Michigan Medicaid home care
Last checked: May 18, 2026
Michigan Medicaid may help pay for care at home when a person needs hands-on help with daily tasks, has Medicaid, and meets program rules. The first programs to check are Home Help, MI Choice Waiver, and PACE if it serves your area.
Home Help is often the first call for personal care at home. MI Choice and PACE may help when the person needs a higher level of care, such as services that can help avoid or delay nursing home care.
Quick answer
Michigan Medicaid home care is not one single program. It can mean Home Help personal care, MI Choice Waiver home and community services, PACE, Medicaid health plan transportation, or local aging services.
For many families, the first step is to call the local Michigan Department of Health and Human Services office and ask for the Adult Services unit and the Home Help program. If the person may need nursing home level care, also ask the local Area Agency on Aging, MI Options, or the local MI Choice Waiver Agency about MI Choice and PACE.
Michigan warning: confirm the route before you rely on it
Rules can change. Counties, managed care plans, waiver contractors, PACE programs, and agencies may use different names for intake, screening, and care planning. Always confirm the current rule with MDHHS, the Medicaid health plan, the MI Choice Waiver Agency, the PACE program, or the local Area Agency on Aging.
Main Michigan routes to check
| Program or route | Who it may help | Where to start |
|---|---|---|
| Home Help | Michigan Medicaid members who need hands-on help with activities of daily living, such as bathing, dressing, eating, moving, transferring, grooming, or toileting. | Local MDHHS office. Ask for the Adult Services unit and Home Help. |
| MI Choice Waiver | Adults who meet Medicaid financial rules and need services like those provided in a nursing facility, but can receive care in a home or certain community settings. | Local MI Choice Waiver Agency, Area Agency on Aging, or MI Options. |
| PACE | People age 55 or older who live in a PACE service area, meet the required level of care, and can live safely in the community with PACE support. | Nearest Michigan PACE organization or MDHHS PACE information page. |
| Medicaid health plan transportation | Medicaid members who need rides to Medicaid-covered health care visits and have no other ride. | The Medicaid health plan member services line or MDHHS transportation information. |
| Area Agency on Aging services | Older adults and caregivers who need meals, caregiver support, respite, adult day services, or local referrals. Some services are not Medicaid. | Local Area Agency on Aging or MI Options. |
What Medicaid home care may cover in Michigan
Medicaid home care means help that lets a person receive care at home or in a community setting instead of going without needed support. In Michigan, coverage depends on the program.
Some services are part of regular Medicaid. These are often called state plan services. Home Help is the main personal care route for many Michigan Medicaid members living at home.
Other services may come through a waiver. A waiver lets the state pay for home and community-based services for people who meet higher care needs. To learn the basic idea, see Medicaid HCBS waivers explained.
Some services may come through a managed care plan or a special program, such as PACE. A managed care plan is an insurance-style plan that manages Medicaid benefits for many members.
Personal care
Personal care can include hands-on help with bathing, dressing, grooming, eating, moving through the home, transferring from one position to another, and using the toilet. In Michigan, Home Help is the main program to ask about for this kind of help.
Homemaker help
Homemaker help may include light housework, laundry, shopping for needed items, and meal preparation or clean-up. Home Help may cover some of these tasks if the person also needs hands-on help with at least one daily living task. Heavy housework, home repairs, yard work, and general supervision are not the same as covered Home Help tasks.
Meals
Home Help may help with meal preparation and clean-up when approved. MI Choice may include home-delivered meals when they are in the care plan. Area Agencies on Aging may also have meal programs, but those programs can have local rules, funding limits, and waitlists.
Transportation
Home Help does not cover regular transportation. Medicaid may cover non-emergency medical transportation for Medicaid-covered services. MI Choice and PACE may also include transportation when it is part of the approved plan.
Emergency response
A personal emergency response system is a device or service that lets a person call for help in an emergency. MI Choice and some other long-term care routes may include this when it is needed and approved.
Respite and adult day care
Respite gives a caregiver a break while the care recipient is watched or helped by another approved provider. Adult day health, sometimes called adult day care, may give the person care, activities, and supervision outside the home during the day. These services are more likely through MI Choice, PACE, or local aging services than through basic Home Help.
For more plain-English help, see respite care for caregivers.
Programs to check first
Home Help
Home Help is run by MDHHS. It pays for approved personal care services for Medicaid clients who need hands-on help with daily activities. The person must have active Medicaid, not just Medicare.
The person receiving care usually chooses the provider. The provider must be approved and enrolled through the state before payment can be made. Do not assume a family member can be paid until MDHHS confirms the rules and provider steps.
If your main question is caregiver pay, also read Can I get paid to be a caregiver? and try the paid caregiver quiz.
MI Choice Waiver
MI Choice is Michigan’s main Medicaid waiver for many adults who need nursing facility level services but want to stay in a home or community setting. It can include supports coordination plus services such as adult day health, chore services, community living supports, transportation, home-delivered meals, personal emergency response systems, nursing services, respite, and equipment.
MI Choice is not the same as regular personal care. It is for people with higher care needs. There may be screening steps, care planning, and possible waitlists or limited slots.
PACE
PACE stands for Program of All-Inclusive Care for the Elderly. In Michigan, PACE provides medical and social services mainly through an adult day health center, with added in-home and referral services when needed.
PACE can be a strong route when the person is at least 55, lives in a PACE service area, meets the care level rules, and can live safely in the community with PACE services. It is not available in every county or ZIP code.
Area Agency on Aging and MI Options
Michigan’s aging network can help older adults and caregivers find local services. This may include caregiver support, meals, adult day services, respite, in-home services, and long-term care options. Some services may be funded by Medicaid. Others may come from Older Americans Act or state aging funds.
Ask the Area Agency on Aging what is open now, what has a waitlist, and what backup choices exist.
Medicaid health plan services
Many Michigan Medicaid members are enrolled in a Medicaid health plan. The plan may handle some benefits, prior approvals, and rides to covered health care. If a service is denied by the plan, the plan notice should explain appeal steps.
Who may qualify
Each program has its own rules. In general, the person must live in Michigan, meet Medicaid financial rules for the program, and have a care need that fits the service.
For Home Help, the person must have active Medicaid and need hands-on help with at least one activity of daily living. Examples include bathing, dressing, eating, moving, transferring, grooming, or toileting. A medical professional must certify the need on the state form, and MDHHS must assess the person.
For MI Choice, the person must meet Medicaid rules and the medical or functional rules for nursing facility level of care. This means the person needs a level of help similar to care that could be provided in a nursing facility, even if they want services at home.
For PACE, the person generally must be 55 or older, live in a PACE service area, meet the required care level, and be able to live safely in the community with PACE support.
Income and assets can be a problem
If the person is over a Medicaid income or asset limit, do not give up after one “no.” Ask MDHHS if a deductible, patient-pay amount, special long-term care rule, or another Medicaid category may apply. Read more about Medicaid spend-down and the Medicaid look-back period.
How the assessment works
An assessment is a review of what the person can and cannot do safely. It should look at daily tasks, health problems, memory issues, falls, behavior, caregiver support, and the home setting.
For Home Help, an MDHHS adult services worker reviews the need for help. The worker looks at activities of daily living and other tasks. The care plan should match the approved tasks and time.
For MI Choice, the process may include a nurse and social worker. They review whether the person meets the care level and what services are needed. If approved, the care plan may include waiver services such as adult day health, respite, meals, emergency response, or community living supports.
For PACE, the PACE team assesses the person and builds a care plan. PACE may include center-based care, home care, medical care, transportation to the PACE center, prescriptions if approved by the team, and other supports.
Do not understate the need
A tired caregiver may say, “We manage.” That can hurt the assessment. Be clear about what happens on a bad day. Say if the person falls, forgets medicine, cannot bathe safely, soils clothing, leaves the stove on, wanders, refuses care, or cannot be left alone.
How to apply
Step 1: Apply for Medicaid if needed
Use MI Bridges to apply for health care coverage. If online filing does not work, ask MDHHS for the paper health care application. Keep copies of everything you submit.
Step 2: Ask for Home Help
Contact the local MDHHS office. Ask for the Adult Services unit. Ask how to submit the Adult Services Application and the Adult Services Medical Needs Certification form. The medical form is important because payment cannot start before the required certification and provider approval dates.
Step 3: Ask for MI Choice screening
Use the state MI Choice Waiver Agency list to find the agency for your area. Ask for intake or screening for MI Choice Waiver. If the person is older, the local Area Agency on Aging or MI Options may also help point you to the right route.
Step 4: Check PACE if the person is 55 or older
PACE is based on service area. If a PACE program serves the person’s home address, ask the PACE enrollment team about screening, care level rules, Medicaid, Medicare, and what costs may apply.
Phone script for MDHHS Home Help
“Hi, I care for a Michigan Medicaid member who needs hands-on help with bathing, dressing, toileting, meals, and light housework. I want to request Home Help. Can I speak with the Adult Services unit? What forms do we need, and how do we get the adult services assessment started?”
Phone script for MI Choice
“Hi, I am calling about MI Choice Waiver screening. My family member may need nursing home level care but wants to stay at home. Can you tell me the intake steps, waitlist status, and what documents you need?”
For more call help, use caregiver phone scripts.
Documents to gather before you call
- Medicaid card or Medicaid ID number, if the person has one.
- Medicare card and other insurance cards.
- Photo ID, Social Security number, birth date, and address.
- Proof of income, bank accounts, and assets.
- Rent, mortgage, utility, and medical bills if money is tight.
- Doctor names, phone numbers, diagnoses, and medication list.
- Hospital discharge papers, rehab notes, home health notes, or therapy notes.
- A daily care list that shows help with bathing, dressing, toileting, meals, walking, transfers, memory, and safety.
- Fall records, wandering notes, dementia concerns, pressure sore risks, or emergency room visits.
- Power of attorney, guardianship papers, or written permission to speak for the person if needed.
- Any denial, cut, or closure notice.
For a printable planning aid, see caregiver checklists.
What to do while waiting
Waiting is common. Do not wait in silence if the person is unsafe.
Ask what is open now
Ask the agency if there is a waitlist. If yes, ask what services are open now. Ask about meals, respite, adult day services, transportation, home safety items, caregiver support, and short-term help after a hospital stay.
Use the Medicaid health plan
If the person has a Medicaid health plan, call member services. Ask about non-emergency medical transportation, care management, home health after a doctor order, and any prior approval rules.
Check VA benefits if the person served
If the care recipient or spouse is a veteran, ask about VA care, Aid and Attendance, homemaker and home health aide services, respite, and adult day health care. Start with VA Aid and Attendance.
Track the real cost of care
Write down unpaid care hours, paid help, supplies, rides, missed work, and home changes. This helps with care planning and family talks. Use the care cost calculator.
Ask about tax records
Some care costs may matter at tax time. Tax rules are strict. Keep receipts and ask a tax professional. See caregiver tax deductions for a plain-English starting point.
If services are denied or cut
A denial is not always the end. It may mean the wrong program was requested, the form was missing, the assessment did not show the full need, or the person must use a plan appeal first.
1. Ask for the decision in writing
Do not rely on a phone-only “no.” Ask for the written notice. The notice should explain the reason, the rule used, and the appeal or hearing steps.
2. Check the deadline
Appeal deadlines can be short. Read the notice the same day you get it. If services are being cut, ask whether filing before the effective date can keep services in place during the appeal.
3. Fix missing proof
Get doctor notes, therapy notes, discharge papers, fall records, dementia notes, and a daily care log. Ask the doctor to describe the hands-on help needed, not just the diagnosis.
4. Use the right appeal path
If MDHHS made the decision, ask about an administrative hearing. If a Medicaid health plan, PACE program, or MI Choice Waiver Agency made the decision, you may have to use its internal appeal process before asking for a state fair hearing. Confirm this from the notice and the official Michigan hearing page.
Phone script after a denial
“I received a denial or reduction notice. I need to understand the reason, the deadline, and the appeal steps. Please tell me if this is an MDHHS hearing request, a plan appeal, a PACE appeal, or a MI Choice waiver appeal.”
If the first answer is no, ask: “What program should we try next?” Also ask whether the person should be screened for Home Help, MI Choice, PACE, Medicaid health plan care management, Area Agency on Aging services, or non-Medicaid respite.
Common problems that slow families down
- Applying for Medicaid but never asking for Home Help.
- Asking for “home care” without naming the program.
- Forgetting the medical needs certification form for Home Help.
- Saying the person is “fine” during the assessment.
- Not asking about MI Choice when the person needs a higher level of care.
- Assuming Home Help covers rides, supervision, or home repairs.
- Missing appeal deadlines because the notice was left unopened.
- Not keeping copies of forms, notices, and care logs.
FAQ
Does Michigan Medicaid pay for a family caregiver?
It may be possible through certain routes, but it is not automatic. Home Help lets the Medicaid client hire a provider, but the provider must meet state approval and enrollment rules. Ask MDHHS before assuming a spouse, adult child, or other relative can be paid.
Is Home Help the same as MI Choice?
No. Home Help is a Medicaid personal care program for people who need hands-on help with daily tasks. MI Choice is a Medicaid waiver for people who meet nursing facility level-of-care rules and need home and community services.
Does Home Help cover respite?
Home Help is mainly for approved personal care and related tasks. Respite is more likely through MI Choice, PACE, or local aging services. Ask the Area Agency on Aging and MI Choice Waiver Agency about current respite options.
Can Medicaid cover adult day care in Michigan?
It may, depending on the program. MI Choice lists adult day health as a waiver service. PACE also uses an adult day health center model. Local aging programs may offer adult day services outside Medicaid when funding is available.
Who should I call first?
If the person has Medicaid and needs help with bathing, dressing, toileting, or meals, call the local MDHHS office and ask for Adult Services and Home Help. If the person may need nursing home level care, also call the local MI Choice Waiver Agency, Area Agency on Aging, or MI Options.
What if my loved one has Medicare but not Medicaid?
Medicare alone usually does not pay for long-term personal care at home. Apply for Medicaid through MI Bridges if income and assets may fit. Also ask the Area Agency on Aging about non-Medicaid services while Medicaid is pending.
Resumen en espanol
En Michigan, Medicaid puede pagar algunos servicios en el hogar si la persona cumple las reglas del programa. Las primeras opciones para preguntar son Home Help, MI Choice Waiver y PACE si existe en su area.
Llame a la oficina local de MDHHS y pida hablar con Adult Services sobre Home Help. Si la persona necesita mucho cuidado, pregunte tambien por MI Choice, PACE, comidas, transporte, cuidado de dia para adultos y respiro para el cuidador.
Official sources used
- Michigan Department of Health and Human Services: Medicaid
- MDHHS: Apply for Healthcare Assistance
- MI Bridges
- MDHHS: Independent Living, Home Help
- MDHHS: Home Help Program
- MDHHS: DHS PUB 0815, Home Help Services
- MDHHS: Home Help Program Client Handbook
- MDHHS: Adults and Seniors Forms and Publications
- MDHHS: MI Choice Waiver Program and waiver agency information
- MDHHS: Program of All-Inclusive Care for the Elderly, PACE
- MDHHS: Aging Services
- MDHHS: Long Term Services and Supports and MI Options
- MDHHS: Non-Emergency Medical Transportation
- MDHHS: Medicaid Fair Hearings
- Medicaid.gov: Home and Community-Based Services 1915(c)
- CMS: Program of All-Inclusive Care for the Elderly
About this guide
This guide was written for caregivers who need a practical starting point for Michigan Medicaid home care. It is general information, not legal, tax, medical, or financial advice. For legal or tax questions, talk with a qualified professional in your state.
