Indiana's MCEs Explained for Home Care Providers
If you provide home care or home health services in Indiana, you are likely working with at least one Managed Care Entity, or MCE.
Indiana has multiple MCEs, and they do not all serve the same programs or populations. Knowing which plans cover your clients is the starting point for getting contracted and billing correctly.
Indiana’s Medicaid Programs and Their MCEs
Indiana Medicaid is divided into several programs. The MCEs participating in each one are different, so the plans you need to work with depend entirely on who you serve.
Indiana PathWays for Aging
PathWays for Aging launched July 1, 2024 and covers Medicaid members age 60 and older who need both medical care and long-term services and supports. This includes home and community-based services, attendant care, and home health.
PathWays is the program most relevant to home care agencies serving elderly clients. The three MCEs for PathWays are Anthem, Humana, and UHC.
Hoosier Care Connect
Hoosier Care Connect covers adults age 59 and younger who are blind or disabled, are not institutionalized, are not receiving HCBS waiver services, and are not eligible for Medicare.
The MCEs for Hoosier Care Connect are Anthem, CareSource, MHS, and UHC. Humana does not participate in this program.
Healthy Indiana Plan (HIP)
HIP covers working-age adults ages 19 through 64 who are not disabled. The MCEs for HIP are Anthem, CareSource, MHS, and UHC.
Hoosier Healthwise
Hoosier Healthwise covers children up to age 19 and pregnant women. Most home care agencies do not encounter this program often, but the MCEs are the same as HIP: Anthem, CareSource, MHS, and UHC.
Fee-for-Service (Traditional Medicaid)
Not every Indiana Medicaid member is in managed care. Traditional Medicaid, also called fee-for-service or FFS, covers members who are not enrolled in any MCE plan. This includes many dual-eligible members and certain HCBS waiver recipients. FFS claims go directly to IHCP rather than through a health plan.
The Five Indiana MCEs
Anthem
Anthem participates in all four of Indiana’s managed care programs, making it the most broadly encountered plan for Indiana home care providers. Provider enrollment goes through Availity and typically takes 30 to 60 days.
Contact: INMLTSSProviderRelations@anthem.com | 833-569-4739
Humana
Humana participates only in PathWays for Aging. If your clients are primarily adults age 60 and older, Humana will be a significant payer for your agency. If you serve a younger population, you likely will not encounter Humana at all.
Enrollment requires the standard MCE HCBS Provider Enrollment Form plus an additional HCBS Provider Assessment Form. Initial processing averages around 21 days, but full credentialing can take 60 to 90 business days.
Contact: InMedicaidProviderRelations@humana.com | 866-274-5888
UHC (UnitedHealthcare Community Plan of Indiana)
UHC participates in all four managed care programs. Agencies with a broad client mix will encounter UHC frequently across multiple programs.
UHC asks providers to send an email introduction to their HCBS provider network team before submitting any paperwork. Turnaround from a complete submission typically runs 30 to 60 business days.
Contact: hcbsprovidernetwork@uhc.com (enrollment) | 877-610-9785
CareSource
CareSource participates in Hoosier Care Connect, HIP, and Hoosier Healthwise, but not PathWays for Aging. Agencies focused on elderly clients may not work with CareSource at all. Agencies serving younger adults with disabilities or HIP members will.
CareSource has its own provider portal and credentialing process. Contact them directly for current enrollment instructions.
MHS (Managed Health Services)
MHS also participates in Hoosier Care Connect, HIP, and Hoosier Healthwise, not PathWays. MHS is a Centene subsidiary and has served Indiana Medicaid members for over 30 years.
Contact MHS directly for enrollment details and processing timelines.
Provider resources: mhsindiana.com/providers
How to Get Contracted with Indiana MCEs
Step 1: Enroll with IHCP. You must be an active IHCP provider before any MCE will contract with you. Enrollment is done through the CoreMMIS portal at portal.indianamedicaid.com.
Step 2: Visit Indiana’s provider page for MCEs. Resources are available on the IHCP provider enrollment page at in.gov/medicaid/providers.
Step 3: Submit to each MCE separately. Every MCE has its own submission process. Humana requires an additional assessment form. UHC asks for an email introduction first. Anthem, CareSource, and MHS each have their own processes outlined on their provider websites.
A few things to keep in mind: have your IHCP enrollment confirmation, NPI, and tax documentation ready before you start. Incomplete applications are the most common reason for delays. And plan for back-and-forth — MCEs often request additional information before finalizing enrollment.
Important 2027 deadline: Starting in 2027, MCEs will be allowed to deny provider contracts. Right now, they are required to accept all IHCP-enrolled providers — so this year is a good time to get contracted if you have not already.
Authorizations, Claims, and Documentation
Each MCE manages its own prior authorization process with its own portal, clinical criteria, and timelines. The same service can have different PA requirements depending on which plan the client is enrolled in. For fee-for-service clients, prior authorization is handled centrally through Acentra Health.
Claims are submitted through each plan’s own system. Anthem and Humana both use Availity. UHC, CareSource, and MHS each have their own portals. FFS claims go through the IHCP portal.
On documentation: IHCP sets the baseline requirements, but MCEs can apply additional standards for their own clinical reviews. When you start working with a new MCE, reviewing their provider manual is a practical step toward avoiding claim issues down the line.
Common Questions
Which MCEs do I need for PathWays for Aging? Anthem, Humana, and UHC. These are the only three plans contracted for PathWays.
Does Humana cover Hoosier Care Connect or HIP members? No. Humana only participates in PathWays for Aging.
Do I need to contract with all five MCEs? It depends on your clients. PathWays agencies need Anthem, Humana, and UHC. Agencies serving younger adults or HIP members should also look at CareSource and MHS.
What happened to MDwise? MDwise exited Indiana Medicaid on January 1, 2026. If your agency was contracted with MDwise, verify your credentialing status with the MCE that picked up those members.
Questions About Your Billing Setup?
Most Indiana home care agencies are billing across a mix of MCEs and fee-for-service at the same time. Each plan has its own requirements, and keeping up with all of them takes real bandwidth. If you want a second set of eyes on how your billing is set up across payers, GEOH works with Indiana agencies across all active MCEs and FFS.