For many Indiana families, the decision is not whether a loved one needs help—it is how to afford dependable help at home. Indiana Medicaid’s home- and community-based services (HCBS) waivers are designed to give eligible people an alternative to institutional care, with supports tailored to daily living at home or in the community.
The main Indiana home care waivers
The Aged & Disabled (A&D) Waiver supports adults who are older or who have disabilities and meet the program’s level-of-care and financial requirements. It may be a fit for a senior who needs regular assistance with bathing, meals, mobility, or supervision but wants to remain at home. The Traumatic Brain Injury (TBI) Waiver serves people with a qualifying brain injury whose needs require specialized community supports.
Both are HCBS programs. That means the state assesses the person’s needs, develops a person-centered care plan, and authorizes services that help the individual live as safely and independently as possible. Availability and program details can change, so use the Indiana Family and Social Services Administration (FSSA) as the source for the current application process.
Who may qualify?
Eligibility generally has three parts: Indiana residency, Medicaid financial eligibility, and a demonstrated need for a nursing-facility level of care. The assessment looks at health, mobility, cognition, and the help required with daily tasks. A diagnosis alone does not guarantee enrollment; the care need and financial review both matter.
- A&D Waiver: often considered for adults 65 and older and adults with qualifying disabilities.
- TBI Waiver: intended for people with a traumatic brain injury who need coordinated community-based supports.
- Medicaid status: an applicant may already have Medicaid or may apply for Medicaid as part of the process.
Services that may be covered
An approved plan can include attendant or personal care, homemaker support, respite for family caregivers, transportation, home modifications, and other services that are medically necessary and authorized in the care plan. The exact hours and services depend on the assessment; a waiver is not a blank check for every type of assistance.
For example, a caregiver may help with bathing, dressing, meal preparation, laundry, safe transfers, and routine reminders. That support can make a meaningful difference for families in Indianapolis and Carmel who are balancing work, appointments, and a loved one’s changing needs.
How to apply and choose a provider
Start with FSSA’s Medicaid and waiver information at FSSA.in.gov, or contact the appropriate local entry point listed by the state. Gather identification, Medicaid information if available, medical records, medication lists, and notes about the help your loved one needs. Ask how long the assessment and enrollment steps may take, and keep copies of every notice.
Once services are authorized, ask prospective agencies whether they are enrolled for the services on the plan, how they recruit and screen caregivers, and how they communicate schedule changes. Guiding Angels can explain the practical questions to ask, coordinate around an approved plan, and help families understand the difference between personal care, homemaker support, and respite. For more decision help, read our seven questions for choosing an agency.
A calm next step
The waiver process can feel paperwork-heavy, but you do not have to solve every detail in one day. Begin the application, describe needs honestly during the assessment, and use the care plan as a working roadmap. Home care is most effective when the family, participant, care manager, and agency stay in touch as needs change.
Make a plan your family can use
Set aside a short family meeting to turn this information into a practical next step. Begin with the person receiving care: ask what feels difficult, what support they would welcome, and what routines they want to keep. Then list the tasks that need attention, who is helping now, and the times of day when help matters most. A written list is useful when you speak with an agency, a care manager, or a clinician because it replaces vague worry with examples.
Keep the first plan small enough to follow. You might arrange one companion visit each week, schedule a personal care assessment, organize a medication list, or ask a program representative about coverage. Decide who will be the family point person, where updates will be recorded, and how an urgent concern should be handled. Revisit the plan after the first few weeks. If something is not working—timing, caregiver match, task list, or communication—say so early and ask what can be adjusted.
Home support works best when it reflects the client’s choices and the family’s real capacity. Bring questions to the conversation, ask for explanations in plain language, and do not feel pressured to solve every future need at once. The next right step is the one that makes today safer, calmer, and more sustainable.