Michigan caregiver pay guide
Last checked: May 18, 2026
If you care for a parent in Michigan, there may be a way to get paid. It depends on your parent’s Medicaid status, care needs, program, and whether you can meet the caregiver rules.
This guide gives you the first calls, the words to use, and the papers to gather. It focuses on benefit paths, payment routes, forms, and next steps.
Quick answer
Yes, an adult child may be able to get paid as a caregiver in Michigan. The most direct route is often the Medicaid Home Help Program, if the parent has Medicaid and needs hands-on help with daily activities.
MI Choice Waiver services may also help if your parent needs a nursing home level of care but wants to stay at home. Michigan has also been working on a MI Choice live-in caregiver service called Coordinated Caregiving, with an expected July 1, 2026 effective date, but families should confirm current status with the waiver agency before counting on it.
VA benefits or a private caregiver agreement may help some families. None of these routes promise approval.
Start here
- Call your local MDHHS office. Ask for the Adult Services unit and say you want to make a Home Help referral for your parent.
- Call MI Options if your parent is older or may need long-term care. Ask about MI Choice, PACE, local Area Agency on Aging services, caregiver support, and respite. Michigan lists MI Options at 1-800-803-7174.
- Start a care folder. Put your parent’s Medicaid card, Medicare card, VA papers if any, medicine list, doctor names, diagnosis list, daily care notes, income papers, and legal papers in one place.
Main options for adult children in Michigan
Use this table to pick the right first call. Rules can change. Counties, waiver agencies, managed care plans, and local offices may use different names. Always confirm with the official Michigan office handling your parent’s case.
| Program or route | Who it may help | Where to start |
|---|---|---|
| Michigan Medicaid Home Help Program | A Medicaid client who needs hands-on help with at least one activity of daily living, such as bathing, dressing, eating, mobility, toileting, or transferring. | Call the local MDHHS office. Ask for Adult Services and a Home Help referral. |
| MI Choice Waiver | An adult who meets Medicaid and nursing facility level of care rules but wants services at home or in another community setting. | Call MI Options or the local MI Choice waiver agency. Ask about an intake screening and any wait list. |
| Coordinated Caregiving / Structured Family Caregiving | A MI Choice participant with a trusted live-in caregiver, if the service is active and approved for that person’s plan. | Ask the MI Choice supports coordinator if Coordinated Caregiving is available now and whether an adult child live-in caregiver can qualify. |
| PACE | A person age 55 or older who lives in a PACE service area, meets long-term care level rules, and can live safely in the community at enrollment. | Call the local PACE organization or MI Options. PACE usually pays its care team and providers, not a family wage. |
| VA caregiver or pension benefits | A veteran or surviving spouse who meets VA rules. Some VA routes may support a family caregiver. Aid and Attendance is paid to the eligible veteran or survivor, not directly to the adult child. | Contact VA, a VA-accredited representative, or the caregiver support team at the nearest VA medical center. |
| Private pay caregiver agreement | A parent who can pay from their own funds and wants to pay an adult child for care. | Use a written agreement before payment starts. Talk with an elder-law attorney or tax professional if Medicaid may be needed now or later. |
Medicaid and self-directed care
Medicaid is often the first place to check because private family payments can create tax and Medicaid issues. In Michigan, the key Medicaid routes are Home Help and MI Choice.
Home Help Program
The Home Help Program is run by the Michigan Department of Health and Human Services, often called MDHHS. It is a Medicaid-funded program for people who need hands-on personal care at home.
Home Help is not Medicare. Your parent must have Medicaid, or must be in a Medicaid deductible, also called spend down, situation that works with Home Help rules.
The official Home Help handbook says the client has the right to choose the caregiver. It also says the caregiver works for the client, not for the State of Michigan or MDHHS.
For an adult child, the key point is this: the Home Help handbook says a spouse cannot be the paid caregiver, and a parent cannot be paid to care for a minor child. It does not list an adult child caring for an adult parent as a banned caregiver. Still, you should ask the Adult Services Worker to confirm your exact case.
Home Help may pay for
- Bathing.
- Dressing.
- Eating or feeding help.
- Grooming.
- Mobility.
- Toileting.
- Transferring, such as moving from bed to chair.
- Some instrumental activities, such as meal preparation, laundry, shopping, and medicine help, if your parent also qualifies for help with an activity of daily living.
Important limits
Home Help is for the approved client’s needs. It does not pay for help that is mainly for other people in the home. It also does not cover every task. The official handbook lists limits such as transportation to medical appointments, lawn mowing, home repairs, money management, home-delivered meals, and adult or child day care.
Supervision, reminders, guiding, or prompting by itself may not count as paid Home Help time. Ask the Adult Services Worker how your parent’s dementia, falls, or safety needs are counted.
How a Home Help case usually starts
- Referral. Anyone can make a Home Help referral. You can call, mail, fax, or go in person.
- Application and medical form. Michigan’s Adult Services forms page lists the Adult Services Application, DHS-390, and the Adult Services Medical Needs Certification, MDHHS-6200. Ask the local office which version they want.
- Assessment. An Adult Services Worker, often called an ASW, visits and asks about the tasks your parent needs help with.
- Written decision. Michigan’s handbook says applications must be approved or denied within 45 calendar days from the day MDHHS gets the referral.
- Caregiver enrollment. The adult child must meet caregiver rules, enroll through CHAMPS, pass the required screen, and follow service reporting rules before payment can happen.
Phone script: Home Help
Hello. I am caring for my parent in Michigan. They need hands-on help with daily activities like bathing, dressing, toileting, transferring, meals, or medicine. I want to make a referral for the Medicaid Home Help Program. May I speak with the Adult Services unit or an Adult Services Worker?
Also, can you tell me where to send the DHS-390 Adult Services Application and the current medical needs certification form?
MI Choice Waiver
MI Choice is Michigan’s Medicaid home and community-based waiver for adults who meet nursing facility level of care rules and want services in a home or community setting.
MI Choice can cover services that are different from Home Help. Michigan lists services such as supports coordination, adult day health, chore services, community living supports, transportation, home modifications, home delivered meals, nursing services, respite, personal emergency response systems, and specialized medical equipment.
MI Choice also has a self-determination option. Self-determination means the participant may have more control over the budget, workers, and service arrangements in the approved plan. Ask the supports coordinator whether an adult child can be hired for any approved service and what payroll or fiscal intermediary rules apply.
Home Help and MI Choice may not pay for the same service at the same time
The Home Help handbook warns that Home Help does not cover services another Medicaid resource is providing at the same time, such as MI Choice or Community Living Supports. Ask before you switch programs or start a second service.
Coordinated Caregiving / Structured Family Caregiving
Michigan has official MDHHS documents about adding a live-in caregiver service to MI Choice. In public materials, this is described as Structured Family Caregiving. In a 2026 MDHHS letter, Michigan called the planned service Coordinated Caregiving.
The basic idea is that a trusted live-in caregiver may be paid through an approved provider to give personal care and daily support to a MI Choice participant. The caregiver may also receive training, coaching, and support.
As of this last check, MDHHS listed the anticipated effective date for the 2026 waiver changes as July 1, 2026. That means families should not assume it is open today. Ask the MI Choice waiver agency whether Coordinated Caregiving is active, whether there is a local provider, and whether an adult child who lives with the parent can qualify.
PACE
PACE stands for 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, live in a PACE service area, can live safely in the community at enrollment, and meet other program rules.
PACE can be a strong care option for some parents because it combines medical care and long-term services. But it is usually not the main route for paying an adult child as an hourly caregiver. Ask the PACE organization directly if they allow any paid family role in your situation.
VA options if your parent is a veteran or surviving spouse
Two VA routes may matter.
VA PCAFC caregiver program. A son or daughter can meet the family relationship part of the VA caregiver rule if all other VA rules are met. The veteran generally must have a VA disability rating of 70% or higher, need at least six months of continuous in-person personal care services, and be enrolled in VA health care. The primary family caregiver may receive a monthly stipend if approved.
VA Aid and Attendance or Housebound allowance. This is extra money added to a VA pension for qualified veterans or survivors who need help with daily activities or are housebound. It is paid to the eligible veteran or survivor, not directly to the adult child. A family may use it to help pay for care, but keep a written agreement and records.
Live-in caregiver options
Living with your parent does not automatically make you paid. It can also change reporting rules.
For Home Help, Michigan says live-in individual caregivers are exempt from Electronic Visit Verification, often called EVV. EVV is the system some caregivers use to record visits. But live-in caregivers still must follow the current service verification rules, such as electronic or paper service verification, until MDHHS says otherwise.
Ask the Adult Services Worker if a live-in caregiver form is needed. Also ask how shared household tasks are counted. For example, meal preparation or laundry may be reduced when other adults live in the same home unless the task is clearly only for your parent.
For MI Choice, ask about Coordinated Caregiving if the adult child lives with the parent. Confirm whether it is active in your area, whether the parent must already be on MI Choice, who employs or pays the caregiver, and what backup plan is required.
If your parent pays you privately
Your parent can choose to pay an adult child from private funds, but it should be done carefully. Cash gifts, vague transfers, and after-the-fact payments can cause problems if your parent later applies for Medicaid long-term care.
Use a written caregiver agreement before payments start. The agreement should be signed and dated. It should say what care you provide, how many hours are expected, the pay rate, how and when you are paid, and how records will be kept.
Private pay records to keep
- Signed caregiver agreement.
- Daily time logs.
- Task notes, such as bathing, meals, transfers, toileting, and medicine help.
- Proof of payment, such as checks or bank transfers.
- Doctor notes that show why care is needed.
- Tax forms and year-end records.
Do not use a private pay agreement to hide money or move assets out of your parent’s name. If Medicaid is likely, talk with a Michigan elder-law attorney before large payments, back payments, home transfers, or adding a child to accounts or deeds.
Tax and Medicaid cautions
Caregiver pay is usually income
If you are paid to care for your parent, the money may count as income to you. How it is reported can depend on who pays you, whether you are an employee, whether a state program pays you, and whether you run a care business. The IRS says family caregivers still may need to report payments as income, and self-employment tax depends on the facts.
Ask the program how it reports pay. For private pay, ask a tax professional whether your parent is a household employer and whether you need a W-2, 1099, or other tax reporting.
Medicaid look-back can treat gifts as a problem
When someone applies for Medicaid long-term care, states review asset transfers. Federal Medicaid materials explain that transfers for less than fair market value can create a penalty. The look-back period for many long-term care cases is 60 months, or five years.
This is why a written caregiver agreement and proof of fair payment matter. A payment for real care under a real contract is different from a gift, but you may need records to prove it.
Estate recovery may apply
Michigan has an Estate Recovery program. Michigan says it applies to Medicaid beneficiaries who are age 55 or older and received long-term care services on or after September 30, 2007. It may seek repayment from the estate after death, with some exceptions or deferrals.
Do not transfer a home or bank account just to avoid estate recovery without legal advice. Michigan warns that asset transfers can affect eligibility and can affect hardship claims.
Common mistakes that slow families down
- Calling Medicare first and stopping there. Medicare usually does not pay an adult child for long-term daily care.
- Asking only, “Can I get paid?” instead of asking for Home Help, MI Choice, PACE, and VA screening.
- Not keeping daily notes about bathing, dressing, toileting, transfers, meals, medicine, falls, and unsafe moments.
- Starting private payments with no written agreement.
- Letting the parent give cash or transfer property without checking Medicaid rules.
- Missing the caregiver enrollment steps after the parent is approved.
Resumen en español
En Michigan, un hijo adulto puede tener una opción para recibir pago por cuidar a un padre, pero depende del programa y de las reglas. La ruta más común puede ser Medicaid Home Help si el padre tiene Medicaid y necesita ayuda física con actividades diarias.
Llame a la oficina local de MDHHS y pida hablar con Adult Services sobre Home Help. Si su padre necesita mucho cuidado, también pregunte por MI Choice, PACE, servicios de la Agencia local de Envejecimiento, y beneficios de VA si fue veterano.
FAQ
Can an adult child be paid through Michigan Home Help?
Possibly. Michigan’s Home Help materials say the client can choose the caregiver and list a spouse and a parent caring for a minor child as not allowed. They do not list an adult child caring for an adult parent as banned. Confirm with the Adult Services Worker for your parent’s case.
Does the parent need Medicaid?
For Home Help and MI Choice, yes. These are Medicaid routes. If your parent does not have Medicaid, ask MDHHS how to apply and whether spend down may apply. You can also read Medicaid spend down.
Can an adult child get paid if they live with the parent?
Maybe. Living together does not automatically end the question. But it can affect program rules, service logs, EVV rules, and whether a live-in service is available. Ask the program directly before you assume the answer.
Is Michigan Structured Family Caregiving available?
Michigan has been moving toward a MI Choice live-in caregiver service called Coordinated Caregiving. MDHHS materials describe it as a live-in caregiver service tied to MI Choice. Because program details can change, ask the MI Choice waiver agency whether it is active in your area and whether your parent can be screened.
Can my parent pay me from their own money?
Yes, if your parent has the legal ability to agree or the right legal representative can act for them. Use a written caregiver agreement. Keep time records and payment records. Ask an elder law attorney about Medicaid effects before large payments or back pay.
Will VA Aid and Attendance pay the adult child?
Usually no. VA Aid and Attendance is extra money added to a VA pension for a qualifying veteran or survivor. The money is paid to the beneficiary, not directly to the adult child. The family may use it to help pay for care if rules allow.
What if MDHHS says no?
Ask for the reason in writing. Ask what form, care need, Medicaid issue, or caregiver enrollment issue caused the denial. If you get a written notice, read the hearing or appeal section right away. Deadlines can be short.
About this guide
This guide was written for family caregivers who need a first step, not a policy paper. It focuses on Michigan benefit routes, official agencies, forms, phone scripts, documents, and appeal paths.
For more help, see Can I get paid to be a caregiver?, try the caregiver pay quiz, review Medicaid HCBS waivers, or use our phone scripts and caregiver checklists.
Official sources used
- Michigan Department of Health and Human Services: Home Help Program
- Michigan Department of Health and Human Services: Individual Caregivers
- Michigan Department of Health and Human Services: Home Help Services Program Client Handbook
- Michigan Department of Health and Human Services: Adult Services Forms and Publications
- Michigan Department of Health and Human Services: MI Choice Waiver Program
- Michigan Department of Health and Human Services: MI Choice Provider Information
- Michigan Department of Health and Human Services: MI Choice waiver amendment letter on Coordinated Caregiving
- Michigan Department of Health and Human Services: PACE
- Michigan Department of Health and Human Services: Long Term Services and Supports and MI Options
- Michigan Department of Health and Human Services: Aging Services and Area Agencies on Aging
- Michigan Department of Health and Human Services: Medicaid Estate Recovery
- U.S. Department of Veterans Affairs: Family and caregiver benefits
- U.S. Department of Veterans Affairs: Aid and Attendance and Housebound benefits
- Centers for Medicare & Medicaid Services: Medicaid transfer of assets backgrounder
- Internal Revenue Service: Family caregivers and self-employment tax
Disclaimer
This is general information, not legal, tax, medical, or financial advice. For legal or tax questions, talk with a qualified professional in your state. Rules can change, and local offices may apply program rules based on the facts in your parent’s case.
