Your right to choose your provider
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A Georgia EDWP member chooses their own Traditional or Enhanced provider, including their case management agency, and may change that choice later. The case manager must inform the member of the providers available in their geographic area. No provider may require a member to take all services from one company.
The right, stated plainly
You choose who provides your care.
Georgia’s waiver rules at §1894 give an EDWP member the right to choose their Traditional or Enhanced EDWP provider. That includes the case management agency. It is your choice, made by you, and it can be made again later.
Nobody assigns you an agency. If it felt that way at enrollment – a name came up, paperwork followed, and no options were mentioned – that is not how the rule reads.
What the case manager has to do about it
§1896 places the matching duty on the case manager: inform the member of the providers available in their geographic area, and let the member choose.
Three things follow from that, and they are worth spelling out.
Options, not a recommendation. Being told about the available providers means being told about more than one where more than one exists. A list is information. A single name presented as the obvious answer is not.
Not only at enrollment. The duty does not expire the day the paperwork is signed. A member who asks in year three what else is available is entitled to the same answer as a member who asks on day one.
Available in your area. Provider coverage is geographic. What exists an hour away may not be usable. The honest version tells you what is genuinely available where the member lives, including when that is a short list.
No company gets to take the whole plan
§1834.13 means no provider may push a member into taking all of their services from that provider or a company connected to it.
This one is quiet but it matters. A member may use one agency for personal support, a different one for meals, and a different one again for case management. Convenience is a reason to choose a single company. It is not a reason anyone else may impose.
If a member is told they must accept a bundle, or that a service is only available if they also move something else across, that is worth raising – with the case manager, and if necessary as a complaint.
Where this bites in practice
Case management agencies and service providers are separate organizations, and a case management agency does not employ the person who comes to the house. That separation is deliberate: the person judging how much care someone needs should not be the person paid for the hours.
It also means a member has two distinct choices to make – who coordinates, and who delivers – and can change either one without changing the other.
What a member should feel able to say
Any of these, without apology:
- “What other agencies serve our area for this service?”
- “We would like to think about it before deciding.”
- “We would like to change to a different provider.”
- “We would prefer not to take all our services from one company.”
None of those requires a reason, a complaint or a justification. They are the ordinary exercise of a right that is written into the rules, and an agency that treats them as a problem is telling you something useful.
The practical steps for making a change are on the page about changing a provider.
Questions people ask about this
Does a member really get to choose their case management agency?
Yes. Georgia's waiver rules give the member the right to choose their Traditional or Enhanced EDWP provider, and the case management agency is one of those providers. The choice is the member's to make, and it is not permanent.
What is the case manager actually required to do?
Inform the member of the providers available in their geographic area and let the member choose among them. That means presenting options, not a single recommendation, and doing it whenever the member asks, not only at enrollment.
Can a company insist on providing all of a member's services?
No. No provider may require a member to take all of their services from that company or a related one. A member is entitled to use different agencies for different services if they prefer, and being told otherwise is worth raising with the case manager.
Does choosing a provider at enrollment lock a member in?
No. The right to choose applies for as long as the member is on the waiver. A member may change providers later, with or without giving a reason, and eligibility and the plan of care are not restarted by a change.
What if there is only one provider offering a service nearby?
Availability varies by geographic area, and in some places the practical choice is narrow. The obligation is to tell the member what is genuinely available in their area rather than to present a single option as the only one. It is reasonable to ask what else exists and how far away it is.
Related questions
- Changing a provider How an enrolled EDWP member changes a service provider or their case management agency in Georgia, what the case manager must tell them, and what happens to the care plan.
- The case manager's role What an EDWP case manager does month to month, and the Georgia rule that gives a member the right to choose their case management agency and to change it.
- Filing a complaint How a Georgia waiver member complains about a service provider, a case management agency including this one, or the handling of their case, and what each route is for.
- Your rights What a Georgia Medicaid waiver member is entitled to: choosing a provider, appealing a decision, complaining about an agency, and living in the community on your own terms.