Resources
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Watch the PathWays story.
Glossary of Terms
| Term | Definition |
|---|---|
| Health Plan | A health plan is a health insurance company. Physicians, hospitals, and other healthcare providers, including waiver providers, enroll with a health plan to provide care for members. Indiana partners with health plan for its Indiana PathWays for Aging, Hoosier Healthwise, Healthy Indiana Plan, and Hoosier Care Connect programs. |
| Care Coordinator | A care coordinator is a person who may contact you to create a personalized care plan based on your preferences and needs. They can also help answer questions about your health care and help you with your providers. |
| Service Coordinator | A Service Coordinator is a person who will work with you to create a personalized Service Plan to help coordinate your Home and Community-Based Services (HCBS). The Service Plan will help develop a plan of care of services and supports that best meet your needs and goals. |
| Health Assessment | A health assessment is a set of questions that ask about your personal behaviors, life-changing events, health goals and priorities, service coordination and overall health. Your health plan will use these assessments to create a personalized care plan based on your preferences and needs. |
| Service Plan | A service plan is a support plan, developed by a service coordinator, for assisting you in gaining access to long-term care services, as well as medical, social, housing, educational, and other supports. Not everyone in PathWays will need a service plan. |
| Managed Care Entities (MCE) | Organizations that oversee the overall care of a patient so as to ensure cost-efficient quality health care to their members. |
| Managed Care | An arrangement whereby a single provider or organization oversees the overall care of a patient so as to ensure cost-efficient quality health care to its members. |
| Area Agencies on Aging | There are 16 of these not-for-profit agencies around the state. They provide case management, information and referrals to various services for persons who are aging or developmentally disabled. |
| Dual Eligible Special Needs Plan (D-SNP) | A Dual Eligible Special Needs Plan is a type of health insurance plan. It’s for people who have both Medicaid and Medicare. If that’s you, you’re “dual-eligible.” |
| Home and community-based services (HCBS) | These are services for eligible individuals who choose to remain in their home as an alternative to residing in a long-term care institution, such as a nursing facility. |
Stakeholder Engagment
Stakeholder engagement is essential, and FSSA is committed to co-designing an Indiana Pathways for Aging program that is right for older Hoosiers. The state is engaging national experts, providers, members and caregiver communities to ensure a diverse range of voices is represented.
Plan Selection Notices
Aligned D-SNP Member - English example | Spanish example
- Sent to aligned DSNP Members. A member who is already with a current PathWays MCE (Medicare Anthem members, Medicare UnitedHealthcare members, and Medicare Humana members).
Aligned HCC Member - English example | Spanish example
- Sent to aligned Hoosier Care Connect Member. A Member who is aging in from HCC and already with a current PathWays MCE. ( HCC Anthem members and HCC United members)
Unaligned HCC Member - English example |Spanish example
- Sent to unaligned Hoosier Care Connect Member. Managed Health Services members aging into PathWays. (HCC Managed Health Services members.)
NF Member Notice - English example | Spanish example
- Sent to members who reside in a Nursing Facility.
Waiver FFS Member - English example | Spanish example
- Sent to members who currently receive home and community-based services and supports through the Aged and Disabled Waiver.
General FFS Member - English example | Spanish example
- Sent to Traditional Medicaid members. These are members who are unaligned or in Traditional Medicaid (Unaligned D-SNP members, Fee For Service Medicare members, and Medicare Advantage Plan members)
AI/NA Opt-In - English example | Spanish example
- Sent to members of a federally recognized tribe.
Hospice Opt-In - English example | Spanish example
- Sent to members who are receiving hospice services.
Hospice Opt-In Plan MCE - English example | Spanish example
- Sent to members utilizing Managed Care Entities
60-Day Prior to Go Live - English example| Spanish example
- Sent to all members who selected an MCE or were auto-assigned. Will be sent this notice 60-days before go-live to notify them of their assigned PathWays MCE.
