Quick Answer: “Yes, in many cases you can switch home care agencies in New York without automatically losing your Medicaid-authorized hours. Your care authorization is generally managed by your Medicaid or MLTC plan, not owned by the home care agency. The safest approach is to coordinate the new agency with your care manager before ending services with your current provider.”
Families sometimes stay with a home care agency longer than they want because they are afraid changing providers will affect their Medicaid coverage.
That fear is understandable, especially when a loved one depends on an aide every day. But changing the agency that provides the care is different from changing the Medicaid plan or care authorization that pays for it.
Individual Home Care works with families receiving Home Health Aide services in New York and can help coordinate agency-managed care when the appropriate Medicaid or Managed Long Term Care authorization is already in place.
Who Actually Controls Your Medicaid Home Care Hours?
Your home care agency generally does not decide how many Medicaid-funded hours you receive.
For people enrolled in Managed Long Term Care, the MLTC plan manages the plan of care and authorizes covered long-term care services. The home care agency delivers the services that have been authorized.
This distinction matters when changing agencies.
Moving from one participating home care agency to another does not, by itself, mean that your care needs have changed. The new agency still has to work with the Medicaid plan or other responsible entity and receive the information necessary to provide the authorized services.
New York State describes Licensed Home Care Services Agencies as providers that may contract with Medicaid-managed entities to deliver services such as home health aide and personal care services.
Can Changing Agencies Reduce Your Home Care Hours?
Simply asking to use a different home care agency should not automatically reduce your authorized hours.
However, it is better to avoid thinking of the existing number of hours as permanently guaranteed.
Your plan may reassess your care needs when required under program rules or when there is a significant change in condition. A reduction, suspension, or termination of previously authorized services is a separate coverage decision that comes with notice and appeal rights. New York State policy requires plans to provide proper notice when previously authorized services are reduced, suspended, denied, or terminated.
That means two separate things can happen:
- You can request a different agency to deliver your existing authorized care.
- Your Medicaid or MLTC plan can separately review whether your current care plan remains appropriate.
Changing agencies does not give the new agency authority to increase or reduce your hours.
Switching Agencies vs. Switching MLTC Plans
These are not the same process.
| Switching Home Care Agencies | Switching MLTC Plans |
| Changes who delivers your authorized home care | Changes the managed care organization coordinating your long-term care |
| Usually requires the new agency to participate with your existing plan | Requires enrollment in a different eligible plan |
| Does not automatically create a new care authorization | May involve new enrollment and care-management procedures |
| Usually coordinated through your existing care manager | Often involves New York Medicaid Choice and plan-transfer rules |
| Main goal is changing the provider delivering care | Changes the organization responsible for managing covered long-term care |
This difference is one of the most important things to understand before making a change.
Your preferred home care agency may not participate with every MLTC plan. Before doing anything with your current agency, confirm that the replacement provider can work with the plan that currently authorizes your care.
How Do You Switch Home Care Agencies?
A well-planned transfer can reduce the risk of missed shifts or a temporary interruption in care.
1. Identify why you want to switch
Families change providers for many reasons, including:
- Frequent missed or uncovered shifts
- Poor communication
- Difficulty reaching the office
- Repeated caregiver changes
- An aide who is not a good fit
- Language or communication needs
- Scheduling problems
- Concerns about reliability
- Difficulty obtaining replacement coverage
Knowing what is not working helps you ask better questions when evaluating a new agency.
2. Contact your MLTC care manager
For someone receiving care through an MLTC plan, the care manager should be involved early.
Tell the care manager that you want to change home care agencies and ask what steps the plan requires.
You should confirm:
- Which agencies participate with the plan
- Whether your preferred agency is in network
- What authorization information must be transferred
- When the current agency should stop
- When the new agency can officially begin
Do not assume that contacting only the new agency is enough.
3. Confirm the new agency can take the case
A provider may participate with your plan but still need to confirm that it can actually staff your authorized schedule.
Ask specific questions such as:
- Can you cover all of the currently authorized days and hours?
- Can you staff weekends?
- What happens when the regular aide calls out?
- Can you accommodate language preferences?
- How quickly can intake be completed?
- Who handles communication with my MLTC plan?
Individual Home Care also provides Managed Long Term Care support for families working through plan-authorized home care.
4. Coordinate a firm transfer date
This is one of the most important steps.
The current agency should not stop providing care before the replacement agency, plan, and family understand when the transfer will take effect.
A rushed transfer can create a gap even when the Medicaid authorization itself has not disappeared.
The goal should be a clear handoff:
Current agency ends → new agency begins.
The dates should be coordinated rather than guessed.
Should You Cancel Your Current Agency First?
Usually, no.
Do not end an existing home care arrangement simply because you have spoken with another provider.
First confirm that:
- The new agency participates with your coverage
- The plan has approved or processed the provider change
- The new agency has completed required intake
- Staffing is available
- A start date has been confirmed
This becomes even more important when the person cannot safely be left without assistance.
Someone who needs help transferring out of bed, using the bathroom, preparing meals, or moving safely around the home may not be able to tolerate even a short gap in care.
Can You Keep the Same Home Health Aide?
Sometimes, but it depends on the circumstances.
The caregiver may work for the current agency, and moving to another agency can involve employment, credentialing, contracting, and plan-network requirements.
New York State guidance dealing with certain LHCSA contract changes specifically recognizes situations where consumers may want to preserve their relationship with an existing home care worker and describes options that can include moving to another LHCSA or, in some circumstances, considering another plan.
That does not mean every caregiver can simply follow a client to another agency.
Ask the new agency and your care manager before assuming the arrangement can continue.
When Is Switching Agencies Worth Considering?
Changing agencies may make sense when the problem involves how the authorized care is being delivered rather than the care authorization itself.
Examples include:
Repeated staffing gaps
An approved schedule has limited value when shifts regularly go uncovered.
Poor communication
Families need to know who to contact when a caregiver is absent, a schedule changes, or a concern arises.
Caregiver mismatch
A caregiver may be qualified but still not be a good match for the person’s communication style, routine, language, or household needs.
Changing care needs
A person’s condition may evolve, and the family may want an agency with appropriate staffing experience for the current situation.
However, changing agencies is not the solution to every problem.
If the main concern is that the person does not have enough authorized hours, that issue needs to be addressed with the MLTC plan or responsible Medicaid entity.
Changing providers alone does not create additional Medicaid authorization.
What If Your Current Agency Cannot Staff All Your Hours?
This is an important distinction.
A person may be authorized for a certain amount of care but not actually receive every scheduled hour because the agency cannot fill the shifts.
In that situation, the problem may be provider staffing rather than insufficient Medicaid authorization.
Keep a record of:
- Missed shifts
- Late arrivals
- Uncovered weekends
- Dates replacement coverage was unavailable
- Calls or messages to the agency
- Responses from your care manager
This information can help explain why you are requesting a provider change.
A new agency should still confirm that it has realistic staffing capacity before the transfer is completed. Moving from one understaffed provider to another does not solve the underlying problem.
What If You Want to Change the MLTC Plan Too?
Changing MLTC plans is a larger decision than changing home care agencies.
New York’s current MLTC model handbook explains that certain MLTC members can change plans during the first 90 days after enrollment. Depending on the type of enrollment, a nine-month lock-in period may apply afterward unless there is good cause for a transfer.
Good-cause situations can include circumstances such as:
- Moving outside the plan’s service area
- The plan being unable to provide required services
- The current home care provider not working with the plan
- Other qualifying circumstances
Because plan-transfer rules depend on the person’s enrollment type and situation, families should verify current requirements before changing the MLTC plan.
Do not change plans solely because you want another home care agency until you have checked whether that agency already participates with your current plan.
Will You Need Another Assessment?
Not necessarily just because you switch agencies.
Changing the provider delivering authorized services is different from reporting a change in the person’s medical or functional condition.
A reassessment may be appropriate when care needs change, such as when the person:
- Needs more hands-on assistance
- Has worsening mobility
- Experiences new falls
- Develops new cognitive or behavioral concerns
- Returns home after hospitalization
- Requires a different level of supervision
If the issue is simply poor service or unreliable staffing, the family should clearly explain that the request is for a provider change rather than assuming a completely new eligibility process is required.
Questions to Ask Before Choosing the New Agency
A little preparation can prevent another difficult provider relationship.
Ask the prospective agency:
- Do you participate with my exact Medicaid or MLTC plan?
- Can you cover the authorized schedule?
- How quickly can you complete intake?
- What happens when an aide calls out?
- Is after-hours support available?
- How are caregiver concerns handled?
- Can we request a different aide when there is a poor fit?
- How does the agency communicate with our MLTC care manager?
- Are caregivers available who meet our language or scheduling needs?
The best agency is not simply the one that says yes first. It is the one that can reliably deliver the care already authorized.
Common Questions About Changing Home Care Agencies
Will I lose my Medicaid home care hours if I switch agencies?
Changing home care agencies does not automatically cancel your Medicaid authorization. The authorization is generally managed by the MLTC plan or responsible Medicaid entity. The new agency must be able to participate with that coverage and accept the authorized case.
Do I need permission from my MLTC plan to change agencies?
You should coordinate the change with your MLTC care manager. The plan needs to confirm that the new agency participates in its network and complete any required provider-transfer process.
Can a new home care agency increase my hours?
No. The home care agency does not independently decide how many Medicaid-funded hours you receive. Requests for additional services or hours need to be reviewed by the responsible plan or Medicaid entity.
Can I switch agencies because my aide keeps missing shifts?
Yes, unreliable staffing is a reasonable concern to raise with your agency and care manager. Before transferring, confirm that the replacement agency can realistically cover the authorized schedule.
Can I keep my current aide when I move to another agency?
Possibly, but it is not guaranteed. The caregiver’s employment, the new agency’s hiring requirements, and Medicaid or MLTC contracting arrangements may affect whether the same worker can continue.
Should I tell my current agency before I find a replacement?
You can raise concerns with your current agency, but you should avoid creating an end date for essential care before the replacement agency and care plan are coordinated.
Will changing agencies trigger a new NYIA assessment?
A provider change alone does not necessarily mean a new NYIA assessment is required. Assessment requirements depend on the person’s program status, care needs, and whether there has been a relevant change in condition or eligibility.
Changing Agencies Without Interrupting Care
Families should not feel locked into poor home care because they are afraid of losing Medicaid services.
The safest way to change providers is to separate the care authorization from the agency delivering it. Confirm your current authorization, involve your MLTC care manager, choose an agency that participates with the plan, make sure it can staff the schedule, and establish the new start date before ending the current arrangement.
Families considering a provider change can contact Individual Home Care to discuss their current home care arrangement, coverage, and the steps involved in transitioning to a new agency.