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1624.00.00 INDIANA PATHWAYS FOR AGING (PATHWAYS) Indiana PathWays for Aging, also referred to as “PathWays,” is a managed care program for Medicaid members who are:

• 60 years of age and older, and • Receiving Medicaid in an aged, blind or disabled category (Including MEDWorks and MASI).

Members enrolled in PathWays include those who:

• May or may not be enrolled in or eligible for Medicare, • May or may not be receiving LTSS (long-term support services) including those who are: • Residing in a nursing or long-term care facility, or • Receiving services under an approved PathWays waiver (formerly called the Aged and Disabled waiver). • Receiving BPHC services in a MED 1 category

Medicaid members that are not eligible for PathWays include:

• Those under 60 • HIP members of any age • Hoosier Healthwise Members of any age • Individuals who are only partial benefit dually eligible (QMB-only, SMLB-only, QI, or QDWI) • MAGF members who are not in the PathWays waiver • DDRS waiver recipients, including: o FSW (Family Support Waiver) o CIH (Community Integration and Habilitation Waiver) • TBI (Traumatic Brain Injury) Waiver recipients • TBI out-of-state placements • Residents of State Operated Facilities (SOF) • Program of All Inclusive Care for the Elderly (PACE) members • RCAP (Room and Board) members • Breast and Cervical cancer members on MA12 • I/DD residents in intermediate care facilities (ICF) • ESO (Emergency Services Only) members

Certain populations will not be placed into the PathWays program and will remain in Fee-for- Service (FFS). These members are not required to participate in the PathWays program but have the option to Opt-in.