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Last updated: 13 September 2026
Paying for home care in Michigan often takes more than one source. Medicare may cover short-term skilled home health care, but it does not pay for most long-term help with bathing, dressing, meals, or supervision. Michigan Medicaid programs can matter much more for ongoing hands-on care.
This guide compares the main Michigan routes, including Home Help, MI Choice, MI Coordinated Health, PACE, aging-network services, veterans benefits, and private-pay options. If you also need help with food, utilities, housing, or other bills, the Michigan benefits guide can help you build a wider support plan.
Bottom Line
If you need ongoing help with daily activities, do not assume Medicare will pay. Call MI Options at 1-800-803-7174 for statewide long-term care counseling and local referrals. If you have Medicaid and need hands-on help with at least one daily activity, ask your county Michigan Department of Health and Human Services (MDHHS) office about Home Help. If your needs are closer to nursing-home-level care, ask for a MI Choice screening.
Need Help Right Now?
If someone is in immediate medical danger, call 911. If you suspect abuse, neglect, exploitation, or serious self-neglect of a vulnerable adult, Michigan Adult Protective Services takes reports at 1-855-444-3911 at any time, day or night.
If the care plan is failing but there is no immediate emergency, call MI Options and explain what support is missing.
Start Here
- Name the care need. Write down what help is needed with bathing, dressing, toileting, transferring, meals, medication, mobility, supervision, or skilled nursing.
- Call MI Options. Call 1-800-803-7174. Ask which home-care programs fit the person’s health, income, insurance, and county.
- Use local aging help. The Michigan aging directory can help you find the Area Agency on Aging (AAA) serving your county.
Quick Reference: Which Route Fits?
| Situation | Best first route | Main limit |
|---|---|---|
| Need ongoing hands-on personal care and have Medicaid | Home Help | Requires Medicaid and an MDHHS assessment |
| Need nursing-home-level support but want to stay home | MI Choice | Functional and Medicaid financial rules apply |
| Need skilled nursing or therapy after illness or injury | Medicare home health | Not a long-term custodial-care benefit |
| Have both Medicare and Medicaid in a 2026 MICH county | MI Coordinated Health | Geographic and enrollment rules apply |
| Age 55+ with nursing-home-level needs | PACE | Must live in a PACE service area |
| Need lighter help, respite, meals, or rides | AAA / aging services | Services and capacity vary locally |
Know What Kind of Care You Need
“Home care” can mean several different things. The payer depends on the service.
- Skilled home health: nursing, wound care, therapy, or other medical services ordered by a health professional.
- Personal care: hands-on help with bathing, dressing, toileting, eating, transferring, grooming, or mobility.
- Homemaker help: meals, laundry, light housework, and shopping that support safe living at home.
- Supervision or respite: someone stays with the person for safety or gives the family caregiver a break.
Michigan has different programs for these needs. Services can sometimes be combined, but Home Help will not pay for care that duplicates the same service from another program. For a broader explanation of care types, see our home care basics.
When Medicare Pays for Home Health
Medicare can pay for certain home health services when you are homebound, need part-time or intermittent skilled care, have a qualifying order, and use a Medicare-certified home health agency. Covered services can include skilled nursing, physical therapy, occupational therapy, speech-language pathology, medical social services, and limited home health aide care when you are also receiving qualifying skilled services. Medicare says you pay nothing for covered home health services, although other costs can apply for items such as durable medical equipment.
Read the current Medicare home health rules before assuming a service is covered. A doctor, nurse practitioner, or other allowed provider must certify the need for care.
Important: Medicare does not pay for most long-term custodial care when that is the only care you need. That includes ongoing help with bathing, dressing, toileting, meals, adult day care, or transportation. Medicare’s long-term care page states that these costs are generally not covered.
If Medicare costs are taking money away from your care budget, check the Michigan Medicare savings guide. Lowering premiums or cost sharing can free part of a fixed income for other needs.
Michigan Home Help: The Main Personal-Care Route
Michigan’s Home Help program is one of the most important programs to check when a Medicaid beneficiary needs hands-on assistance at home. The state says a person must be eligible for Medicaid fee-for-service and need physical help with at least one activity of daily living.
What Home Help can cover
Covered tasks can include bathing, dressing, eating, grooming, mobility, toileting, and transferring. Home Help can also pay for approved help with light housework, laundry, medication tasks, meal preparation, and shopping. Certain complex care tasks can be covered after assessment.
Home Help does not pay for heavy housework, home repairs, simple prompting or reminding, supervision, transportation, or yard work.
How to apply
A referral goes to the Adult Services unit of your local MDHHS office. The client or another person can make it by phone, mail, fax, or in person. Michigan currently uses the DHS-390 Adult Services Application and the MDHHS-6200 Adult Services Medical Needs Certification. A Medicaid-approved medical provider completes the medical form.
If you do not have Medicaid, you can apply through MI Bridges. Our MI Bridges guide explains the portal and document steps.
An Adult Services Worker then completes a home assessment. The state says written approval or denial is sent within 45 days. You can request a hearing if you disagree.
Hours and caregiver choice
The current Home Help FAQ says there is no fixed maximum number of hours. Approved hours are based on the person’s assessed needs. That does not mean unlimited care is automatically approved.
A client may choose an agency or individual caregiver. The caregiver may be an adult family member or friend, but not the client’s spouse, a parent caring for a minor child, or another Home Help recipient. The caregiver must enroll as a Michigan Medicaid provider and pass a background check.
For services beginning January 1, 2026, MDHHS set the Home Help individual caregiver rate at $17.13 per hour, according to the state’s 2026 caregiver-rate letter. That is the program’s individual caregiver payment rate, not the private-market price of home-care agencies.
MI Choice Waiver: Broader Support at Home
MI Choice is Michigan’s Medicaid home- and community-based services waiver for adults who would otherwise need nursing-facility-level care. It can provide a wider package than Home Help, such as community living supports, respite, adult day health, home-delivered meals, transportation, nursing, personal emergency response systems, home modifications, and specialized medical equipment.
Regional MI Choice agencies screen functional needs, help with Medicaid financial steps, and develop a service plan when a person qualifies.
2026 financial rule to know
Michigan’s current HCBS comparison chart states that MI Choice uses expanded financial eligibility allowing gross income up to 300% of the Supplemental Security Income federal benefit rate, or $2,982 per month in 2026. Asset rules, transfer rules, and protections for a spouse can still matter, so this number is not a complete eligibility test. Ask the waiver agency or MDHHS to screen the actual household before assuming income or savings are too high.
Reality check: MI Choice intake includes screening for program eligibility and waiting-list placement. A person may meet basic rules but still face assessment, paperwork, provider, or local-capacity delays. Ask the waiver agency whether there is a wait and what can be used while waiting.
MI Coordinated Health and PACE
MI Coordinated Health
Michigan ended MI Health Link on December 31, 2025 and launched MI Coordinated Health (MICH) on January 1, 2026. MICH is for eligible adults age 21 or older who have both Medicare and Medicaid. It coordinates both programs and can connect qualifying members to long-term services and supports.
In 2026, the official MICH eligibility page lists Wayne, Macomb, Barry, Berrien, Branch, Calhoun, Cass, Kalamazoo, St. Joseph, and Van Buren counties, plus Upper Peninsula counties except Chippewa, Gogebic, and Menominee. Plan availability can differ within the service area. If you have both Medicare and Medicaid, ask MI Options whether MICH or another long-term care route fits your county and needs.
PACE
The Program of All-Inclusive Care for the Elderly (PACE) combines medical care and long-term support under one care team. Michigan’s PACE page says a participant must be at least 55, meet Medicaid long-term-care functional criteria, live in an approved service area, and be able to live safely in the community at enrollment.
PACE can help when a person has several medical and daily-care needs and wants one team coordinating approved services. PACE is not available everywhere, and a person cannot be enrolled in MI Choice at the same time.
How you pay depends on coverage. Under Medicare’s PACE cost rules, a person with Medicaid does not pay a monthly PACE premium. A person with Medicare but not Medicaid pays PACE premiums that include the long-term-care portion and Medicare drug coverage. A person with neither Medicare nor Medicaid may pay the PACE premium privately. PACE does not charge a deductible, copayment, or coinsurance for care approved by the PACE team.
Compare Michigan Medicaid Home-Care Paths
| Program | Functional level | Financial point | Best fit |
|---|---|---|---|
| Home Help | Hands-on help with at least one daily activity | Must have qualifying Medicaid coverage | Ongoing personal care at home |
| MI Choice | Nursing-facility level of care | 2026 expanded income rule up to $2,982/month; other Medicaid rules apply | Broader home/community supports |
| MICH HCBS | Nursing-facility level for waiver services | Must have Medicare and Medicaid; waiver rules also apply | Dual-eligible adults in the 2026 service area |
| PACE | Nursing-facility level of care | Medicaid route: up to $2,982/month in 2026; non-Medicaid premiums may apply | Coordinated medical and long-term care for age 55+ |
Financial screening is more detailed than one income number. Never move or give away assets just to qualify without getting qualified advice about Medicaid transfer and spousal rules.
Can Michigan Pay a Family Caregiver?
Sometimes. Home Help lets an approved adult family member or friend become the paid individual caregiver, subject to program rules. A spouse cannot be the paid Home Help caregiver. The client selects and employs the caregiver, and the caregiver must complete provider enrollment before payment can begin.
For a step-by-step explanation of family-caregiver routes, use our paid family caregiver guide.
Do not budget around a proposed benefit. Michigan submitted 2026 MI Choice waiver amendments proposing a new Coordinated Caregiving service for a live-in caregiver. As of 13 September 2026, the state’s waiver status page still listed the 2026 MI Choice amendments as submitted, not approved. Ask a MI Choice agency whether that status has changed before relying on the proposed service.
Veterans and Local Aging Services
Veterans benefits
Veterans should check both VA health-care services and pension benefits. The VA’s Homemaker and Home Health Aide service can help enrolled Veterans with daily activities when clinical and community-care rules are met and the service is locally available. A copay may apply.
For Veterans or surviving spouses already eligible for VA pension, Aid and Attendance may add a monthly amount when qualifying care needs are present. A Michigan Veteran Service Officer can help review a claim. Use the state’s VSO locator or call 1-800-642-4838. Our Michigan veteran benefits guide covers other state and federal routes.
Area Agencies on Aging
Local aging programs can sometimes fill gaps with respite, homemaker help, adult day services, home-delivered meals, transportation, caregiver support, care management, or other services. Michigan’s current home- and community-based services comparison chart notes that Older Americans Act programs are not Medicaid-funded and are generally not income-based, although age, priority, funding, and service availability vary by program and region.
These services usually do not replace round-the-clock paid care. They can still reduce the number of private-pay hours a family must buy.
Private Pay, Long-Term Care Insurance, and Cost Sharing
If public programs do not cover all needed hours, private pay may fill the gap. Before hiring, get a written rate sheet and check minimum shifts, weekend or holiday rates, cancellation fees, transportation charges, and worker status.
If you have long-term care insurance, call the insurer before paying for care. Ask what home care is covered, what triggers benefits, whether there is an elimination period, which providers qualify, and whether family caregivers can be reimbursed.
Also reduce costs around the care itself. Equipment loans can prevent unnecessary purchases; the Michigan medical equipment guide lists reuse and loan options. If home care is no longer safe or affordable even after benefits are combined, compare residential alternatives before a crisis. Our assisted living payment guide explains Michigan options.
How to Start Without Wasting Time
- Write the care list. Record each task the person cannot do safely without help and how often help is needed.
- Separate medical from personal care. Ask the doctor whether skilled home health is medically needed. Use Medicaid or aging routes for ongoing personal care.
- Call MI Options. Ask for the correct local entry point based on county, Medicaid status, Medicare status, and functional needs.
- Apply for Medicaid if needed. Use MI Bridges or ask the county MDHHS office for help. Start the application even if some supporting records still need to be gathered.
- Ask for both screenings when appropriate. If the person needs hands-on help but may also meet nursing-facility level of care, ask about Home Help and MI Choice instead of assuming only one is possible.
- Track every contact. Save names, dates, reference numbers, notices, and form copies. Written notices matter for appeals.
Documents and Information to Gather
| Item | Why it matters |
|---|---|
| Medicare and Medicaid cards | Shows current coverage and program status |
| Medication and diagnosis list | Helps explain medical and safety needs |
| Daily-care task list | Shows what help is needed and how often |
| Income records | Used for Medicaid financial screening |
| Bank and asset records | May be needed for long-term care Medicaid rules |
| Insurance policies | May identify long-term care or other coverage |
| Caregiver information | Needed if an individual caregiver will enroll |
| Recent denial notices | Appeal deadlines and reasons are written there |
Reality Checks
- Approval does not guarantee immediate staffing. You may still wait for a worker or agency.
- Medicaid programs use different rules. Home Help, MI Choice, MICH waiver services, and PACE are not interchangeable.
- One income number is not enough. Assets, spouse rules, coverage category, transfers, and functional criteria can change the answer.
- Medicare is limited. It can be valuable for skilled home health, but it is not a general long-term personal-care payer.
- Local aging funds can run short. AAA services may have priority rules or waits even when there is no Medicaid-style income test.
Common Mistakes to Avoid
- Hiring private care for months before checking Home Help, MI Choice, veterans benefits, or aging services.
- Assuming a spouse can be paid through Home Help.
- Calling all home care “home health” and expecting Medicare to cover it.
- Giving away money or property because someone says it will make Medicaid approval easier.
- Using an old MI Health Link contact instead of checking the new MICH system for 2026.
- Relying on a proposed family-caregiver program before the waiver change is approved and implemented.
- Ignoring a written denial or reduction until the appeal deadline passes.
Denied, Delayed, or Overwhelmed
If Home Help, Medicaid, MI Choice, or another Medicaid service is denied or reduced, keep the written notice. Read the reason and deadline before calling. Michigan’s Medicaid hearing page lists hearing forms for eligibility and service disputes. For Medicaid beneficiary hearing questions, the Michigan Office of Administrative Hearings and Rules lists 1-800-648-3397.
If a managed care plan or waiver made the decision, you may need its appeal process before a state fair hearing. Follow the notice instructions.
While an appeal or waitlist is pending, ask MI Options and the local AAA about temporary respite, homemaker help, meals, transportation, caregiver support, or other services. If remaining at home is no longer safe, compare assisted living, adult foster care, or nursing-facility options instead of waiting for a crisis.
Michigan Contacts at a Glance
- MI Options: Call 1-800-803-7174 for free statewide counseling about long-term care, caregiver support, and local services.
- Home Help: Use the county MDHHS finder to make a referral or ask which Adult Services office handles your address.
- MI Choice: Use the MI Choice agency list to find the waiver agency serving your county.
- Adult Protective Services: Call 1-855-444-3911 at any time to report suspected abuse, neglect, exploitation, or serious self-neglect.
- Veteran help: Call 1-800-MICH-VET (1-800-642-4838) or use the Michigan VSO locator to find an accredited benefits counselor.
Phone Scripts You Can Use
MI Options
“I am trying to keep an older adult safely at home. They need help with [tasks]. They have [Medicare/Medicaid/both/neither]. Which Michigan home-care program should we screen for first, and who handles it in our county?”
Home Help referral
“I want to make a Home Help referral. The person has Medicaid and needs hands-on help with [bathing/dressing/toileting/transferring/etc.]. What do we need to do to start the DHS-390 and MDHHS-6200 process?”
MI Choice screening
“I need a MI Choice intake for someone who may need nursing-home-level care but wants to stay at home. Is there a waitlist in our area, what financial documents do you need, and what services could start if approved?”
Veteran Service Officer
“The Veteran needs ongoing help with daily activities at home. Can you check whether VA Homemaker/Home Health Aide services, VA pension with Aid and Attendance, or another VA home-care benefit may apply?”
Resumen en Español
En Michigan, Medicare normalmente no paga el cuidado personal de largo plazo en casa. Para ayuda con baño, vestido, movilidad u otras actividades diarias, pregunte por Home Help si la persona tiene Medicaid. Si la persona necesita un nivel de cuidado parecido al de un asilo de ancianos, pregunte por MI Choice. Para orientación gratuita, llame a MI Options al 1-800-803-7174.
Home Help puede permitir que un familiar o amigo adulto aprobado sea el cuidador pagado, pero el cónyuge no puede ser el cuidador pagado de Home Help. En 2026, la tarifa estatal para un cuidador individual de Home Help es de $17.13 por hora. Guarde todas las cartas de aprobación, reducción o denegación porque pueden incluir plazos para apelar.
Frequently Asked Questions
Does Medicare pay for home care in Michigan?
Medicare can pay for qualifying part-time or intermittent skilled home health. It generally does not pay for ongoing long-term custodial care when that is the only care needed.
Does Michigan Medicaid pay for help with bathing and dressing?
Yes. Home Help can cover approved hands-on help with daily activities such as bathing, dressing, eating, toileting, and transfers for eligible Medicaid beneficiaries after an MDHHS assessment.
Can a family member be paid as the caregiver?
Home Help can pay an approved adult family member or friend, but not the client’s spouse. Other provider rules apply, including Michigan Medicaid enrollment and a background check.
Is MI Choice the same as Home Help?
No. Home Help focuses on hands-on personal care. MI Choice is a Medicaid waiver for adults who meet nursing-facility-level and financial rules and can provide broader home and community services.
What changed for dual-eligible Michigan residents in 2026?
MI Health Link ended December 31, 2025, and MI Coordinated Health launched January 1, 2026. MICH serves eligible dual Medicare-Medicaid adults in its 2026 service area.
About This Guide
Sources: This guide uses official federal, state, local, and other high-trust nonprofit and community sources linked in the article.
Editorial note
This guide is produced based on our Editorial Standards using official and other high-trust sources, regularly updated and monitored, but not affiliated with any government agency and not a substitute for official agency guidance. Individual eligibility outcomes cannot be guaranteed.
Corrections
Please note that despite our careful verification process, errors may still occur. Email info@grantsforseniors.org with corrections and we will respond within 72 hours.
Disclaimer
This article is for informational purposes only and is not legal, financial, medical, tax, disability-rights, immigration, or government-agency advice. Program rules, policies, and availability can change. Readers should confirm current details directly with the official program before acting.
Last updated: 13 September 2026 · Next review: 13 December 2026
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