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What Happens When the Money Runs Out

Spend-down, Medicaid waiver transitions, and why you should ask a community about this before you move in.

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Home›Costs & Paying›What Happens When the Money Runs Out
Short answer

If private funds run out, the options generally are a Medicaid HCBS waiver for care inside a licensed community, Medicaid nursing facility coverage, or moving to a community that holds a waiver provider agreement. Confirm your state's specific programs before relying on this.

Ask before you move in, not after

This is the single most consequential question families skip. A community that does not hold a Medicaid waiver provider agreement will ask your parent to leave when private funds are exhausted — often with short notice, at the point when moving is hardest.

Ask directly: do you hold a Medicaid waiver provider agreement, and how many current residents use it? A community can technically hold an agreement and still have no waiver capacity available.

How families pay for care. Indiana's PathWays Waiver pays for care services, RCAP pays for room and board, and VA Aid and Attendance can help veterans and surviving spouses. Read the full explanation →
The local long-term care ombudsman. Indiana Legal Services' Region 8 Long Term Care Ombudsman covers this entire six-county metro: 317-631-9424, or the statewide line at 800-622-4484. Read the full explanation →

Questions families ask

What's the difference between independent living and assisted living in Indiana?

Independent living is generally unlicensed housing -- apartments or cottages with dining and activities but no personal care. Assisted living communities in Indiana are licensed as Residential Care Facilities and provide medication administration and help with daily activities.

What's the difference between assisted living and memory care in Indiana?

Both can be licensed as Residential Care Facilities, but a memory care unit must also file Indiana's Alzheimer's and Dementia Special Care Disclosure under IC 12-10-5.5 and meet dementia-specific staff training requirements. There is no separate state cost median for memory care, unlike assisted living.

Is in-home care or assisted living cheaper in Indiana?

It depends on hours needed. At Indiana's 2025 median of $35 an hour, a 40-hour week of home care already costs more than Indiana's assisted living median of $5,639 a month. Below roughly 30-35 hours a week, home care is often cheaper; above it, a community usually wins.

What's the difference between a nursing home and assisted living in Indiana?

A nursing home is licensed in Indiana as a Comprehensive Care Facility, providing 24-hour skilled nursing care and carrying a federal CMS star rating. Assisted living is licensed as a Residential Care Facility, a lower level of care with no CMS rating.

What's the difference between hospice and palliative care?

Palliative care focuses on symptom relief and quality of life, and can run alongside curative treatment at any stage of an illness. Hospice is for a life-limiting illness when a physician expects six months or less if the disease runs its normal course, and generally means curative treatment has stopped.

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