The Indiana Family and Social Services Administration will start a new program on July 1, 2024, for Hoosiers 60 and older who receive Medicaid benefits called PathWays (excluding Healthy Indiana Plan Medicaid recipients). The stated goal of this program is to provide more services to seniors such as transportation to medical appointments, home health visits, and help with food, to allow Hoosiers to age at home instead of in a nursing home.
Starting in February 2024, approximately 120,000 eligible Hoosiers will start picking one of three health plans administered by Anthem, Humana, or UnitedHealthcare, the Indiana Managed Care Entities (MCEs).
FSSA will send out letters in January 2024, with a health plan comparison chart of services offered by each of the MCEs, so you can make a choice about which plan is best for you.
Eligible Hoosiers will then enroll in one of the three plans in February and March 2024. FSSA will automatically enroll folks in April who have not picked a plan. Services by the MCEs will start on July 1, 2024.
You can call the PathWays hotline at 877-284-9294 to select a plan or to obtain additional information about which plan will be best for you.
You will want to choose a plan that includes your current medical providers. Indiana has selected an Enrollment Broker (Maximus) to help you choose the best health plan for you. The phone numbers for PathWays and Maximus are the same, 877-284-9294.
Many Hoosiers will enroll in the wrong plan for them. You will be able to change plans in the 90-day period from July 1, 2024, to September 30, 2024, without penalty. There will be other opportunities to change plans in the future.
The MCEs will offer benefits that are not currently offered by Medicaid. These may be food delivery services and an over-the-counter pharmacy allowance. The MCEs are currently building their networks of health care providers who will participate in their 2
health plans. Your health plan should provide enhanced coordination of care since all your medical providers will report to one health plan.
The health plan will employ a Care Coordinator who will help create a personalized care plan for you based on your preferences and needs. Your coordinator will help you schedule visits with your medical providers.
Your health plan will send you a health care assessment questionnaire asking about your personal behaviors, health goals, and priorities.
Your health plan will use these assessments to create a personalized plan for your care to allow you to age in the least restrictive environment (home in most cases). Hoosiers who meet nursing home level of care may receive these services as part of their personal care plan:
- Adult Day Services
- Adult Family Care
- Assisted Living
- Home Modifications
- Health Care Coordinator
- Home-Delivered Meals
- Nutritional Supplements
- Personal Emergency Response System
- Respite Care
- Specialized Medical Equipment
- Structured Family Care
- Vehicle Modifications
When you enroll in a health care plan, you can call your health plan to see if your providers participate in your plan. The MCEs will be contacting folks enrolled in their plans in June 2024, to provide more information about accessing coverage going forward.
This is a new program in Indiana. We will be posting monthly articles on our website with the experiences of our clients as they go through the enrollment process. Please communicate your experience with this process to our team, so we can do our best to make this a successful program for all Hoosiers.
After all, home is where the heart is, and we hope, mom and dad too.
Keith P. Huffman