Indiana Medicaid Waiver Program: An Alternative to Nursing Homes

Writer / Michael Wilhelm
Photography / Provided


DeFur Voran

As an elder law attorney, I am often asked by clients how they can protect assets from potentially substantial long-term care expenses in an institutional setting, such as memory care or custodial skilled nursing. While that conversation can be complex and revolves around many factors, the following touches on an alternative to nursing homes that continues to grow in popularity.

Throughout human history until the second half of the 20th century, most people aged and died at their home or the home of a family member. By the 1980s, only 17% of Americans died at home, as the experience of aging and death in the industrialized world shifted to hospitals and nursing homes. This dramatic change was caused by many factors including longer life, fewer children, and children with duel-income families (leaving fewer children available to care for aging parents). Even as more and more of our elderly population ages in hospitals and nursing homes, their preference for living at home remains strong. Nearly 90% of seniors want to stay at home as they age, which is often referred to as aging in place.

Indiana has adopted the concept of aging in place, and has implemented certain programs and policies to reverse the trend of aging in hospitals and nursing homes. One such program available to seniors in Indiana is the Medicaid Aged and Disabled Waiver. The program began as a response to the national trend toward providing home and community-based services (HCBS). In the past, Medicaid paid only for institutional long-term care services, such as nursing homes. The Medicaid Waiver program waives the requirement of an admission into a nursing home in order for Medicaid to pay for HCBS.

The overall goal of the Medicaid Waiver is to take people out of institutions, or prevent them from going there in the first place, by allowing them to live at home. Specific goals of Medicaid Waiver services are to provide the person with meaningful and necessary services and supports in the home or community, to respect the recipient’s personal beliefs and customs, and to ensure that services are cost effective. Some of the services and supports available include bathing assistance, dressing assistance, restroom assistance, mobility assistance, homemaker services, assistance with taking medications, nutritional supplements, transportation, and case management. These Medicaid Waiver services directly address the needs of the elderly who find it increasingly difficult to remain in their homes, and help to reverse the trend of aging in institutions.

A resident of Indiana must meet a combination of state and federal requirements in order to be eligible for a Medicaid Waiver. DeFur Voran LLP’s elder law group develops and implements plans for clients so that they meet Medicaid resource and income guidelines.

If you would like to discuss the Medicaid Waiver program with an elder law attorney, please call 317-585-8085 or visit

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