How to Get Medicaid-Funded Home Care in Indiana Without an Elder Law Attorney

You can handle many routine steps yourself when seeking Medicaid-funded home care in Indiana. However, if your parent's income exceeds the cap, have an elder-law attorney or qualified Medicaid planner draft the legally compliant Miller Trust; the PathWays for Aging application and CHOICE bridging steps can otherwise be prepared with documented instructions and worksheets.

Here's how the self-service path works, step by step, in the order you'll actually need to do things.

Step 1: Execute Legal Documents While Your Parent Has Capacity (Days 1–3)

Before you touch a single Medicaid form, get two documents signed:

• Durable Financial Power of Attorney — under Indiana Code § 30-5, this authorizes you to manage your parent's finances, sign Medicaid applications, and open bank accounts (including the Miller Trust) on their behalf
• Health Care Representative Appointment — under Indiana Code § 16-36-7, this authorizes you to make medical decisions and access health records

Both require your parent to have legal capacity at the time of signing. If your parent has already lost capacity, you'll need a court-supervised guardianship — that's the one situation where an attorney becomes unavoidable.

Indiana does not require notarization for a Health Care Representative appointment (two witnesses suffice), but the Durable POA should be notarized for practical acceptance at banks and government agencies.

Step 2: Apply for CHOICE Bridging (Days 3–7)

Don't start with the Medicaid waiver application. Start with CHOICE.

Indiana's CHOICE program (Community and Home Options to Institutionalize Care for the Elderly and Disabled) is state-funded, has a $250,000 asset limit — compared to Medicaid's $2,000 — and has locally determined availability. It may provide bridging home care services while you work through the longer waiver application process.

Contact your local Area Agency on Aging — Indiana has 15 regional AAAs under the INconnect Alliance — and request a CHOICE intake assessment. Ask about local availability while you prepare the PathWays for Aging application.

Step 3: Determine If You Need a Miller Trust (Days 3–7)

Indiana's Medicaid income cap for long-term care is $2,982 per month. Add up your parent's gross monthly income:

• Social Security (gross, before Medicare premium deduction)
• Pension payments
• Any other recurring income

If the total exceeds $2,982, you need a Qualified Income Trust (Miller Trust). If it's under, skip to Step 4.

Preparing a Miller Trust with professional drafting:

1. Have an elder-law attorney or qualified Medicaid planner draft the legally compliant trust document
2. Open a dedicated bank account titled "[Parent's Name] Qualified Income Trust" and follow the professional's instructions
3. Each month, deposit the excess income (amount over $2,982) into the trust account as required for that month
4. Maintain a deposit log showing dates, amounts, and running balance
5. Submit a copy of the trust document with your Medicaid application

The monthly administration takes about 15 minutes. The Indiana Home Care Guide includes a Miller Trust preparation worksheet with a bank letter template and deposit tracking log.

Step 4: Prepare for the Maximus LCAR Assessment (Days 7–14)

Since Indiana transitioned to Maximus as the clinical assessment entity, the Level of Care Assessment and Referral (LCAR) determines whether your parent meets Nursing Facility Level of Care — the clinical threshold for PathWays for Aging.

The assessment uses the interRAI tool, which evaluates five core Activities of Daily Living: bathing, dressing, eating, toileting, and mobility or locomotion. To satisfy the Nursing Facility Level of Care standard, your parent must document a qualifying medical condition requiring direct, daily assistance with at least three of those five core ADLs.

What families get wrong: understating limitations. Your parent may insist they're "fine" during the assessment. Document specific incidents beforehand — falls, medication errors, wandering, inability to prepare meals, incontinence episodes — and have this documentation ready for the assessor.

Step 5: Gather Financial Documentation (Days 14–21)

FSSA requires extensive financial documentation for the Medicaid application:

• 60 months of bank statements and other financial records (all accounts)
• Social Security award letter
• Pension statements
• Property tax records for the primary residence
• Vehicle title
• Life insurance policy face values
• Any asset transfers in the past 60 months (the look-back period)

Organize everything by category. The most common cause of application delays is missing documentation, not ineligibility. A Medicaid financial eligibility worksheet helps you classify each asset as exempt or countable before FSSA does.

Step 6: Submit the PathWays for Aging Application (Days 21–30)

With the Miller Trust prepared (if needed), LCAR assessment completed, and financial documentation assembled, submit the waiver application through FSSA.

If your parent qualifies for first-priority consideration — transition off a 100% state-funded program such as CHOICE, nursing facility transition, or hospital discharge — document the qualifying circumstance. Priority consideration can move the application ahead of the general queue.

If your parent doesn't qualify for first-priority consideration, CHOICE services from Step 2 may provide coverage during the waitlist period, subject to local availability.

When This Approach Won't Work

Be honest about the situations where self-service isn't enough:

• Your parent has already lost capacity and no Power of Attorney exists — you need a guardianship attorney
• Asset transfers within the 60-month look-back involve complex transactions (property sales below market value, uncompensated transfers, trust distributions) — an attorney can assess penalty period exposure
• Active disputes between family members about care decisions or financial management
• Denied waiver application reaching the third or fourth appeal level — judicial review benefits from legal representation

For everything else — the standard application, Miller Trust preparation, the assessment, and the CHOICE bridge — the process is navigable with good instructions and the willingness to do the paperwork yourself.

Frequently Asked Questions

Is the PathWays for Aging application something I can fill out myself?

Yes. The application follows a standard FSSA process. The challenging part isn't the form itself — it's gathering the financial documentation, understanding which assets are exempt vs. countable, and timing the Miller Trust deposits correctly. A guide that covers these mechanics lets you organize the application without professional help, while a professional should draft any required Miller Trust document.

What if Maximus denies the Level of Care assessment?

You can appeal, but the route depends on who issued the adverse notice. A direct functional or eligibility determination can proceed to a State Fair Hearing; a PathWays service action by your parent's managed care entity (Anthem, Humana, or UnitedHealthcare) generally starts with the plan's internal appeal. Prepare additional ADL documentation — incident logs, physician letters, caregiver statements — that addresses the specific limitations the assessor may have understated. You don't need an attorney for the first two appeal levels.

How long does the whole process take without an attorney?

Plan for 30 to 60 days from starting legal documents to waiver application submission. An attorney doesn't meaningfully shorten this timeline — the bottlenecks are FSSA processing time, Maximus assessment scheduling, and document gathering, none of which move faster with legal representation. The CHOICE bridge provides services during this period.

Can I get paid as a family caregiver while the waiver application is processing?

Not through the waiver programs (Attendant Care and Structured Family Caregiving require an active waiver and an approved care plan). Some families arrange informal family care during the application period and request paid caregiver services once the waiver is active; do not assume the waiver will pay retroactively.

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