Indiana CHOICE Program: Home Care Services for Aging Parents

Your parent needs help at home but doesn't qualify for Medicaid — or does qualify but is stuck on a waiver waiting list that could take a year or longer. The CHOICE program is Indiana's state-funded alternative that fills exactly this gap.

CHOICE (Community and Home Options to Institutional Care for the Elderly and Disabled) provides home and community-based services to Indiana residents aged 60 and older who need help staying safely at home but lack other funding sources. It's administered through Indiana's network of Area Agencies on Aging (AAAs) and funded by state appropriations rather than federal Medicaid dollars.

What CHOICE Covers

The program offers a practical set of services designed to prevent or delay nursing home placement:

• Homemaker services — light housekeeping, laundry, meal preparation
• Personal care assistance — help with bathing, dressing, grooming, toileting
• Respite care — temporary relief for family caregivers (in-home or facility-based)
• Home-delivered meals
• Transportation to medical appointments and essential errands
• Emergency response systems (medical alert devices)
• Minor home modifications — grab bars, ramp installation, bathroom safety modifications

Services are tailored to each individual's assessed needs through a care plan developed by the local AAA.

Who Qualifies

CHOICE eligibility is broader than Medicaid's strict financial thresholds:

• Age: 60 or older (or under 60 with a qualifying disability in some AAA service areas)
• Functional need: Must need assistance with at least one Activity of Daily Living (ADL) or have a documented condition requiring supervision or support to remain at home safely
• Income: CHOICE uses a sliding fee scale rather than a hard cutoff — individuals with higher incomes pay a cost-share, while lower-income participants may receive services at no cost

Unlike Medicaid long-term care (which requires countable assets below $2,000 and income below $2,982), CHOICE doesn't impose the same punishing asset test. Your parent can have retirement savings, own a home outright, and still receive services — they may just owe a monthly copayment based on income.

How CHOICE Differs from Medicaid Waivers

The critical difference: CHOICE is not an entitlement. Medicaid is a legal right once you qualify. CHOICE depends entirely on the funding allocated to your local AAA, and when the money runs out, services stop or new applicants go on a separate CHOICE waiting list.

Services through CHOICE are also typically less intensive than what Medicaid waivers authorize. CHOICE might provide 10-15 hours per week of home care. The PathWays for Aging program or Health and Wellness Waiver can authorize 40+ hours per week depending on clinical need.

That said, CHOICE can be a lifeline during the gap between crisis and Medicaid approval — providing just enough support to keep your parent safe at home while you prepare the full application.

How to Apply

Contact your local Area Agency on Aging. Indiana has 16 AAAs covering all 92 counties. The AAA will:

1. Conduct an in-home assessment of your parent's functional needs
2. Determine income-based cost sharing
3. Develop a care plan and assign service providers
4. Begin services (if funding is available in that service area)

To find your parent's AAA, call the Indiana Division of Aging's information line or visit the FSSA website.

Using CHOICE as a Bridge to Medicaid

Many families use CHOICE strategically: it keeps their parent safe at home while they spend the weeks or months gathering 60 months of bank statements, setting up a Miller Trust if needed, and completing the Medicaid application process. Once Medicaid is approved and the parent enrolls in PathWays for Aging or secures a waiver slot, CHOICE services transition to Medicaid-funded care.

The advantage of doing this deliberately — rather than scrambling during a hospital discharge crisis — is that you have time to structure a compliant spend-down, avoid lookback penalties on asset transfers, and protect spousal resources before the DFR caseworker reviews the application.

The Indiana Medicaid Long-Term Care & Asset Protection Guide walks through how to use CHOICE alongside Medicaid planning, including the full eligibility checklist, spend-down strategies, and application timeline.

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