How to Switch Your Caregiver Agency in Indiana

Most families don't realize they're allowed to leave. They signed up with the first Structured Family Caregiving agency that called them back, the paperwork got done, the stipend started — and then the agency went quiet. Calls go to voicemail. Questions go unanswered. The rate feels low, but switching sounds like starting over, so they stay.

Here's what almost nobody tells you: you have a federal right to choose your own Medicaid provider, and to change that provider whenever you want. You don't need your current agency's permission, you don't have to reapply for the waiver, and done right, you won't miss a single payment.

This guide explains your rights, walks through the exact steps to switch your caregiver agency in Indiana, and shows you how to time the move so your pay never lapses.

You're Allowed to Switch — It's Federal Law

Start here, because it's the fact that changes everything. Under the Social Security Act, any Medicaid beneficiary "may obtain services from any qualified Medicaid provider" willing to serve them.^[1] This "free choice of provider" rule is written into federal regulation at 42 CFR 431.51, and it's the backbone of your right to leave an agency that isn't serving you.^[1]

In plain terms: the agency works for you, not the other way around. Your loved one's Medicaid eligibility and waiver slot belong to them — not to the agency. Switching agencies does not put your waiver, your eligibility, or your spot at risk. You are moving your business from one provider to another, exactly like changing pharmacies.

Good Reasons to Make the Move

You don't need to justify switching to anyone. But if you're wondering whether your frustration is "reason enough," these are the complaints we hear most — and every one of them is a legitimate reason to leave:

• You can't reach anyone. Calls and emails go unanswered, and no one checks in.
• Your pay rate is lower than it should be. Indiana now requires agencies to pass at least 60% of the SFC daily rate through to the caregiver, and some agencies sit right at the floor while others pay more.^[2]
• They missed the required oversight. Every SFC provider must complete two quarterly home visits by a caregiver coach or registered nurse and stay in regular contact.^[3] If that isn't happening, they're not meeting their obligations.
• They never explained the program. A good agency teaches you how the benefit works; a bad one just collects its cut.
• You feel like a number. A national call center can't sit at your kitchen table.

How to Switch, Step by Step

The process is more straightforward than the dread around it suggests. Here's the order of operations.

1. Choose your new agency first

Don't quit your current agency before you've lined up the next one. Pick the new provider first, because they'll do most of the heavy lifting of the transfer for you. Look for competitive pass-through pay, responsiveness, a local presence, and real support beyond the check. Our honest comparison of Indiana SFC providers lays out what to weigh.

2. Tell your case manager you want to change providers

Your case manager (or, on the PathWays for Aging Waiver, your managed care entity's care coordinator) is the hub of this process. By rule, your case manager must give you a list of available service providers any time you request it and help you select or change providers.^[4] You simply tell them you'd like to switch, and name your chosen agency.

The individual's chosen case manager provides a list of available service providers at any time that the individual requests to select or change service providers.

3. Let the new agency coordinate the transfer

This is the part that surprises people: your new provider does the legwork. They coordinate with your case manager and your current agency to transfer services as smoothly as possible.^[5] Your job is mostly to sign what the new agency puts in front of you and answer a few questions.

4. Give notice to your current agency

Provider agencies on the Health and Wellness and TBI waivers are required to give at least 30 calendar days' written notice before they drop a participant.^[6] Going the other direction — you leaving them — is your right at any time, but a brief heads-up keeps the handoff clean and the timing predictable.

What to Have Ready Before You Call

A switch goes faster when you walk in prepared. None of this is hard to pull together, and having it ready means your new agency and case manager can move without waiting on you. Gather:

• Your loved one's Medicaid ID and waiver information — whichever waiver they're enrolled on (PathWays for Aging, Health and Wellness, or TBI).
• Your current case manager's name and contact, or the care coordinator at your PathWays managed care entity (Anthem, Humana, or UnitedHealthcare).^[5]
• The name of your current SFC agency and, if you have it, your most recent statement showing your daily rate and pass-through percentage.
• A short list of what went wrong. You don't owe anyone an explanation to switch, but knowing your own dealbreakers — pay, responsiveness, missed visits — helps you vet the next agency against the right questions.

When you interview a prospective new agency, ask the questions that actually separate good from bad: What percentage of the daily rate do you pass through to me? How quickly do you return calls? Who is my point of contact, and are they local? How do you handle the quarterly nurse visits? An agency that answers those plainly is showing you how they'll treat you after you sign.

How to Switch Without Losing a Paycheck

This is the worry that keeps families stuck, so let's address it directly. The goal is a clean handoff where your new agency's start date picks up right where the old one's billing ends — no gap.

A few things protect you:

• Your eligibility doesn't reset. You are not reapplying for Medicaid or the waiver. The underlying approval stays in place; only the billing provider changes.^[1]
• Overlap the dates, don't gap them. A good incoming agency will coordinate the effective date with your case manager so there's no uncovered stretch.^[5]
• Keep providing care throughout. Don't stop caring for your loved one during the switch. The care continues; the paperwork catches up.

A Few Honest Cautions

Switching is your right, and usually the right call when an agency is failing you. But go in clear-eyed:

• Timing can take a few weeks. Provider transfers move at the speed of paperwork and case-manager schedules. It's rarely instant, so start before you're at a breaking point.
• The waiver slot is the thing to protect. The benefit lives with your loved one's waiver enrollment. As long as that stays active, switching providers is low-risk — but if your loved one's Medicaid or waiver status is itself in question, sort that out first.
• "We're the only ones who can do this" is a red flag. No single agency owns your benefit. Any agency that tells you you're locked in is misinforming you.
• Don't burn the bridge mid-care. Keep the current agency in the loop until the new one is fully active, so nothing falls through the cracks during the handoff.

What This Means for Your Family

If your current Structured Family Caregiving agency has gone silent, underpaid you, or skipped the support it owes you, you are not stuck. Federal law gives you the right to choose — and to change — your provider, and your loved one's waiver slot comes with you. The switch is mostly handled by the agency you're moving to, and timed correctly, your stipend never skips a beat.

At Tender Home Care, we help Indiana families switch to us all the time, and we'll handle the coordination with your case manager and current agency so you don't have to chase it. We focus only on Structured Family Caregiving in Indiana, we'll match any competitor's caregiver pay rate, and we add a $250 sign-up bonus for new caregivers. If your agency isn't treating you right, the call to explore switching costs you nothing.

Not sure how to compare your options first? Start with our honest comparison of Indiana SFC providers.

Sources

1. [1] U.S. Code of Federal Regulations. "42 CFR 431.51 — Free choice of providers," based on Section 1902(a)(23) of the Social Security Act: beneficiaries may obtain services from any qualified Medicaid provider. Link.

2. [2] Indiana Health Coverage Programs. "Bulletin BT2025105: minimum passthrough percentages for Structured Family Caregiving and Attendant Care," per House Enrolled Act 1120. July 10, 2025. Link.

3. [3] Indiana FSSA. "Structured Family Caregiving (SFC)." Office of Medicaid Policy and Planning program description — required quarterly home visits by a caregiver coach or RN. Updated August 25, 2025. Link.

4. [4] Indiana FSSA, Division of Disability and Rehabilitative Services. "Home- and Community-Based Services Waivers Provider Reference Module" — the case manager provides a list of providers any time the individual requests to select or change providers. Link.

5. [5] CICOA Aging & In-Home Solutions. "Medicaid Waivers" — how case management and provider coordination work under PathWays, H&W, and TBI waivers in Indiana. Link.

6. [6] Indiana FSSA, DDRS. "HCBS Waivers Provider Reference Module" — H&W and TBI waiver providers must furnish at least 30 calendar days' written notice. Link.