Medicaid for Michigan Residents Needing Assisted Living or Home Health Care

Page 2 of 2 of When Medicaid Will Pay for Long-Term Care in Michigan

By , Attorney New York University School of Law

Michigan's Medicaid program will pay for certain types of long-term care for elderly or disabled individuals. For example, Michigan has programs that offer payment for home health care services and nursing home costs, but Michigan does not offer Medicaid payments for most of the costs of an assisted living facility. (Read the first part of this article on Medicaid income and asset limits in Michigan and when a nursing home is a medical necessity.)

Medicaid Coverage of Home Health Services in Michigan

If you receive Medicaid, the program will pay for some limited home care services such as skilled nursing care or therapy services. For Medicaid to pay for home health services, they must be prescribed by your doctor as part of a plan of care for a particular problem, and the services must be directed at curing or rehabilitating you.

If you need ongoing home health services to help you perform activities of daily living or manage your medications, Medicaid will not cover that type of help unless you qualify for Michigan's Medicaid Waiver program, called MI Choice. To qualify for MI Choice, you must have income at or below 300% of the monthly SSI Federal Benefit Rate, or $2,313 in 2019. You also must have less than $2,000 in assets. (If you're married, Medicaid allows your spouse to keep more income and assets.)

To receive MI Choice, you must also show that you would have to live in a nursing home if you did not receive MI Choice waiver services. You also have to show that you can live safely at home with the services. If you do qualify for MI Choice, you can receive assistance through a wide variety of services, including nursing services, respite services, adult day health services, transportation, chore services, home-delivered meals, and changes to make your home more accessible.

To apply for MI Choice, contact the waiver agency in your region.

Michigan's Home Help Services Program

Michigan also operates a program called Home Help Services for seniors who need extra assistance to stay in their own homes. In Home Help Services, you hire your own provider to help you with tasks of daily living that you need assistance with, like bathing, eating, getting around inside your home, light housework and laundry, and some shopping. Medicaid pays the cost of your provider.

To qualify, you must meet Medicaid's income and asset requirements, and your doctor must submit a form saying that you need help in your home. Then an assessor from the Michigan Department of Health & Human Services will visit you and evaluate how much assistance you need with activities around your house. Medicaid will tell you how many hours of assistance it will pay for in a month.

To apply for Home Help Services, contact your local office of the Department of Health & Human Services.

Assisted Living Facilities in Michigan

If you are enrolled in Medicaid or MI Choice (see above), your regular benefits will cover some of your expenses while you live in an assisted living facility, like physical therapy or prescription costs. However, Michigan does not have a Medicaid program that will pay for room and board in an assisted living facility.

Michigan's PACE Program

Michigan operates a Program of All-Inclusive Care for the Elderly (PACE). To qualify for PACE, you must be 55 or older and live in an area served by a PACE provider. You must also require a nursing home level of care, and you must be able to live safely in the community with PACE services. You can see a list of Michigan's 18 PACE centers here.

PACE participants receive their services from an interdisciplinary team of professionals like physicians, nurses, and social workers, whose role is to coordinate individualized care and services to keep seniors in their own homes and communities. Medicaid pays for all the services offered in the PACE program. If you are interested in a PACE program, apply directly to the one you are interested in, and the program will help determine your eligibility.

Supportive Services for Michiganders Who Do Not Qualify for Medicaid

If you don't qualify for Medicaid and do not meet the nursing home level of care, you may still qualify for some personal assistance services if you are physically disabled and need help with activities of daily living like eating, dressing, or bathing. Michigan's Area Agencies on Aging administers a supportive program. Contact your local AAA to apply.

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