Michigan Medicaid HCBS Waivers
Last checked: May 18, 2026
If your loved one needs nursing-home-level care but wants to stay at home, Michigan Medicaid may have more than one route to check. The main adult waiver route is MI Choice. Home Help, PACE, MI Coordinated Health, and some behavioral health waivers may also matter, depending on age, disability, Medicare status, county, and care needs.
Quick answer
Michigan’s main Medicaid HCBS waiver for older adults and adults with physical disabilities is the MI Choice Waiver. It can cover long-term services at home or in another community setting for people who meet Medicaid financial rules and nursing facility level of care.
Do not stop at MI Choice. Ask about Home Help for personal care, PACE for adults age 55 and older in a PACE service area, MI Coordinated Health for some people who have both Medicare and Medicaid, and Community Mental Health routes if the person has an intellectual disability, developmental disability, or serious emotional disturbance.
Start here: the first 3 actions
- Call Michigan’s MI Options line at 1-800-803-7174 and ask for long-term services and supports screening for home care.
- Ask for the MI Choice waiver agency for your county if your loved one may need nursing-home-level care but wants to stay at home.
- Also call the Adult Services unit at your local MDHHS county office and ask about Home Help personal care. This is often the faster route to ask about paid help with bathing, dressing, toileting, moving, eating, and related tasks.
Rules can change. Counties, health plans, waiver agencies, and contractors may use different names. Always confirm the current route with Michigan Department of Health and Human Services, the local MI Choice waiver agency, the person’s health plan, or the local Community Mental Health Services Program.
Main Michigan programs and where to start
| Program or route | Who it may help | Where to start |
|---|---|---|
| MI Choice Waiver | Adults age 18 or older who meet Medicaid rules and need nursing facility level of care, but can receive services at home or in a community setting. | Ask MI Options or MDHHS for the MI Choice waiver agency for your county. |
| Home Help | Medicaid clients who need hands-on help with at least one activity of daily living. This is personal care, not a full waiver package. | Call the Adult Services unit at the local MDHHS county office. |
| PACE | Adults age 55 or older who meet long-term-care level rules, live in a PACE service area, and can live safely in the community at enrollment. | Contact the local PACE organization or ask MI Options for the PACE site serving your area. |
| MI Coordinated Health HCBS Waiver | Some people who qualify for both Medicare and Medicaid and need nursing facility level of care. This replaced MI Health Link as Michigan moved to MI Coordinated Health in 2026. | Ask the MI Coordinated Health plan or Michigan ENROLLS about HCBS waiver screening. |
| Behavioral health and developmental disability waivers | People with intellectual or developmental disabilities, children with developmental disabilities, or children and youth with serious emotional disturbance. | Call the county Community Mental Health Services Program access center and ask for waiver screening. |
What an HCBS waiver is
HCBS means home and community-based services. In plain English, it means Medicaid services that help a person stay at home or in a community setting instead of moving to an institution.
A waiver is special Medicaid permission from the federal government. It lets a state cover services that regular Medicaid may not cover in the same way. Many waiver programs have limited slots. That means a person can meet the rules and still have to wait.
For a full plain-English overview, see Medicaid HCBS waivers explained.
Main waivers in Michigan
MI Choice Waiver
MI Choice is the main Michigan Medicaid waiver for many older adults and adults with physical disabilities who need nursing facility level of care. Michigan says MI Choice can provide Medicaid-covered long-term care services and supports in a home or residential setting.
MI Choice services are given through local waiver agencies. These agencies screen applicants, do assessments, build a service plan, and arrange covered waiver services. The person must also meet Medicaid financial rules.
MI Coordinated Health HCBS Waiver
MI Coordinated Health, also called MICH, is for people who qualify for both Medicare and Medicaid. It includes long-term services and supports. For people in the MICH plan who need nursing facility level of care and prefer to live in the community, the MICH HCBS waiver may help pay for home and community services.
This route depends on plan enrollment and service area. Ask the person’s plan, Michigan ENROLLS, or MDHHS how MICH applies in the county where your loved one lives.
Behavioral health and developmental disability waivers
Michigan also has Medicaid waiver routes run through the behavioral health system. These include the Habilitation Supports Waiver for people with intellectual or developmental disabilities, the Children’s Waiver Program for some children under 18 with developmental disabilities, and the Serious Emotional Disturbance Waiver for some children and youth.
These are not the same as MI Choice. Start with the county Community Mental Health Services Program access center and ask for a waiver assessment.
Important warning
Home Help and PACE are not the same as MI Choice. They are still important home-care routes in Michigan. Ask about them even if someone says, “There is a waitlist for the waiver.”
Services that may help caregivers
Services are based on the assessment and the approved plan. A person does not get every service just because the service exists. Ask which services are open, which ones are denied, and why.
MI Choice services may include
- Adult day health, also called adult day care
- Community living supports
- Community transportation
- Chore services
- Respite services
- Home delivered meals
- Environmental accessibility adaptations, such as some home changes
- Specialized medical equipment and supplies
- Personal emergency response systems
- Nursing services
- Private duty nursing or respiratory care, when approved
- Supports coordination
- Fiscal intermediary services for some self-directed arrangements
Home Help may cover hands-on personal care
Home Help is often key for families who need paid help with daily care. Michigan says it may pay for help with eating, bathing, dressing, grooming, moving through the home, transferring, toileting, and some complex care tasks.
If the person qualifies for one of those daily living tasks, Home Help may also help with medicine setup, laundry, light housework, meal preparation, shopping for essential items, and travel for shopping or laundry. Home Help does not cover every need. Michigan lists items such as heavy housework, home repairs, supervision, transportation, and yard work as not covered by Home Help.
For respite options, see respite care for caregivers.
Can family caregivers be paid through a waiver?
Maybe. In Michigan, the most direct official route to ask about paid family care is often Home Help. Michigan says Home Help recipients hire and employ their own providers. Providers may be a relative, friend, neighbor, or health care agency. A spouse or a parent caring for a minor child cannot be paid by MDHHS to provide Home Help care.
The caregiver must be approved through CHAMPS, Michigan’s Medicaid provider system, and must pass a criminal history screen before payment can happen.
For MI Choice, ask the waiver agency about self-determination, fiscal intermediary services, and whether a family member can be the worker for the specific service in the person’s plan. The answer can depend on the service, the family relationship, the plan, and current policy.
Michigan also issued 2026 notice of a proposed MI Choice service called Coordinated Caregiving, tied to structured family caregiving. The notice said the proposed service would support a trusted live-in caregiver. As of this check date, caregivers should not assume this is active for new payment until MDHHS, CMS, or the local waiver agency confirms approval and start rules.
For more help, see Can I get paid to be a caregiver? and the paid caregiver quiz.
Waitlists and priority
MI Choice can have a waiting list because waiver slots are limited. Michigan says MI Choice waiver agencies use an approved phone screening tool, called the MI Choice Intake Guidelines, to decide likely eligibility and waiting list placement.
Ask the waiver agency these questions:
- Is there a waiting list in this region today?
- Was my loved one screened with the MI Choice Intake Guidelines?
- What date was the person placed on the list?
- What priority category, if any, applies?
- Can you send a written notice if the person is removed from the list?
- What services can we ask for while waiting?
Older Michigan policy bulletins discuss priority for some nursing facility transition cases and current Adult Protective Services clients. Current priority rules should be confirmed with the local waiver agency because policies can change.
Do not wait without checking other routes. Ask about Home Help, PACE, MI Coordinated Health, Area Agency on Aging services, respite, adult day programs, and VA benefits if the person served in the military. For care cost planning, use the care cost calculator.
How to apply
Step 1: Ask for long-term services screening
Call MI Options at 1-800-803-7174. Say that your loved one needs help staying at home and you need screening for Medicaid long-term services and supports.
Step 2: Apply for Medicaid if needed
Michigan says people can use MI Bridges to apply for health care assistance, check eligibility, and manage an account. If online access is hard, ask MDHHS about the paper health coverage application. Medicaid looks at age, income, resources, and other facts.
If income is too high, ask about a Medicaid deductible, often called spend down. Learn more at Medicaid spend down. If the person gave away money or property, read Medicaid look-back period and talk with a qualified elder law attorney before guessing.
Step 3: Call the right local office
For MI Choice, ask for the waiver agency serving your county. For Home Help, ask the Adult Services unit at the local MDHHS county office. For PACE, ask whether the person lives in a PACE service area. For developmental disability or serious emotional disturbance waivers, call the county Community Mental Health Services Program access center.
Step 4: Ask for the assessment in writing
Keep notes. Write down the date, name of the person you spoke with, phone number, and what they told you. Ask for a written denial or written waitlist notice if the answer is no.
Phone script
“Hi, I am calling for my [mother/father/spouse/relative]. They have Michigan Medicaid or are applying now. They need help with bathing, dressing, toileting, meals, moving safely, and staying out of a nursing home. I need to request screening for MI Choice and also ask about Home Help. Can you tell me the correct office or waiver agency for our county?”
Documents to gather
- Medicaid card, Medicare card, and other insurance cards
- Photo ID and Social Security number
- Proof of address
- Bank statements and proof of income
- Doctor names, diagnoses, medicine list, and hospital or rehab discharge papers
- Notes about falls, wandering, memory issues, missed medicine, bathing needs, toileting needs, and unsafe time alone
- Power of attorney, guardianship papers, or release forms, if you have them
- Any denial, reduction, termination, or waitlist letter
Use caregiver checklists to keep the papers in one place.
If denied or waitlisted
A no is not always the end. First, ask what was denied. Medicaid eligibility, MI Choice enrollment, Home Help hours, a specific service, a plan decision, and a waiver waitlist decision may have different appeal steps.
Appeals and hearings
Michigan has Medicaid hearing forms for people who disagree with a Medicaid decision, service issue, service level change, or managed care decision. The Michigan Office of Administrative Hearings and Rules lists forms such as DCH-0018, DCH-0092, and MDHHS-5617. For Medicaid hearing questions, Michigan lists 1-800-648-3397 for Medicaid beneficiaries.
Read every notice. Follow the deadline on the notice. Keep a copy of what you send.
For call wording, use caregiver phone scripts. If your loved one is a veteran or surviving spouse, also check VA Aid and Attendance. For tax questions about paid care, see caregiver tax deductions and talk with a tax professional.
Common problems that slow families down
- Only asking for “a caregiver” instead of asking for MI Choice, Home Help, PACE, and waiver screening.
- Not saying the person may need nursing-home-level care.
- Not listing night needs, falls, confusion, toileting, transfers, and unsafe time alone.
- Thinking Medicare will pay for long-term home care. Medicare is not the same as Medicaid.
- Missing a deadline on a notice.
- Assuming a family member can be paid before the program approves the person, the service plan, and the caregiver as a provider.
Resumen en espanol
En Michigan, la ruta principal de Medicaid para servicios en el hogar para muchos adultos mayores o adultos con discapacidades fisicas es MI Choice Waiver. Tambien pregunte por Home Help, PACE, MI Coordinated Health, y Community Mental Health si la persona tiene una discapacidad del desarrollo o una necesidad de salud mental grave.
Llame y diga: “Necesito una evaluacion para servicios de cuidado a largo plazo en el hogar. Tambien quiero preguntar por MI Choice y Home Help.” Pida una decision por escrito si le dicen que no.
FAQ
Is MI Choice the same as Home Help?
No. MI Choice is a Medicaid HCBS waiver for people who need nursing facility level of care and meet other rules. Home Help is a Michigan Medicaid personal-care program that may pay for hands-on help with daily living tasks.
Who should I call first in Michigan?
Call MI Options at 1-800-803-7174 for long-term services routing. Also call the Adult Services unit at your local MDHHS county office and ask about Home Help.
Can my loved one get MI Choice if they are already in a nursing home?
Ask the MI Choice waiver agency about nursing facility transition. Michigan policy has used priority rules for some nursing facility transition cases, but current placement rules should be confirmed with the waiver agency.
Can an adult child be paid to care for a parent?
Possibly. Under Home Help, Michigan says providers may include a relative, friend, neighbor, or health care agency, but not a spouse or parent caring for a minor child. The caregiver must be approved as a provider before payment.
Does Michigan have a waitlist for MI Choice?
It can. MI Choice slots are limited. Ask the waiver agency if there is a current waitlist in your region and whether your loved one was screened with the MI Choice Intake Guidelines.
What if Medicaid says income is too high?
Ask MDHHS about Medicaid deductible or spend down rules. Do not move money or give away assets without legal advice because Medicaid transfer rules can cause problems.
About this guide
This guide was written for family caregivers who need a starting point for Michigan Medicaid home care. It focuses on official Michigan and federal sources, current program names, first calls, waitlists, payment questions, and appeal routes.
Disclaimer
This is general information, not legal, tax, medical, or financial advice. Rules can change. For legal or tax questions, talk with a qualified professional in your state.
Official sources used
- Michigan Department of Health and Human Services: MI Choice Waiver Program
- Michigan Department of Health and Human Services: MI Choice Waiver Program documents and provider information
- Michigan Department of Health and Human Services: Independent Living (Home Help)
- Michigan Department of Health and Human Services: Home Help Individual Caregivers
- Michigan Department of Health and Human Services: Program of All-Inclusive Care for the Elderly (PACE)
- Michigan Department of Health and Human Services: MI Coordinated Health
- Michigan Department of Health and Human Services: Long Term Services and Supports and MI Options
- Michigan Department of Health and Human Services: Apply for Healthcare Assistance
- Michigan Office of Administrative Hearings and Rules for MDHHS: Medicaid hearings and forms
- Michigan Department of Health and Human Services: Habilitation Supports Waiver
- Michigan Department of Health and Human Services: Children’s Waiver Program
- Michigan Department of Health and Human Services: Children with Serious Emotional Disturbances Waiver
- Medicaid.gov: Home and Community-Based Services 1915(c)
