Structured Family Caregiving Indiana: Get Paid to Care for an Elderly Parent

You've been providing hands-on care for your aging parent for months — maybe years — and nobody has told you that Indiana has a program that actually pays family members to do it. The Structured Family Caregiving (SFC) program is one of Indiana's least-publicized Medicaid benefits, and most families discover it only after they've already burned through savings and vacation days.

How Structured Family Caregiving Works in Indiana

SFC is a Home and Community Based Services (HCBS) benefit available through Indiana's Medicaid waiver programs. The program pays a tax-exempt daily stipend to a family member or close friend who lives with and provides daily care to a Medicaid-eligible senior or disabled adult.

The stipend levels are tiered based on the care recipient's assessed needs:

• Level 1: $50+ per day for moderate assistance needs
• Level 2: $60+ per day for significant daily care
• Level 3: $80+ per day for intensive, around-the-clock support

Under IRS Notice 2014-7, these payments are classified as "difficulty of care" payments and are exempt from federal income tax when the caregiver lives in the same household as the care recipient.

Who Qualifies for the SFC Program

The care recipient must meet two requirements: they must be enrolled in Indiana Medicaid, and they must require a nursing facility level of care (NFLOC) as determined through the LCAR assessment process managed by Maximus.

For seniors aged 60 and older, SFC is accessed through the Indiana PathWays for Aging program. Your parent would need to be enrolled in one of the three managed care plans — Anthem, Humana, or UnitedHealthcare — and their PathWays care coordinator would authorize the SFC benefit.

For adults aged 59 and younger with disabilities, SFC is available through the Health and Wellness (H&W) Waiver.

The caregiver must live in the same home as the care recipient, complete a background check, and participate in a care plan developed with a designated SFC provider agency.

How to Enroll Step by Step

1. Confirm Medicaid eligibility. If your parent isn't already on Medicaid, the application goes through the FSSA Division of Family Resources. Indiana's 2026 income cap for long-term care Medicaid is $2,982 per month — income above that requires a Miller Trust.

2. Request a level-of-care assessment. Contact the LCAR Help Desk at 833-597-2777 to schedule the interRAI assessment that determines NFLOC eligibility.

3. Contact the PathWays care coordinator. Once enrolled in PathWays, the assigned managed care plan coordinator can authorize SFC and connect you with a licensed SFC provider agency.

4. Complete provider training. The SFC agency conducts a home assessment, develops a person-centered care plan, and trains you on required documentation and care tasks.

5. Begin receiving stipend payments. Payments are issued by the SFC provider agency, typically on a biweekly or monthly schedule.

The Waitlist Reality

Here's the catch: both the PathWays for Aging waiver and the Health and Wellness waiver maintain enrollment caps with significant waiting lists. As of 2026, the PathWays waiting list exceeds 12,000 individuals, and the H&W list has over 6,500 people waiting.

If your parent is being discharged from a hospital and cannot safely return home, they may qualify for priority status on the waiver waitlist — bypassing the standard chronological queue. Ask the hospital discharge planner to document the clinical need and contact your local Area Agency on Aging to initiate the priority request.

Once a waiver invitation arrives, you have exactly 45 days to formally accept and 180 days to complete all eligibility steps, or the slot is permanently rescinded.

SFC vs. Consumer-Directed Services

Indiana offers a related option called Consumer-Directed Services (CDS) under PathWays, which lets your parent hire their preferred caregiver — including a family member — as a paid attendant. CDS gives your parent more control over scheduling and tasks, while SFC provides a structured care framework with regular agency oversight.

Both programs pay family caregivers, but SFC typically offers higher daily rates because it covers a broader scope of around-the-clock care responsibilities.

What This Means for Your Family's Finances

Many Indiana families don't realize that the unpaid caregiving they've been providing has a Medicaid-funded alternative. A Level 2 SFC stipend of $60 per day adds up to roughly $1,800 per month — tax-free. That won't replace a full salary, but it can cover groceries, utilities, or the mortgage payment that's been slipping while you've been providing care.

If you're navigating a parent's hospital discharge and trying to figure out how to manage care at home without going broke, the Indiana Hospital-to-Home Transition Guide walks through SFC enrollment alongside the full discharge planning process, waiver waitlist strategies, and Medicaid financial structuring.

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