RAW2HHC – Nutritional & Food Support Services
RAW2HHC Nutritional & Food Support Services may be available to eligible individuals receiving services through qualifying Indiana waiver programs, including Health & Wellness, PathWays for Aging, and TBI, when authorized through the individual’s care plan. Services may require Medicaid waiver eligibility, service authorization, and approval through the individual’s case manager, care coordinator, or health plan. Submitting a request does not guarantee approval or services.
About RAW2HHC Nutritional & Food Support
Who This May Help
Waiver Program Information
Full Name
*
First Name
Last Name
Which program are you currently on or applying through?
*
Health & Wellness Waiver
PathWays for Aging
TBI Waiver
Other Indiana waiver/program
Not sure
Phone Number
*
-
Area Code
Phone Number
Email Address
*
example@example.com
County or City
*
Are you requesting help for yourself or someone else?
*
Myself
Someone else
Case Manager / Care Coordinator Phone or Email
Enter a phone number or email address if available
Case Manager / Care Coordinator Name, if known
Best time to contact you
Medicaid ID / Member ID, if available
Brief description of your food or nutrition support need
*
I understand Nutritional & Food Support Services may require waiver eligibility, authorization, and care plan approval. Submitting this request does not guarantee approval or services.
*
I acknowledge and understand
Request Food Support Information
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