Indiana PathWays Managed Care Plans: Anthem, Humana, and UnitedHealthcare Compared

Once your parent clears Medicaid eligibility and the PathWays for Aging waiver waitlist, the enrollment broker will ask you to pick a Managed Care Entity (MCE). You get three choices: Anthem Blue Cross and Blue Shield, Humana, and UnitedHealthcare. If you don't choose, the state auto-assigns one. That's not ideal — these plans differ in ways that directly affect your parent's daily care.

What MCEs Actually Do

Under Indiana's PathWays for Aging program, the MCE isn't just an insurance card. It's the organization that:

• Assigns a Care Coordinator who conducts home visits every 90 days
• Develops the Person-Centered Service Plan (PCSP) that dictates authorized care hours, services, and providers
• Manages the provider network — which home care agencies, adult day centers, and specialists your parent can access
• Coordinates non-emergency medical transportation (NEMT) to covered appointments
• Handles prior authorizations for services and equipment

The MCE's care coordinator is your parent's primary point of contact within the system. A responsive coordinator who understands your family's situation makes an enormous difference; an unresponsive one creates bottlenecks at every turn.

How to Choose Between the Three

Since all three MCEs are required to cover the same core PathWays waiver services, the real differences come down to network coverage, care coordination quality, and supplemental benefits.

Check provider networks first. If your parent already has a preferred home care agency, primary care physician, or specialist, verify that those providers are in the MCE's network before enrolling. Use the IHCP Provider Locator on the Indiana Medicaid website or call each MCE's member services line directly.

Ask about care coordinator caseloads. Lower caseloads generally mean more attentive coordination. When calling member services during your decision window, ask how many members each coordinator typically manages.

Compare supplemental benefits. MCEs may offer extras beyond the standard waiver package — over-the-counter health product allowances, additional dental or vision coverage, or wellness programs. These vary by plan and can change annually.

Consider the Dual Care program. If your parent qualifies for both Medicare and Medicaid (a "fully benefit dual eligible"), the PathWays Dual Care program launched January 1, 2026 coordinates all medical, behavioral, and HCBS benefits through a single D-SNP plan. All three MCEs offer D-SNP options, but their Medicare Advantage networks differ significantly.

Switching Plans

You're not locked in permanently:

• First 90 days: switch to any other MCE for any reason, no justification needed
• Annual open enrollment: mid-October through mid-December each year
• Just cause: switch at any time if your parent's preferred provider leaves the MCE's network, the MCE fails to provide covered services, or other qualifying circumstances arise

To switch, call the enrollment broker or contact the FSSA directly. The transition takes effect the first of the following month.

The Bigger Picture

Choosing an MCE is one step in a longer process that includes the Maximus assessment, financial eligibility, Miller Trust setup, and Person-Centered Service Plan development. The Indiana Home Care, Waivers & Support Guide walks through each stage in sequence — so the MCE decision fits into a plan you've already built rather than a choice you're making under pressure.

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