Start with the change—not a requested number of hours

Make the support gap understandable

Describe what the person now needs help doing, how that differs from the current plan, and which needs are not being met. Then ask the responsible coordinator or health plan whether a plan review or reassessment is appropriate.

For example, a family might report that a previously available support person can no longer help at a certain time. Another might describe a change in the assistance needed during a daily routine. These are discussion examples, not automatic reasons for additional Medicaid services. Avoid guessing a diagnosis or assuming a particular approval.

Know which Indiana program you are asking about

Do not assume every Indiana home-care arrangement follows PathWays rules. Check the program name on current paperwork and identify the person responsible for coordination. A private-pay agreement also has its own process for changing scope and costs.

For PathWays members, Indiana’s official FAQ says reassessment occurs when status changes and that service-plan changes depend on assessment results. The 2026 PathWays model handbook describes plan review at least annually, when needs or circumstances change significantly, and at the member’s request. Ask the member’s plan how its current process applies; do not wait for a routine date to report an unmet need.

Indiana FSSA’s Level of Care Assessment Representative guidance distinguishes nursing-facility level-of-care assessment from ongoing service planning. It explains that Area Agencies on Aging and independent case-management agencies continue service-planning coordination primarily for Health and Wellness and TBI waiver participants. Ask the current case manager which contact handles your particular request.

Prepare a short, factual change summary

A concise summary can make a telephone conversation more useful. Consider these five prompts:

  1. What was the usual routine? Describe the assistance previously needed.
  2. What is different now? State the task, time of day, frequency, and when the change was noticed.
  3. What support is currently available? Distinguish paid services from help someone has actually agreed to provide.
  4. What is the person asking for? Include their priorities, preferences, and communication needs.
  5. What needs attention first? Identify an immediate support concern separately from a longer-term planning question.

For instance, “The current visit ends before the evening routine, and the relative who helped then is no longer available” explains more than “We need more care.” Add only accurate, relevant facts. Do not exaggerate limitations, coach someone to give particular assessment answers, or describe an informal helper as available when they are not.

Share relevant professional instructions or recent discharge information through the secure process the team specifies. Avoid sending sensitive records through a general website inquiry. Do not change medication or clinical-care instructions while preparing an administrative request.

Contact the coordinator and the provider for different reasons

Ask the coordinator or health plan how to submit a request, whether another assessment is needed, who makes the decision, and when to follow up. Ask the direct-service agency about current visit delivery, worker communication, staffing concerns, and whether the authorized tasks can be safely provided.

A repeated missed visit may need an agency response even if the authorized plan itself is appropriate. A change in the person’s needs may require both provider communication and a coordinator review. Our coordinator-versus-provider guide explains the roles; the backup-planning guide addresses gaps in scheduled support.

Ask for a clear next step while the review is pending

  • Has the request been received, and by whom?
  • Is anything else needed from the participant or an authorized representative?
  • What services remain authorized during the review?
  • Who should be contacted if support needs change again?
  • When should the family follow up if no response arrives?
  • How will any decision and effective date be communicated?

Keep a dated note of the contact and agreed action. A discussion, referral, or provider inquiry is not the same as an authorization. Do not assume new services can begin or be billed before the required approval and provider arrangements are confirmed.

If a written decision is unclear or unfavorable, ask the issuing organization to explain its grievance or appeal information, available help, and any deadlines. This article does not interpret a notice or advise which legal action to take. Keep the original paperwork and seek qualified assistance when needed.

Separate urgent health needs from administrative review

A service-plan request is not a medical assessment or emergency-response service. Contact the appropriate healthcare professional promptly for a new health concern and call 911 for an immediate emergency. Tell the provider and coordinator about relevant changes through the established process, but do not wait for a plan meeting to obtain urgent help.

Discuss Indiana support with Veracity Systems

Veracity Systems LLC DBA Hoosier Care Givers can discuss Indiana personal attendant and related in-home support within its scope and current capacity. Start a service inquiry with the county, requested support, schedule, and current authorization status if known. Veracity does not replace the entity that determines eligibility or authorizes Medicaid services.

Explore our family-caregiver information for separate questions about permitted paid-caregiver arrangements. Prospective employees can review caregiver opportunities and complete the caregiver application. Advertised caregiver pay is $18–$21 per hour, depending on state, role, experience, and assignment. A plan-review request does not guarantee added hours, coverage, staffing, employment, or a start date.

Frequently asked questions

Must a PathWays member wait for an annual review to report changed needs?

No. The 2026 Indiana PathWays model handbook describes review when circumstances or needs change significantly and at the member’s request, as well as periodic review. Contact the member’s service coordinator or health plan to confirm the applicable process.

Can a home-care agency approve more Medicaid hours?

An agency can discuss service delivery and communicate observations, but it cannot independently promise a change in Medicaid authorization. Ask the responsible coordinator or health plan how the request will be assessed and decided.

Does requesting reassessment guarantee additional support?

No. A request starts a review, not a guaranteed outcome. Assessment, program rules, authorization, provider capacity, and other individual circumstances still matter.

What should families do while a review is pending?

Ask who is responsible for immediate support concerns, what remains authorized, and when to expect follow-up. Do not assume requested services have been approved. Seek appropriate medical or emergency help for urgent needs rather than waiting for administrative review.

Authoritative resources

Sources reviewed October 18, 2026. Confirm the applicable program and current instructions with the member’s plan or coordinator.

General-information notice: This article is educational, not individualized medical, legal, eligibility, appeal, or service-plan advice. Rules, processes, coverage, and provider availability may change. Follow the current authorized plan and confirm decisions with the responsible program, health plan, coordinator, and qualified professionals.