Welcome to Indiana PathWays for Aging. Our Humana PathWays members get hearing, medical, vision coverage, behavioral health services, transportation, and extra benefits. You must get services from facilities and providers in our network. Providers in our network agree to work with us to make sure you get the care you need.

Out-of-Network

If you need medically necessary services, we will allow you out-of-network care if an in-network provider is not able to provide services. We will work with the out-of-network provider, so there is no cost to you. Indiana PathWays for Aging also takes into consideration continuity of care and long-term specialized care needs, such as cancer treatment or transplant services. Call 866-274-5888 Monday – Friday, 8 a.m. – 8 p.m. Eastern time to learn more about this program.

See your Member Handbook for more information about your health coverage and our provider network.

Need a place to turn for mental health, chemical dependency and/or substance use issues? We can help. As your healthcare partner, we can help you get the care you need via our Crisis Line at 855-254-1758 (TTD/TTY: 711), 24 hours a day, 7 days a week, and 365 days a year.

Indiana PathWays for Aging provides two types of state benefits packages to our PathWays members. The first includes primary medical care, behavioral health services, nursing facility, home health, hospice care, and more. The second benefits package includes everything from the first plus Home and Community Based Services (HCBS). This is available to all who have been determined to meet Nursing Facility Level of Care but wish to stay at home or in an Assisted Living Facility.

PathWays services include at a minimum all benefits and services deemed medically reasonable and necessary, meaning you need the services to prevent, diagnose, or treat a medical condition.

Managing your medicines is important. We want you to feel comfortable knowing what medicines your plan covers. As an enrollee of the PathWays program, you can access a full range of safe and effective medicines. These medicines are part of a formulary or a Preferred Drug List (PDL). These are drugs that we prefer your provider use when choosing the best medicine to treat you and your condition.

Dental care

Dental services are covered for Indiana PathWays for Aging members. Covered services include:

• Two exams and one cleaning every year
• Bitewing X-ray once every year and one complete set of X-rays every three years
• Other medically necessary services

Dental coverage is administered by DentaQuest, an independent company that does not provide Humana Healthy Horizons products.

Need help finding a dentist near you?
Call DentaQuest toll free at 888-291-3762 or visit DentaQuest.

Routine vision is covered for Indiana Pathways for Aging members. Covered services include:

• A routine vision exam once every 2 years.
• One complete pair of eyeglasses every 5 years
• Contact lenses if determined medically necessary.
• Up to $150 annual allowance for 1 set of glasses (frames and lenses) and/or contacts every 24 months.
• Member pays any cost over $150.

Vision coverage is provided by EyeMed. 

For coverage details or help locating a provider please contact 844-961-2057, Monday – Friday, 8am – 8pm Eastern Time

We want to make sure you always have transportation available to get to see your healthcare providers. PathWays includes transportation (ride) benefits. Rides to the locations listed below are included in these plans including non-emergency medical transportation.

• Any doctor visit or health care appointment
• Eligibility redetermination appointments with the State
• Urgent (upon approval) and Recurring Appointments

As a state, Indiana strives to make sure everyone who receives long-term services and supports (LTSS) can live, learn, work, and enjoy life in the most integrated setting. The goal is for people to lead lives that are meaningful to them. To do this, we must have a person-centered support system that helps people:

• Build or maintain relationships with their families and friends
• Engage in productive activities, such as employment
• Live as independently as possible 
• Participate in community life

Based on your eligibility you may select or be assigned a care coordinator and/or a service coordinator. Care and Service Coordinators are specially trained health professionals who work with you and your doctors to make sure you get the right care when and where you need it. You may change your coordinator at anytime. In general, your Care Coordinator will help you coordinate your medical needs, whereas your service coordinator specializes in supporting all your non-medical needs. Your Care and Service Coordinator (Care Team) will work together to support you in the most efficient way possible. 

Your Care Team will use the information you share through the completion of a health needs screening and a more detailed comprehensive health assessment to identify your needed medical, behavioral health, and non-medical services. On an ongoing basis, your Care Team will check in with you to ensure the care and services you receive continue to meet your needs; your Care Team will make changes to your plans at any time to ensure you are getting the support you need to live your best life. These periodic updates to your plan can occur during the regular Care Team outreach to you, as your Care Team becomes aware you have experienced a change, or at your request. 

In addition, with the appropriate consent, your care coordinator and/or service coordinator will notify your integrated care team if you are hospitalized or receive emergency treatment for behavioral health issues, including substance use disorder. 

By engaging in person-centered practices throughout your service plan development and implementation, you are assured the opportunity to engage fully in your community to the extent you so choose. Your Service Coordinator will check in with you throughout the year to ensure your service plan continues to meet your needs. 

Care Management is the foundational Care Coordination level of service that shall be made available to all Humana Healthy Horizons in Indiana members enrolled in PathWays and is intended to provide you with assistance with care coordination activities, making preventive care appointments, and/or accessing care for needed health or social services to address your chronic health condition(s). Care Management services include coordination 31 of care across care and service providers to assist you with scheduling, location of specialists and specialty services, intellectual and developmental disability services, transportation needs, twenty-four (24)-hour Nurse Line use, general preventive (e.g., mammography) and disease specific reminders, pharmacy refill reminders, tobacco quitting services and education regarding use of primary care and Emergency services. 

Care coordinators want to learn more about you. Then they can help you learn self-care and how to get help from others. Care coordinators may meet with your PMP and other health resources to make sure they are working together. Care coordinators work to make sure you have all the services you need, including non-medical services like food and housing. If you think you need Care Management, call Member Services at 866-274-5888. 

Complex Case Management is a program is for members with complex needs who need help to manage their healthcare. Our nurses and social workers will team up with you and your provider to ensure you are receiving the best care. We will contact you if: 

• Your doctor recommends it.  
• You ask for it.  
• Our nurses and social workers see you have health issues they can help with. 

To see if you qualify or get additional information about Complex Case Management Program, self-referrals, or to opt-out of the Complex Case Management Program call Member Services at 866-274-5888. 

Humana Healthy Horizons in Indiana will take care of all Medicare and Medicaid services for members who are enrolled in the Indiana PathWays for Aging program. This includes traditional Medicare, unaligned Medicare Advantage plans, Chronic Conditions Special Needs Plans (C-SNPs), and Institutional Special Needs Plans (I-SNPs). 

Humana Healthy Horizons in Indiana is responsible for providing medically necessary Medicaid covered services to you for the Indiana PathWays for Aging program. If the service is not covered by Medicare, you may have coverage through Medicaid benefits. Humana will engage with Medicare payers, Medicare Advantage plans, and Medicare providers as appropriate to coordinate the care and benefits you receive. They coordinate with relevant State and social service agencies and community-based organizations (CBOs) as needed to better identify and address both your medical and social needs.