Will I lose my Medicaid if I join PathWays Dual Care?

FSSA says: “If you join PathWays Dual Care, you do not lose any of your Medicare and Medicaid benefits.” Your Medicaid eligibility is still decided by the state.

Who can join PathWays Dual Care?

Full-benefit dual eligible Hoosiers age 60 and older. It is voluntary, and members can enroll or disenroll in any month. Partial duals do not qualify.

Does Indiana use an income spend-down?

No. FSSA says Indiana discontinued its income spend-down on June 1, 2014, when it moved people who are aged, blind or disabled with income up to 100% of poverty to full Medicaid. Its Medicaid policy manual still describes a spend-down of resources (assets).

I'm turning 65 and already in a PathWays Medicaid plan. What happens?

FSSA says the state default-enrolls people newly eligible for Medicare into the matching PathWays Dual Care plan, so you do not need to take action, but you keep the freedom to choose another option.

Medicare and Medicaid in Indiana: PathWays for Aging and PathWays Dual Care

By Alexander James, Licensed Independent Insurance Agent · NPN 19291077

Part of our guide to Medicare and Medicaid together. For general Medicare help in Indiana, see Medicare in Indiana.

Indiana at a glance

Medicaid is run by
Indiana Family and Social Services Administration (FSSA)
Current state programs
Indiana PathWays for Aging; PathWays Dual Care
Published Medicaid figures
3 figures below, each with the date it applies
Federal change, January 1, 2027
One D-SNP per area for full-benefit duals, generally, where a company also offers a Medicaid plan

Sources: the Indiana Family and Social Services Administration (FSSA) (linked below) and 42 CFR 422.514.

Indiana's Medicaid program for people with Medicare

Medicaid in Indiana is run by the Indiana Family and Social Services Administration (FSSA). The state decides who qualifies for Medicaid; a Medicare plan or an agent cannot.

Indiana PathWays for Aging: Medicaid managed long-term services and supports for Hoosiers 60 and older, launched July 1, 2024.
PathWays Dual Care: A voluntary program for full-benefit duals 60 and older, delivered through FIDE SNPs, launched January 1, 2026.

PathWays Dual Care since January 1, 2026

PathWays Dual Care is Indiana's voluntary program for full-benefit duals 60 and older, delivered through FIDE SNPs. FSSA describes integrated member materials, one ID card and an integrated appeals and grievance process. Members can enroll or disenroll in any month.

FSSA says people newly eligible for Medicare who are already in a PathWays Medicaid plan are default-enrolled by the state into the matching dual plan, so they do not need to take action, but they keep the freedom to choose.

FSSA also states: “If you join PathWays Dual Care, you do not lose any of your Medicare and Medicaid benefits,” and “You will keep your Medicare and Medicaid benefits if you join a PathWays Dual Care plan.”

If you are under 60 or have QMB, SLMB or QI only

FSSA says people under 60 with full Medicaid, and all partial duals, use coordination-only D-SNPs. Partial duals do not qualify for the PathWays Dual Care FIDE SNP program.

Looking ahead to 2027

We did not find any Indiana-specific changes announced for 2027. The federal one-D-SNP-per-area rule that starts January 1, 2027 applies in Indiana as everywhere. Check with FSSA for the latest.

Indiana Medicaid figures, as the state publishes them

These are the figures in Indiana's Medicaid eligibility guide, effective March 1, 2026.

Indiana: published Medicaid figures, with the date each applies

Aged, blind or disabled Medicaid income (monthly)
Amount
$1,330 single, $1,803.33 couple
As of
effective March 1, 2026
Source
Indiana Medicaid eligibility guide
Aged, blind or disabled Medicaid assets
Amount
$2,000 single, $3,000 couple
As of
effective March 1, 2026
Source
Indiana Medicaid eligibility guide
Nursing-home or waiver-eligible income (individual income only)
Amount
up to $2,982 a month
As of
2026
Source
Indiana Medicaid eligibility guide

Indiana: published Medicaid figures, with the date each applies
Figure	Amount	As of	Source
Aged, blind or disabled Medicaid income (monthly)	$1,330 single, $1,803.33 couple	effective March 1, 2026	Indiana Medicaid eligibility guide
Aged, blind or disabled Medicaid assets	$2,000 single, $3,000 couple	effective March 1, 2026	Indiana Medicaid eligibility guide
Nursing-home or waiver-eligible income (individual income only)	up to $2,982 a month	2026	Indiana Medicaid eligibility guide

Your own eligibility depends on your full situation and is decided by the state. Federal figures that apply in every state are in our guides to the Medicare Savings Programs, Extra Help and Medicaid long-term care.

What works the same in every state

Some rules are federal. Medicare pays first and Medicaid pays last. Since 2025, people with Medicaid or Extra Help have a once-a-month option to change drug coverage, and full-benefit duals have a once-a-month option to join an integrated plan that matches their Medicaid plan. Starting January 1, 2027, federal rules generally limit companies to one D-SNP per area for full-benefit duals where they also offer a Medicaid plan. Our guide to integrated D-SNPs explains each step, and Will I lose my Medicaid if I join a D-SNP? covers what changes when you join one.

Who pays first when you have Medicare and full Medicaid

Step 1
You get a Medicare-covered service
A doctor visit, a hospital stay or a prescription that Medicare covers.
↓→
Step 2
Medicare pays first
Through Original Medicare or your Medicare plan. Your prescription drugs are covered by a Medicare drug plan, not by Medicaid.
↓→
Step 3
Medicaid pays last
After Medicare and any other health insurance you have. Medicaid can also cover some services Medicare does not, depending on your state.

Source: Medicare.gov, “Medicaid” (people who have both Medicare and full-benefit Medicaid).

Before you change anything

FAQ

Medicare and Medicaid questions from Indiana

Sources

Each page was read on October 23, 2026.

Guides for other states

Continue learning