Can a Spouse Get Paid as a Caregiver in Michigan?

1. Michigan Home Help

Home Help is run by the Michigan Department of Health and Human Services, often called MDHHS. It can pay for personal care for a Medicaid client who wants to stay at home.

Michigan says Home Help may pay for help with activities of daily living. These can include eating, bathing, dressing, grooming, moving around the home, transferring, and using the toilet.

If the person qualifies for help with at least one covered daily activity, Home Help may also cover some related tasks, such as light housework, laundry, meals, medicine setup, and shopping for needed items.

Spouse rule: For Home Help, the answer is no. A client’s spouse cannot be paid by MDHHS to provide care. A parent caring for a minor child also cannot be paid by MDHHS for Home Help care.

Other people may be possible providers. Michigan says providers must be at least 18 and may be a relative, friend, neighbor, or health care agency. Providers must enroll in CHAMPS, pass a criminal history screen, and be approved before payment.

Representative role: A spouse can usually help make calls, gather papers, and be present during the assessment if the client wants that. If the spouse needs to act as an authorized representative for Medicaid papers or case notices, ask MDHHS what form is needed. That is different from being the paid Home Help provider.

Start with the Adult Services unit at the local county MDHHS office. Say you want to apply for Home Help or request an Adult Services assessment.

2. MI Choice Waiver

MI Choice is a Medicaid waiver for people who meet nursing facility level of care but can receive services at home or in another community setting.

MI Choice can include supports coordination, adult day health, chore services, Community Living Supports, community transportation, home delivered meals, respite, nursing, equipment, and other approved services.

Spouse rule: This is not the same as Home Help. Michigan’s MI Choice renewal materials say a spouse or legally responsible adult may be hired in limited situations through a network provider agency. The same materials say they must not be hired through self-determination arrangements such as Agency with Choice.

That means the details matter. The spouse may need to be hired, trained, supervised, and paid through a home care agency that contracts with the MI Choice waiver agency. The spouse may not be allowed to be the paid worker if the family is trying to self-direct the worker outside that agency setup.

Representative role: If the spouse is also helping make decisions, ask the support coordinator if that creates a conflict. Ask whether another trusted person can serve as representative if the spouse may be hired through an agency.

To apply or ask about eligibility, contact your local MI Choice waiver agency. Ask for an intake screen for MI Choice and tell them the person may need nursing facility level of care at home.

3. Coordinated Caregiving in MI Choice

Michigan has been working on a new MI Choice service called Coordinated Caregiving. Earlier materials called this structured family caregiving.

The idea is to support a live-in caregiver who provides personal care and daily support to a MI Choice participant. Michigan’s 2026 notice said the state planned to add this service to MI Choice, with an expected effective date of July 1, 2026.

Because this was still tied to a waiver amendment process, treat it as a program to confirm, not a promise. Ask the MI Choice waiver agency if Coordinated Caregiving is active, whether spouses can qualify, and whether the caregiver can also be a representative.

4. PACE

PACE stands for Program of All-Inclusive Care for the Elderly. It is for some people age 55 or older who meet long-term care level of care, live in a PACE service area, and can live safely in the community when they enroll.

PACE is not usually a way to pay a spouse directly. It may help by arranging medical care, personal care, day center care, rides, meals, therapy, and care planning through the PACE team.

PACE and MI Choice cannot be used at the same time. If PACE is available in your area, ask the PACE organization how it would support the spouse caregiver and whether respite or in-home care can be part of the plan.

Medicaid money rules to ask about

Medicaid has income and asset rules. Some people may have income over the limit but still use a Michigan Medicaid deductible. This is similar to a Medicaid spend-down.

If the person may need long-term care Medicaid, do not move money or give away property without advice. Asset transfers can cause problems under the Medicaid look-back period.

For a plain-English overview of waivers, see Medicaid HCBS waivers explained.

VA PCAFC

PCAFC is a VA family caregiver program. A spouse can be a family caregiver if the Veteran and caregiver meet VA rules.

The caregiver must be at least 18. VA says the caregiver can be a spouse, son, daughter, parent, stepfamily member, extended family member, or someone who lives with the Veteran or is willing to live with the Veteran if chosen as a family caregiver.

The Veteran must meet VA rules, including VA health care enrollment, a qualifying VA disability rating, and a need for at least six months of in-person personal care services.

Eligible primary family caregivers may receive a monthly stipend. Other benefits may include training, counseling, travel benefits in some cases, respite, and other support. Approval is not automatic.

To apply, the Veteran and caregiver apply together. VA uses VA Form 10-10CG.

Veteran Directed Care

Veteran Directed Care, often called VDC, gives some VA-enrolled Veterans a flexible budget for home and community care. VA says Veterans or their representatives get help with a spending plan and hiring workers, which might include a family member or neighbor.

This program is not offered everywhere. Ask the Veteran’s VA social worker whether VDC is offered through the local VA medical center and whether a spouse can be hired in that case.

Aid and Attendance is different

VA Aid and Attendance is an added VA pension amount for some Veterans and survivors who need help. It is not the same as caregiver payroll.

It may help pay for care costs if the Veteran or survivor qualifies. See VA Aid and Attendance for more detail.