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Elderly Support Interaction

FAM-AID Eligibility

Fill out the form below to see if you qualify for FAM-AID's services. FAM-AID's owner, Cary Hammond, will reach out to you personally to discuss your eligibility and next steps.

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The PATIENT is the person receiving care. The CAREGIVER is the person providing care.

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Who is Eligible?

  • Patients currently receiving Medicaid Waiver

  • Patients who live under the same roof as their Caregiver

  • Patients who require help with one or more daily living activities

  • Indiana residents only

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***THE PATIENT MUST CURRENTLY BE RECEIVING MEDICAID WAIVER***

Patient Date of Birth
Month
Day
Year
Patient Address
Do the Patient and Caregiver live together, under the same roof, full time?
Yes
No
Is the Patient currently receiving Medicaid WAIVER?
Yes
No
Unsure

Medicaid Waiver is a different program than Medicaid. Please note: Patient must be receiving Medicaid Waiver to be eligible.

*Caregiver must be 18 years or older

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