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CHOICE in Indiana: A Home Care Option Families Should Know About
What if your loved one needs help at home, but Medicaid isn't covering the services they need?
When an older adult begins struggling with bathing, dressing, meals, mobility, medications, or other everyday activities, families often start asking a difficult question:
“Does this mean Mom needs to move into a nursing home?”
Not necessarily.
Indiana has a state-funded program called CHOICE, short for Community and Home Options to Institutional Care for the Elderly and Disabled. The program is designed to help eligible older adults and people with disabilities remain independent in their homes and communities for as long as it is safely possible.
And here's the part many families may not know:
CHOICE can be an important resource to explore when someone needs support at home but doesn't have another funding source available to meet those needs.
Let's break it down.
What Is the Indiana CHOICE Program?
CHOICE is an Indiana state-funded home and community-based services program administered through Indiana's Area Agencies on Aging.
Its purpose is straightforward:
Help people remain independent in their own homes or communities instead of moving into institutional care when appropriate.
The program can provide a variety of supportive services based on an individual's needs and eligibility.
This makes CHOICE different from a Medicaid waiver.
Medicaid waivers are Medicaid-funded programs. CHOICE is state-funded.
However, both can be part of the larger conversation about helping eligible individuals remain at home.
Who Is CHOICE For?
According to Indiana FSSA, an individual generally must:
Be an Indiana resident
Be at least 60 years old, or have a qualifying disability
Be determined to be at risk of losing independence
Have needs that affect daily activities or other aspects of independent living
That could include difficulty with activities such as:
Bathing
Dressing
Walking
Transferring
Medication setup
The important thing is that CHOICE isn't simply based on age.
The individual must have a demonstrated need for assistance.
💡 Ask Yourself: Is Your Loved One Starting to Struggle?
Take a moment and think about the last six months.
Has your loved one started having difficulty with:
☐ Getting dressed independently?
☐ Preparing meals?
☐ Getting in and out of the shower?
☐ Walking safely around the house?
☐ Getting to medical appointments?
☐ Managing everyday household tasks?
☐ Staying safely alone?
If you've checked several boxes, it may be time to explore available community resources.
Needing assistance doesn't automatically mean someone needs a nursing home.
Sometimes the right support can help someone remain at home.
What Services Can CHOICE Provide?
One of the most useful things about CHOICE is that support isn't limited to one type of service.
Depending on the individual's needs and available funding, services may include:
Personal & Daily Support
Attendant care
Homemaker services
Home health aide
Respite care
Health & Safety
Skilled nursing
Personal emergency response systems
Specialized medical equipment
Environmental modifications
Everyday Living
Home-delivered meals
Transportation
Handy chore services
Pest control
Community Support
Adult day services
Case management
Indiana FSSA lists these and other services among those available through CHOICE.
Not everyone receives every service. Services are based on the person's circumstances, assessed needs, and available program resources.
Is CHOICE the Same as Medicaid?
No.
This is one of the most important things families should understand.
CHOICE is state-funded, while Medicaid HCBS waivers are Medicaid-funded programs.
Indiana Medicaid also offers home and community-based services for eligible individuals who choose to remain at home instead of receiving services in an institution.
So why would a family look at CHOICE?
Because not every person who needs assistance will qualify for Medicaid-funded services, and funding sources have different eligibility requirements.
Indiana specifically states that CHOICE funds may not be used when another funding source, such as Medicare or Medicaid, is available to meet the individual's needs.
In other words:
CHOICE isn't necessarily a replacement for Medicaid. It can be another resource within Indiana's broader system of support.
Does CHOICE Have an Income Limit?
Here's where CHOICE is different from what many families might expect.
Indiana FSSA states that there are no income limits for the CHOICE program.
However, there is a cost-sharing formula, meaning individuals with higher incomes may be asked to contribute toward the cost of their services.
There are also asset/resource rules.
Indiana currently lists a $250,000 asset limit, with an additional $20,000 in countable assets excluded when determining eligibility.
Because financial rules can be complicated, families should have their specific situation reviewed rather than assuming they qualify or don't qualify based on income alone.
What Does "At Risk of Losing Independence" Mean?
This phrase is important.
CHOICE is intended for individuals who are having difficulty maintaining independence safely.
That could look very different from one person to another.
For one senior, it might mean:
“I can't safely shower without help anymore.”
For another:
“I can't prepare meals or get around the house like I used to.”
For another:
“My daughter is helping me with everything, but she's becoming overwhelmed.”
These changes don't necessarily mean someone needs institutional care.
They may indicate that it's time to explore additional support.
CHOICE vs. Medicaid Waiver: What's the Difference?
Here's a simple way to think about it:
CHOICE | Medicaid HCBS | |
Funding | Indiana state-funded | Medicaid-funded |
Goal | Support independence at home/community | Support eligible individuals in home/community settings |
Eligibility | Age/disability + assessed need + financial/resource rules | Medicaid + program-specific requirements |
Cost | Cost-sharing may apply | Depends on Medicaid/program rules |
Services | Varies based on needs and availability | Varies by waiver and approved plan |
Where to Start | Area Agency on Aging | Medicaid/PathWays or appropriate program |
Indiana's Medicaid HCBS programs and CHOICE both support community-based living, but they are separate programs with different eligibility and funding rules.
What If My Loved One Is Already on Medicaid?
This is where families should ask questions before assuming CHOICE is the answer.
Indiana says CHOICE funds cannot be used when Medicare or Medicaid is available to meet the individual's needs.
If your loved one already receives Medicaid, ask about the appropriate Medicaid program or HCBS option first.
For older adults, Indiana PathWays for Aging may be relevant depending on their circumstances and eligibility.
We recently covered PathWays in:
“What Is Indiana PathWays for Aging? A Simple Guide for Seniors and Families.”
Understanding the difference between CHOICE, PathWays, Medicaid, and Medicare can save families a lot of confusion.
How Do You Apply for CHOICE?
This doesn't have to start with a complicated online search.
Indiana FSSA directs individuals interested in CHOICE to their local Area Agency on Aging (AAA).
The state provides a statewide number:
1-800-986-3505
The Area Agency on Aging can help with the application process and determine what resources may be appropriate.
You can also explore Indiana's official CHOICE information here:
🎥 Want to Learn More?
Instead of relying on social media posts or information from someone who “heard” about the program, start with official Indiana resources.
You can also speak with your local Area Agency on Aging about CHOICE and other available in-home support resources.
A Quick Family Checklist
Before calling about CHOICE, gather some basic information about your loved one.
Write down:
Age: __________
Current living situation: __________
Medicaid: Yes / No / Unsure
Medicare: Yes / No / Unsure
Needs help with bathing: Yes / No
Needs help with dressing: Yes / No
Needs help with meals: Yes / No
Has mobility difficulties: Yes / No
Needs transportation: Yes / No
Family caregiver available: Yes / No
Biggest concern right now: __________
Having this information ready can make the conversation with an Area Agency on Aging or care professional much easier.
Final Thoughts: You May Have More Options Than You Think
When a loved one begins struggling at home, it's easy to jump to the conclusion that the next step must be assisted living or a nursing facility.
But care doesn't have to be an all-or-nothing decision.
Indiana's CHOICE program is one resource designed to help eligible older adults and people with disabilities maintain independence in their homes and communities for as long as safely possible.
It isn't Medicaid, and it doesn't guarantee that someone will receive free home care. Eligibility, available funding, assessed needs, and other potential funding sources all matter.
But that's exactly why families should ask questions before making assumptions.
At Nurtured Home Care Indiana, we believe families deserve to understand their options before making major decisions about their loved one's care.
If you're beginning to explore home care, we're here to help you understand the types of support your loved one may need and guide you toward appropriate resources.
📍 Serving Fort Wayne, Elkhart, and surrounding areas
📞 Call Nurtured Home Care Indiana at (260) 418-9911
Before you decide that your loved one has to leave home, explore the resources that may help them stay.
This article is for educational purposes only. It does not determine eligibility for CHOICE, Medicaid, or any other program. Program rules, funding, and service availability can change. For the most current eligibility information, contact Indiana FSSA or your local Area Agency on Aging.
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