Michigan Medicaid caregiver pay guide
Last checked: May 18, 2026
Michigan has Medicaid routes that may let a person choose who helps them at home. The main route for paid help with daily tasks is the Michigan Home Help program. Some MI Choice Waiver participants may also ask about self-determination, which can let them control more of their waiver services, budget, and workers.
Rules can change. Counties, waiver agencies, managed care plans, and provider offices may use different names. Always confirm the current rule with MDHHS, the local MDHHS Adult Services unit, the MI Choice waiver agency, or the person’s supports coordinator.
Quick answer
Yes, Michigan Medicaid may let some people hire a family caregiver, but the route matters. The clearest route is Michigan Home Help, a Medicaid-funded personal care program run by the Michigan Department of Health and Human Services (MDHHS).
Home Help lets the person choose an individual caregiver, an agency, or both. A spouse cannot be paid to care for a spouse through Home Help, and a parent cannot be paid to care for a minor child. An adult child may be able to be paid if the person receiving care has Medicaid, needs hands-on help, and the caregiver enrolls and is approved.
Start here
- Call the local MDHHS office and ask for the Adult Services unit. Say: “I want to apply for Home Help personal care services.”
- Ask what medical form is current. Michigan materials refer to an Adult Services Application and a medical needs form. Ask the Adult Services worker which form to use now.
- If the person may need nursing home level care, also ask about MI Choice. Say: “Can we be screened for the MI Choice Waiver, and can we ask about self-determination?”
Not sure which route fits? Start with Can I Get Paid to Be a Caregiver? or use the caregiver pay quiz.
Main Michigan programs and routes
| Program or route | Who it may help | Where to start | Family caregiver pay point |
|---|---|---|---|
| Home Help | Michigan Medicaid clients who need hands-on help with at least one activity of daily living, such as bathing, dressing, toileting, mobility, eating, grooming, or transferring. | Local MDHHS office. Ask for the Adult Services unit and Home Help. | The person can choose an individual caregiver. Some relatives may be allowed. Spouses and parents of minor children are not paid through Home Help. |
| MI Choice Waiver | Adults who meet Medicaid rules and need services like those provided in a nursing home, but can be served at home or in another community setting. | Local MI Choice waiver agency or local MDHHS office. Ask for MI Choice screening. | MI Choice includes a self-determination option. Ask the supports coordinator which workers can be hired for the approved waiver services. |
| PACE | Some adults age 55 or older who qualify for nursing home level care and live in a PACE service area. | PACE organization serving the person’s area, or MDHHS senior services information. | PACE is a full care model. Do not assume it lets you hire a family caregiver. Ask the PACE team before changing care. |
| Medicaid spend down or deductible route | People who have too much income for full Medicaid but may qualify after medical costs are counted. | Local MDHHS office and Adult Services worker. | Home Help may not pay until the monthly deductible is met. Ask about the Personal Care Option if care costs are high enough. |
Need more background on waivers? Read Medicaid HCBS waivers explained. If income is the issue, see Medicaid spend down. If assets or transfers may be an issue, read Medicaid look-back period.
What self-directed care means
Self-directed care means the person getting services has more say in who helps, when help happens, and how approved tasks are done.
In Michigan, the words may change by program. You may hear self-determination, participant direction, consumer direction, or individual caregiver. These words are close, but they are not always the same.
In Home Help, the person receiving care is treated as the employer of the caregiver. The person can choose, hire, and fire the caregiver. MDHHS decides what tasks and hours are approved after the assessment.
In MI Choice, self-determination can give the participant more control over waiver services. The participant may help control the budget, arrange services, and hire aides. The supports coordinator and waiver agency still have a role. The plan must fit Medicaid rules and the person-centered service plan.
Program name in Michigan
The main Michigan Medicaid program to ask about first is Home Help.
Home Help pays for personal care services for people who have active Medicaid and need hands-on help with daily activities. Medicare alone does not pay for Home Help.
Home Help can cover help with activities of daily living. These are basic body care tasks. Examples include bathing, dressing, eating, grooming, mobility, toileting, and transferring. If the person qualifies for help with at least one of these tasks, they may also be able to get help with some household tasks, such as meal preparation, laundry, light housework, shopping, and taking medicine.
The second program to know is MI Choice Waiver. MI Choice is for adults who need a nursing facility level of care but want services at home or in a community setting. MI Choice has a self-determination option, but the public rules for family hiring can be harder to read. Ask the waiver agency or supports coordinator to explain the rule for the exact service you want to self-direct.
Do not mix up Home Help, MI Choice, and PACE. They may all help with long-term care, but they have different entry points and rules.
Who to call first in Michigan
If the person needs help with bathing, dressing, toileting, mobility, eating, or similar care: call the local MDHHS office and ask for the Adult Services unit. Ask for Home Help.
If the person may need nursing home level care but wants to stay at home: ask about MI Choice Waiver screening. You can also ask your local Area Agency on Aging or local MI Choice waiver agency where to apply.
If the person is 55 or older and wants a full care team model: ask whether PACE serves the person’s area. PACE may be useful for some families, but it is not the same as hiring your own family caregiver.
If the person does not have Medicaid: apply through MI Bridges or ask the local MDHHS office for a paper application.
What to say on the phone
Use this short script when you call MDHHS:
“Hello. I am calling about Home Help for a family member. They need hands-on help at home with daily care. Can I speak with the Adult Services unit? I want to make a referral for Home Help and ask what forms we need.”
If you are asking about MI Choice, say:
“My family member may need nursing home level care, but we want to keep care at home if possible. Can we be screened for the MI Choice Waiver? Also, can we ask about self-determination and whether a family caregiver can be hired?”
For more scripts, see caregiver phone scripts.
Who can be hired
For Home Help, the person can choose an individual caregiver, an agency provider, or both. The caregiver must meet Michigan’s rules.
A Home Help individual caregiver generally must:
- be at least 18 years old;
- be able to do the approved care tasks;
- be willing to follow Home Help rules;
- take part in training if needed;
- enroll in CHAMPS, Michigan’s Medicaid provider system;
- pass the required criminal history screening before payment can be made;
- submit service verification so payment can be issued.
Home Help does not pay some people. Michigan materials say Home Help does not pay a responsible relative. This means a spouse caring for a spouse, or a parent caring for a minor child. It also does not pay a minor age 17 or younger. A fiscal intermediary is not a direct hands-on care worker.
An adult child may be able to be paid to care for a parent through Home Help if all program rules are met. The adult child still has to enroll and be approved. Being family does not skip the paperwork.
If the person has a guardian, ask the Adult Services worker before assuming the guardian can be paid. Michigan policy has special limits when a guardian has a permissive exclusion. The safest step is to ask the Adult Services worker to review the exact case.
Spouse and adult child rules
Can a spouse be paid?
For Michigan Home Help, the answer is no. A spouse cannot be paid to care for a spouse through Home Help. Michigan’s Home Help handbook also says a spouse cannot be paid as an individual caregiver or as an employee of an agency for that spouse’s care.
If the spouse cannot provide care because of health, work, school, or another reason, ask the Adult Services worker what other caregiver options may be used. Another person may be able to provide the care if approved.
Can an adult child be paid?
Yes, an adult child may be able to be paid to care for a parent through Home Help. The adult child must be at least 18, enroll in CHAMPS, pass screening, and be approved before payment can be made.
Taxes may be handled differently for some family relationships. Ask MDHHS or a tax professional how the caregiver’s W-2, FICA, and household employment issues apply.
Can a parent be paid for a child?
A parent cannot be paid through Home Help to care for a minor child. Michigan’s Home Help FAQ says that when the child turns 18, the parent may be able to be the caregiver if all other rules are met.
Can a live-in relative be paid?
Living in the same home does not, by itself, answer the question. The relationship and program rules matter. A spouse is still not paid through Home Help. A parent of a minor child is still not paid through Home Help.
Michigan’s current Home Help EVV information says services provided to clients who live with their caregiver may be exempt from electronic visit verification. That does not remove the need to use Home Help service verification. It also does not remove the need for CHAMPS enrollment and approval.
What about MI Choice self-determination?
MI Choice self-determination rules should be confirmed with the waiver agency. Ask the supports coordinator these exact questions:
- “Can an adult child be hired for this service?”
- “Can a spouse be hired for this service?”
- “Can a live-in relative be hired?”
- “Can a guardian or legal representative be paid?”
- “Which provider qualifications, background checks, and training apply?”
- “Will a fiscal intermediary handle payroll?”
If the answer is no, ask for the rule in writing and ask what other care options can be added to the plan.
Payroll and timesheets
Home Help and MI Choice handle payment in different ways.
Home Help payment basics
Home Help caregivers must enroll in CHAMPS and be approved by MDHHS. Enrollment starts the criminal history screening. Payment is only made to a caregiver who is enrolled and approved to provide services for the person.
Michigan says a caregiver is not fully enrolled until they receive a seven-digit provider ID number. If the caregiver starts helping before approval, payment may be delayed or denied.
Home Help services must be verified before payment. Individual caregivers use Electronic Service Verification, also called ESV, or a paper service verification if allowed. Michigan also has Electronic Visit Verification, called EVV, for many Home Help caregivers. Some live-in or other exempt services may not need EVV, but current service verification is still required.
Service verification must match the approved tasks and dates. If the caregiver forgets to submit it, uses the wrong date, misses the deadline, or bills for tasks not approved, payment problems can happen.
Checks, taxes, and W-2s
Michigan Home Help materials describe dual-party checks in many cases. That means the check may be made out to both the person receiving care and the caregiver. The person receiving care signs the back and gives it to the caregiver. Some payments may be single-party checks to the caregiver.
MDHHS may withhold and send FICA taxes for Home Help payments. MDHHS may issue a W-2 to the caregiver on the client’s behalf. This can affect taxes, Social Security credits, and household income. For tax questions, see caregiver tax deductions and speak with a tax professional.
MI Choice fiscal intermediary basics
In MI Choice self-determination, a fiscal intermediary may help with the money side. This can include payroll, tax withholding, unemployment items, accounting, tracking the individual budget, checking worker qualifications, and helping with billing records.
The fiscal intermediary is not the direct care worker. It is a support for the participant’s self-determination arrangement.
Documents to gather before you apply
Try to collect these before the first call:
- Medicaid card or Medicaid case number, if the person already has Medicaid;
- Medicare card, if the person has Medicare;
- photo ID and Social Security number;
- proof of address;
- guardian, power of attorney, or patient advocate paperwork, if any;
- doctor, nurse practitioner, physician assistant, occupational therapist, or physical therapist contact information;
- a list of daily tasks the person cannot do alone;
- hospital, rehab, nursing home, or home health discharge papers, if recent;
- current medicines and diagnoses;
- name, address, phone, and email for the caregiver you want to hire;
- caregiver ID, Social Security number, and bank or mailing details the provider enrollment process may ask for;
- any denial letters, closure letters, or reduction notices.
Michigan materials list an Adult Services Application and a medical needs form for Home Help. Because forms can change, ask the Adult Services unit which form names and versions to use before you submit paperwork.
Use caregiver checklists to keep documents together.
How to switch from agency care
If the person already gets agency care, do not cancel it before the new plan is ready. A gap in care can leave the person without help.
For Home Help, call the Adult Services worker and say:
“We want to switch some or all Home Help hours from an agency provider to an individual caregiver. What steps do we need to take before the caregiver can be paid?”
Ask these questions:
- Does the care plan need to be changed?
- Does the caregiver need to finish CHAMPS enrollment first?
- When can the caregiver start billing?
- Will the agency keep some hours during the change?
- Who verifies the last agency service date?
- How do we avoid duplicate billing?
For MI Choice, talk to the supports coordinator. Ask for a person-centered planning meeting if the worker, schedule, or self-determination setup needs to change. Ask whether a fiscal intermediary must be added before a family worker can start.
If the caregiver needs breaks, ask about respite care. If you are trying to compare home care and facility care costs, use the care cost calculator.
What to do if the first answer is no
A phone answer is not always the final answer. Ask for the reason and the rule.
- Ask for the denial or decision in writing. This matters for appeal deadlines.
- Ask what part was denied. Was it Medicaid, Home Help, the number of hours, the caregiver, CHAMPS enrollment, or MI Choice slot availability?
- Ask for a supervisor or supports coordinator review. Be polite and specific.
- Ask what option is still open. This may be another caregiver, agency care, respite, MI Choice, PACE, a spend down route, or a new medical form.
- Watch the deadline. Home Help materials say a hearing request must be made within 90 calendar days of the action taken.
If the person is a veteran or surviving spouse, also check VA Aid and Attendance. VA programs are separate from Medicaid, but they may help some families.
Common problems
The caregiver helped before approval
Home Help payment is tied to approval, enrollment, and service verification. A caregiver who starts before CHAMPS approval may not be paid for that time. Ask the Adult Services worker when paid care can start.
The spouse wants to be paid
Home Help does not pay a spouse to care for a spouse. Ask whether another caregiver can be hired, or whether agency care, MI Choice, PACE, or respite could help.
The adult child is helping but not enrolled
An adult child still has to enroll and be approved. Ask for CHAMPS instructions. If internet access is a problem, ask the Adult Services worker how the caregiver can get help.
The hours are too low
Ask how the hours were calculated. Give clear examples of the hands-on help needed. If needs changed, ask for a reassessment. If you disagree with a written decision, ask about hearing rights.
Service verification was late or wrong
Ask Provider Support Services or the Adult Services worker how to correct the billing issue. Keep copies of service dates, tasks, and any ESV or paper submissions.
The person has a Medicaid deductible
Home Help may not pay until the monthly deductible is met. Ask the Adult Services worker about the Personal Care Option. Read Medicaid spend down before you decide how to handle medical bills.
The person is in the hospital, nursing home, rehab, adult foster care, or home for the aged
Home Help is for care at home. Payment rules can change when the person is admitted to a facility. Tell the Adult Services worker about admissions, discharges, and address changes right away.
Important Michigan warning
Rules can change. Michigan counties, waiver agencies, managed care plans, PACE organizations, and provider offices may use different names for the same service. They may also have local steps for screening, forms, enrollment, payroll, EVV, or service verification.
Before relying on any rule, ask the official office to confirm it for the person’s county, Medicaid status, living setting, relationship to the caregiver, and care plan.
FAQ
Is Home Help the same as Medicare home health?
No. Home Help is a Michigan Medicaid-funded personal care program. Medicare home health is different and usually covers short-term skilled care after a medical need.
Can I be paid if I already live with my parent?
Maybe. If you are an adult child, living together does not automatically block Home Help. But you still need approval, CHAMPS enrollment, screening, and service verification. Spouses and parents of minor children are different.
Can a spouse ever be paid through Michigan Home Help?
No. Michigan Home Help materials say a spouse cannot be paid to care for a spouse.
Can a family caregiver choose the hours?
No. The approved tasks and hours come from the program assessment and care plan. The caregiver can only bill for approved services actually provided.
Can Home Help pay for transportation to medical appointments?
Michigan’s Home Help FAQ says Home Help does not pay for transportation to medical appointments. Ask the Medicaid health plan or local MDHHS office about medical transportation.
Does MI Choice have self-direction?
Yes. Michigan calls the MI Choice option self-determination. Ask the supports coordinator how it works and which services can be directed.
What if my loved one is not on Medicaid yet?
Apply through MI Bridges or ask the local MDHHS office for a paper application. Home Help requires active Medicaid. MI Choice also has Medicaid rules.
Resumen en espanol
Michigan tiene un programa de Medicaid llamado Home Help que puede pagar ayuda en el hogar para personas que necesitan ayuda practica con actividades diarias. La persona puede escoger un cuidador individual, una agencia, o ambos.
Un esposo o esposa no puede recibir pago por cuidar a su esposo o esposa por Home Help. Un hijo adulto puede ser posible si cumple las reglas, se inscribe en CHAMPS, pasa la revision requerida y es aprobado.
Llame a la oficina local de MDHHS y pida hablar con Adult Services sobre Home Help. Si la persona necesita un nivel de cuidado parecido al de un asilo de ancianos, pregunte tambien sobre MI Choice y self-determination.
About this guide
This guide was written for family caregivers who need to know where to start in Michigan. It focuses on Medicaid self-directed care, Home Help, MI Choice, family caregiver pay, paperwork, payroll, and what to ask when a rule is not clear.
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.
Official sources used
- Michigan Department of Health and Human Services, Home Help: https://www.michigan.gov/mdhhs/doing-business/providers/providers/other/homehelp
- Michigan Department of Health and Human Services, Independent Living Services (Home Help): https://www.michigan.gov/mdhhs/adult-child-serv/adults-and-seniors/independent
- Michigan Department of Health and Human Services, Home Help Program Client Handbook, MDHHS-Pub-1733: https://www.michigan.gov/mdhhs/-/media/Project/Websites/mdhhs/Adult-and-Childrens-Services/Adults-and-Seniors/Forms-and-Publications/MDHHS-Pub-1733.pdf
- Michigan Department of Health and Human Services, Adult Services Manual ASM 135, Home Help Caregivers: https://mdhhs-pres-prod.michigan.gov/olmweb/EX/AS/Public/ASM/135.pdf
- Michigan Department of Health and Human Services, Individual Caregivers and EVV information: https://www.michigan.gov/mdhhs/doing-business/providers/providers/other/homehelp/individual-providers/individual-caregivers
- Michigan Department of Health and Human Services, CHAMPS Instructions and Information: https://www.michigan.gov/mdhhs/doing-business/providers/providers/other/homehelp/individual-providers/champs-instructions-information
- Michigan Department of Health and Human Services, Home Help Individual Provider Checklist: https://www.michigan.gov/mdhhs/-/media/Project/Websites/mdhhs/Medicaid-Provider-Assets/Home-Help-Assets/Home-Help-Individual-New-Provider-Checklist.pdf
- Michigan Department of Health and Human Services, MI Choice Waiver Program: https://www.michigan.gov/mdhhs/assistance-programs/healthcare/seniors/michoicewaiver/mi-choice-waiver-program-use
- Michigan Department of Health and Human Services, MI Choice Participant Handbook: https://www.michigan.gov/mdhhs/-/media/Project/Websites/mdhhs/Assistance-Programs/Medicaid-BPHASA/Other-Prov-Specific-Page-Docs/MI-Choice-Participant-Handbook—DCH-1433-2-2023-Final.pdf
- Michigan Department of Health and Human Services, Self-Determination in Long Term Care Guidelines: https://www.michigan.gov/mdhhs/-/media/Project/Websites/mdhhs/Folder4/Folder37/Folder337/Self-Determination_Guidelines.pdf
- Michigan Department of Health and Human Services, MI Bridges: https://newmibridges.michigan.gov/
- Michigan Department of Health and Human Services, Medicaid Health Care Programs Eligibility: https://www.michigan.gov/mdhhs/assistance-programs/medicaid/health-care-programs-eligibility
- Michigan Department of Health and Human Services, Program of All-Inclusive Care for the Elderly (PACE): https://www.michigan.gov/mdhhs/assistance-programs/healthcare/seniors/program-of-all-inclusive-care-for-the-elderly-pace
