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UnitedHealthcare Community Plan — Indiana PathWays for Aging

Medicaid

Indiana PathWays for Aging is an Indiana health coverage program for Hoosiers aged 60 and older who are eligible for Medicaid. Research shows that most older adults – 75% or more – want to age at home and in their communities. Indiana PathWays for Aging makes it possible for Hoosiers to age their way. Our plan offers more choices for people to get nursing facility level of care at home or in a community setting, while living independently. Note that a nursing home might be the right choice for some. 

FSSA has contracted with UnitedHealthcare to administer the Indiana PathWays for Aging program. UnitedHealthcare is your health plan. 

  • UnitedHealthcare Community Plan — Indiana PathWays for Aging Steps to Enroll
  • Check Eligibility (opens modal window)

Benefits & Features

New Member Checklist

If you are a new Indiana PathWays for Aging program member, getting connected during your first 30 days is very important. Here is a to-do list. When you complete this list, it lets us know your choices when it comes to managing your health:  

  1. Check your voice mail and call us back. We will be trying to reach you by phone or in person during your first 4 weeks with UnitedHealthcare Community Plan. If you do not answer the phone from unknown numbers, we get it. It makes sense not to trust people who are asking personal questions over the phone. That is why we encourage you to call us at 1-800-832-4643 / TTY 711. We can also meet you in a public place or visit you where you live. 
  2. Complete your health needs screening. This is an important first step. It helps you let us know how you are doing today. Call Member Services at 1-800-832-4643 / TTY 711 and ask to take your health needs screening. If you complete this in the first 30 days, you will get to choose a reward from our member rewards catalog. 
  3. Let us know how you want to hear from us. This includes mail, email, and texting options. We can also help you set a large print, braille, or other format choice. If English is not your first language, we will send materials in your language. You can share these preferences right after you take your health needs screening. 
  4. Choose a Primary Medical Provider (PMP). As soon as you can, it is important to choose a Primary Medical Provider (PMP). This is your main provider. who sees you for annual checkups, routine sick or well visits, and immunizations (shots).  Here are the options for choosing your PMP:
    • Log into your member portal at MyUHC.com/CommunityPlan.
    • You can use our provider search tool to view all of the providers in our network. 
    • Call Member Services for help finding a PMP. We can also email or send you a list of providers to choose from. 

You should also:

  • Schedule an appointment with your PMP.  You should see your PMP as soon as possible after becoming an Indiana PathWays for Aging member. 
  • Connect with your Care Coordinator. Call Member Services to get started. Your Care Coordinator is “your go-to person” here at UnitedHealthcare. Your Care Coordinator listens to you. They share options that support your way, to live life your way. Our goal is to see you live as independently as possible, for as long as possible. 
  • Ask questions! We want to hear from you. Get connected to resources, programs, and services. Call Member Services to find out about all the extras we offer here at UnitedHealthcare. We want to make this a pleasant and easy experience for you. 

 

UnitedHealthcare will help you understand all of your health coverages and benefits. We support coordination of all services under Medicare, Medicaid, or private health insurance. This includes traditional Medicare, a different Medicare Advantage plan, Chronic Condition Special Needs Plans (C-SNPs), and Institutional Special Needs Plans (I-SNPs). 

We make sure that services are covered and provided by the Indiana PathWays for Aging program when members are eligible for both Medicare and Medicaid services. We will work with Medicare payers, Medicare Advantage plans, and your providers to coordinate the care and benefits. We work with all relevant state and social service agencies and community-based organizations (CBOs) as needed to better identify and address both medical and social needs. 

Mental health services are covered and do not need a referral. This includes office visits, inpatient, and outpatient services. See the member handbook for details. 

 

Each UnitedHealthcare member in this program has a single person as a main point of contact. This is the Care Coordinator. The Care Coordinator is trained to understand all programs, services, benefits, and coverages available in Indiana. When members share, the Care Coordinator listens. They support goals and remove barriers. A Care Coordinator gives members, and those who support them, peace of mind as they navigate the health care system.

Chiropractic care is covered with some limits. See the member handbook for details.

Routine dental services are covered. UnitedHealthcare offers extra dental services like X-rays, fluoride, gum disease treatments, and virtual dental visits.

For emergency care, members should call 911 or go to the nearest emergency room (ER). Do not call us before calling 911. Emergency transportation is covered.

Please click the Member Resources section of this website to learn more about our free programs and services. Some of these are only available to UnitedHealthcare members. 

Up to 6 routine foot care visits are covered each year. Some services need prior approval. Please see the member handbook for details.

Home and Community-Based Services (HCBS) include services such as adult day services, home-delivered meals, homemaker and other supports that allow you to live as independently as possible, for as long as possible. Please see the member handbook for details.

Coverage is available to home health agencies for medically necessary skilled nursing services provided by a qualified nurse, as well as home health aide services. See the member handbook for details.

Hospital Services

Whether it is for a procedure that is done the same day (outpatient) or includes an overnight stay (inpatient), hospital services are covered. 

Housing Stability

We want members and their families to enjoy safe and affordable housing. We can help with a plan to improve a current home or plan a move to a different home. A Care Coordinator will work to collect goals and share options that address the needs of our members. 

Informal Helper Support

Many members have friends and family who often help out or check in on them. We have programs to help the people who help our members. Talk to a Care Coordinator to learn more.

Long-Term Care

Long-term care is available. Members and those who support them can talk to a Care Coordinator to understand all available options. We will work to set goals that match up with the member’s desired outcome. All members must be screened and approved for long-term care.

Medical Equipment and Supplies

Coverage is available for medical supplies, equipment, and devices that can be used in the home. A Care Coordinator can help arrange for needed equipment and supplies.

Nursing Home Care

Nursing home care is available. Members and those who support them can talk to a Care Coordinator to understand all available options. We will work to set goals that match up with the member’s desired outcome. All members must be screened and approved for nursing home care.  This can be approved for a short-term or a long-term stay.

Out-of-State Medical Services

There are limits when getting services outside of Indiana. Please see the member handbook for details. If members are experiencing an emergency, visiting an emergency room is covered.

Pharmacy

Prescribed medications are covered. All health plans follow the same rules about the medications that are covered as part of the Indiana PathWays for Aging program. The same list of approved medications is used. This is called the Preferred Drug List, or PDL.

Provider Visits

Most office visits are covered. See the member handbook for details.

Redetermination

When it is time to renew benefits and coverage, this is called redetermination. The Indiana Family and Social Services Administration (FSSA) will mail you a “Notice of Renewal” reminder, which may ask you for information. Carefully read the directions that come with your renewal form. You may be required to sign the form and return it with some information, or you may only need to review the form and report if any of the information has changed within the last year. If it is all correct, you will not have to respond. You must remain Medicaid eligible to stay in the Indiana PathWays for Aging program.

Rehab Center Stays

There are rules for staying in a rehabilitative unit. The member’s Care Coordinator can help answer questions or explain any limits or prior approval needed.

Rehab stays are short-term. The stay could be needed for addiction recovery. It could also be a stay that includes therapies related to physical recovery.

Substance Abuse Treatment

Members can get residential treatment if they are getting help due to alcohol or drug use. This includes overnight stays in a facility. The member’s Care Coordinator can help answer questions or explain any limits or prior approval needed.

Transportation

For members who do not drive or have trouble finding a ride, transportation is covered. UnitedHealthcare members have free transportation (ride) benefits for:

  • A provider visit or health care appointment
  • Pharmacy trips
  • Urgent (upon approval) and recurring appointments
  • Eligibility redetermination appointments with the state
  • Curbside grocery pickup or food bank visits
  • Health-related education classes
  • Local fitness centers
  • State or county agency appointments
  • Parole meetings

There are additional options available for members who are eligible for the HCBS Waiver. These rides must be part of the member’s service plan. The member’s Care Coordinator will make sure needed transportation is on the service plan.

Vision Care

Routine vision care is covered. UnitedHealthcare offers 1 free eye exam each year. We also offer an allowance for the cost of glasses or contact lenses once a year.

Member Resources

Member Resources (opens modal window)