Who manages the situation?
It can be frustrating when a home health aide (HHA) is late or does not show up for your loved one’s scheduled care hours, especially when it is not properly communicated with you or your loved one.
And while your loved one’s insurance provider may be covering some or all of the cost of an HHA, once your loved one has an HHA assigned by a home care agency, that agency is able to help in the event the HHA is late or does not show up.
If you continue to experience difficulty with HHA stability, however, or have concerns regarding the care provided, then contact your loved one’s insurance provider to intervene.
Typically, HHA tardiness and absence are outlined in the home care agency service agreement. It usually states that you (the client) are responsible for finding backup care in the event that the HHA is late or doesn’t show. You'll want to know from the home health agency what the expectation is, whether or not it is outlined in the service agreement.
Contacting your loved one’s insurance provider before contacting the agency will only create delays and further frustration for you. We recommend you first contact the home care agency to address your concerns.
If you do not have the home care agency service agreement, be sure and request another copy.
In the meantime, in the absence of the service agreement and the agency’s contact information, you can try one or more of the following:
Search for the agency on the insurance provider's website. Insurance provider websites typically offer a provider search feature where you can look up home care agencies in your area.
If your loved one’s insurance provider offers a member portal, the agency information may be listed there.
If you know the name of the agency, you can also go directly to their website for contact information.
If your loved one is not yet active with a home care agency – in other words, they are not yet working with an agency and haven’t been assigned an HHA – then there could be an authorization issue. Only in this case should you reach out to their insurance provider first.
It may also be an issue of finding a home care agency with availability. Although your loved one’s insurance provider will make every effort to secure HHA services, sometimes these efforts are unsuccessful for a period and require patience. The insurance provider will continue to search for a home care agency for your loved one and will usually provide monthly updates on placement progress. In the meantime, there may be other options for your loved one covered by their insurance:
Consumer-Directed Personal Assistance Program (CDPAS)
CDPAS is not available in every state or with every insurance plan
Home delivered meals
Housekeeping or companion services
Social Day Care program
Adult Day Health Care program
Facilitating the call for plan-to-plan transfer to another managed long-term care plan
But to reiterate, if your loved one's HHA is late or doesn't show, try calling the HHA directly first.
If you're unable to reach them, consult the service agreement and contact the home care agency.
If you are not satisfied with your loved one's HHA or home care agency because of persistent problems, then contact your loved one's insurance provider who will take action.