Choosing the Right Health Plan under Indiana Pathways for Aging

 

You have probably already seen the commercials for the Indiana PathWays for Aging Program or heard them on the radio.  If you receive Medicaid benefits and reside in a nursing home or have alternative home and community-based services, you should have received a notice in the mail instructing you to pick one of three health insurance plans under the program.  Many of our clients have asked for guidance in making this choice.  While ultimately, the choice will be up to our client, we do want to share some background information about the Indiana PathWays for Aging Program and a tips for making your choice of health insurance plan.

 

What is the Indiana Pathways for Aging Program?

 

The Indiana PathWays for Aging Program is a new Medicaid program for Hoosiers 60 years and older.  The Program will launch in July.  Individuals who already receive Medicaid benefits for nursing home care or home and community-based services under a Medicaid Waiver will be automatically transitioned into the program.

Unlike a fee-for-services model that Indiana Medicaid currently has, services under the Indiana PathWays for Aging Program will be provided by a managed healthcare entity.

Who are the managed healthcare entities?

 

The State of Indiana has enlisted three health insurers to serve as an individual’s managed health care entity:  Anthem, Human, and United Healthcare (UHC).

So, how do I pick between the three managed healthcare entities (aka health plans)?

 

Some health plans will offer different special benefits.  All plans give you the same Medicaid health coverage.  However, one health plan might work with different doctors, hospitals, or facility and community-based providers.  So, if you are in a nursing facility, it is essential for you to ensure that your facility has enrolled in the health plan you have picked.  If you receive community based services such as home care, adult day care, or assisted living, you must ensure that your home care provider, adult day care provider, or assisted living facility is enrolled in the health plan you have picked.  If you are uncertain whether your provider has enrolled in a particular plan, we recommend that you contact the provider’s Business Officer Manager or similarly positioned employee to confirm the provider is enrolled in your plan.  You can also call the Indiana PathWays for Aging Helpline at 87-PATHWAY-4 (877-284-9294).

When must I make my choice?

 

You must make your choice by April 30, 2024, or you will be automatically enrolled in one.

My provider has told me that they are not currently enrolled in the health plan I picked (or was assigned), now what?

 

You may change your health plan at any time up to 90 days after the start of the program.  You should contact the Indiana PathWays for Aging Helpline at 87-PATHWAY-4 (877-284-9294) as soon as possible to change your plan.

 


Planning for Medicaid and navigating the Medicaid application process is complicated and can be daunting.  For expert assistance understanding Indiana Medicaid laws, contact Stinson Law Firm for assistance. Our Indiana Medicaid attorneys will guide you through the steps you should take to protect the family members you love.

How our Indiana Medicaid Attorneys Can Help

If you live in Indiana, and need assistance handling the Medicaid process, the legal team at Stinson Law Firm can help. Our Indiana Medicaid Attorneys have helped hundreds of Indiana residents get through the Medicaid process. Let our Medicaid attorneys provide you peace of mind with care and compassion.

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