Can I Get Paid to Care for a Family Member in Michigan?

Main ways a family caregiver may be paid in Michigan

Michigan does not have one simple program that pays every family caregiver. The right route depends on Medicaid status, care needs, age, disability, veteran status, and where the person lives.

For a broader overview, see Can I Get Paid to Be a Caregiver? and the caregiver pay quiz.

Michigan Medicaid Home Help

Home Help is the first route many Michigan families should check. MDHHS says Home Help helps Medicaid clients stay in their own home instead of moving to an adult foster care home, home for the aged, or nursing facility.

Home Help is Medicaid-funded. Medicare alone is not enough. The person must have active Michigan Medicaid and must need hands-on help with at least one activity of daily living.

Care tasks that may count

Activities of daily living are basic body care tasks. They can include bathing, dressing, eating, grooming, mobility, toileting, and transfers, such as moving from a bed to a chair.

Be clear when you call. Do not only say, “Mom needs help.” Say what happens and what help is needed. For example: “Mom cannot bathe without hands-on help because she falls,” or “Dad needs help moving from bed to wheelchair.”

Who can be a paid Home Help caregiver?

Michigan says Home Help recipients hire and employ their providers. The caregiver is not employed by MDHHS or the State of Michigan.

A provider must be at least 18. A provider may be a relative, friend, neighbor, or health care agency. The caregiver must finish provider enrollment steps before payment can be made.

Individual caregivers must enroll through CHAMPS. CHAMPS is Michigan’s Medicaid provider enrollment and payment system. Ask MDHHS what steps are needed before care hours can be paid.

Michigan states that a spouse cannot be paid by MDHHS to care for a spouse under Home Help. It also states that a parent cannot be paid by MDHHS to care for a minor child under Home Help.

If Medicaid is the barrier

If the person does not have Medicaid, ask MDHHS how to apply. If income is too high, ask whether a Medicaid deductible or spend-down applies.

For plain-English background, read Medicaid spend-down and Medicaid look-back period. Talk with MDHHS or a qualified elder law attorney before moving money or giving away property.

MI Choice Waiver and self-directed care

MI Choice is Michigan’s Medicaid home and community-based waiver for people who need nursing facility level of care but want services at home or in another community setting.

MI Choice can cover many supports. Michigan materials list services such as adult day health, chore services, community living supports, fiscal intermediary services, home-delivered meals, nursing, personal emergency response systems, respite, and medical supplies.

MI Choice is not the same as basic Home Help. It is for people with higher care needs. The person may be assessed by a nurse and social worker. Family can often share care facts if the person agrees.

Self-directed care in MI Choice

Michigan uses the term self-determination for some self-directed services. This may let a participant have more say over approved workers, schedules, and services. A fiscal intermediary may help with payroll and budget steps.

This does not mean every family member can be paid in every case. The care plan, provider rules, budget, and waiver agency all matter.

Structured Family Caregiving in Michigan

Michigan has official materials about adding Structured Family Caregiving as a MI Choice service. The state describes it as a service where a live-in caregiver, often a family member, is paid to provide personal care and gets support from a provider agency.

As of this last check, families should not assume it is open in every county or for every family relationship. Ask the MI Choice waiver agency if the service is active, whether there is a provider in the area, and whether spouses, adult children, siblings, or legal representatives can qualify under current rules.

PACE may help with care, even if it does not pay the family directly

PACE means Program of All-Inclusive Care for the Elderly. In Michigan, PACE is for people age 55 or older who meet long-term care level rules and live in a PACE service area.

PACE can bring medical care, long-term care, and home support together through one team. It may reduce the amount of care the family must do alone.

PACE is usually not a direct paycheck to a family caregiver. Still, ask how family caregivers fit into the care plan and whether any paid family role is allowed.

Can a spouse be paid?

For Michigan Home Help, the answer is usually no. Michigan states that a client’s spouse cannot be paid by MDHHS to provide Home Help care to that spouse.

A spouse should still ask about other supports. Ask about MI Choice, Structured Family Caregiving if available, respite, adult day services, PACE, and VA benefits if the person is a veteran.

For tax topics, see caregiver tax deductions. For breaks from care, see respite care for caregivers.

Can an adult child be paid?

Yes, an adult child may be able to be paid under Home Help if the parent qualifies, the care is approved, and the adult child completes provider enrollment.

A sibling, other relative, friend, neighbor, or live-in caregiver may also be possible under Home Help if that person meets provider rules. Ask about electronic visit verification, provider enrollment, background or tax forms, and when payment can start.

For MI Choice, ask the waiver agency if an adult child, sibling, or other relative can be hired through self-determination or another approved service. Do not assume the rule is the same as Home Help.

What if the person is a veteran?

Veterans may have routes outside Michigan Medicaid. Start with the veteran’s VA care team, VA social worker, or caregiver support team.

PCAFC

PCAFC is the VA family caregiver program that may provide a monthly stipend to an approved primary family caregiver. The caregiver and veteran must apply and meet VA rules.

Do not assume approval. Ask the VA for the current PCAFC rules and whether the veteran’s care needs meet the standard.

Veteran Directed Care

Veteran Directed Care may give an eligible veteran a flexible care budget. VA materials say the budget may be managed by the veteran or family caregiver. This program is only available in certain locations and requires clinical need.

VA Aid and Attendance

Aid and Attendance is an added VA pension payment for some eligible veterans and survivors who need help with daily activities or are housebound. It is not a caregiver paycheck by itself, but it may help pay for care.

For more detail, see VA Aid and Attendance.

What to ask on the phone

Use the program name. This helps you avoid being sent to the wrong office.

For more wording, see phone scripts for caregivers.

Common denial or delay reasons

• The person does not have active Michigan Medicaid.
• The Medical Needs form is missing or not signed by an approved professional.
• The need was described as general supervision, but the program needs proof of hands-on help.
• The caregiver has not finished CHAMPS enrollment.
• The caregiver relationship is not allowed for that route.
• The person does not meet nursing facility level of care for MI Choice or PACE.
• The family asked for “caregiver pay” but did not ask for the exact program name.

If you are told no

Ask why. Ask for the reason in writing. Ask what rule was used. Then ask what route may fit instead.

For Home Help, Michigan’s handbook says a person can ask for a hearing if they think MDHHS made a mistake or treated them unfairly. The handbook says the hearing request must be made within 90 calendar days.

Ask these questions:

• “Is the denial because of Medicaid status, medical need, missing forms, or provider enrollment?”
• “Can we fix the missing item and reapply?”
• “Should we ask for a MI Choice screening?”
• “Is there respite, adult day care, or another Area Agency on Aging service while we wait?”
• “How do I request a hearing or appeal, and what is the deadline?”

Keep copies of notices. Write down the date, time, phone number, and name of each person you speak with.

Who to call first in Michigan

• Has Michigan Medicaid and needs daily hands-on help: call the local MDHHS office and ask for Adult Services and Home Help.
• Needs a high level of care at home: call the local MI Choice waiver agency or Area Agency on Aging and ask for a MI Choice screening.
• Age 55 or older and may need long-term care: ask if PACE serves the person’s ZIP code.
• Has both Medicare and Medicaid: ask the plan care coordinator about home and community services.
• Is a veteran: call the VA caregiver support team or the veteran’s VA social worker.

About this guide

This guide was written for family caregivers who need a clear first step. It focuses on payment routes, Medicaid options, VA options, phone calls, documents, denials, and where to ask for help in Michigan.