the Health and Wellness Waiver, Structured Family Caregiving, consumer-directed care, caregiver rules, and next steps.
