Long-term nursing home care in Michigan doesn't come cheap. In 2024, the average daily cost of a private room in a nursing home in Michigan was $348—more than $10,500 per month. For people with few assets, including those who have already used up all of their own assets to pay for care, Medicaid is a common source of funding for long-term care.
People with too many assets often have to pay for their own care outright because private health insurance policies generally don't cover long-term care, and few people purchase private long-term care insurance policies. Also, Medicare covers nursing home care only for a short time after a hospital stay.
Michigan's Medicaid program, often called Medicaid Assistance (MA), has specific eligibility rules for long-term care services like nursing homes, which we'll cover in this article.
Michiganders who are 65 or older, disabled, or blind can qualify for Medicaid if they meet the program's income and asset limits. People who receive SSI automatically qualify for Medicaid in Michigan.
If you're not receiving SSI, your income must be less than the federal poverty level (plus $20) to qualify for "AD Care" (Medicaid for aged and disabled persons). In 2025, the FPL is $1,304 per month for individuals and $1,763 for married couples (whether or not your spouse is applying for Medicaid).
However, the income limit to qualify for a Medicaid-paid nursing home in Michigan differs from the limit for regular AD Medicaid. You can meet the income limit for Medicaid for long-term services and support (LTSS)—including nursing home care—with a monthly income as high as 300% of the SSI benefit amount for an individual (that's $2,901 per month in 2025).
But if you qualify for Medicaid and live in a nursing home, you'll be expected to spend almost all your income on your care. Michigan allows nursing home residents receiving Medicaid to keep only $60 per month as a personal needs allowance.
If your income is above this limit, you still might qualify for Medicaid if your medical expenses are higher than the amount of extra income you have. In Michigan, people who are 65 or older, blind, or disabled can use their monthly medical bills to "spend down" their income and qualify for Medicaid.
To qualify for Medicaid in Michigan, you must meet the program's resource limit. Resources are assets like money and property.
Until recently, Michigan used the SSI resource limits ($2,000 for individuals and $3,000 for couples) for regular (AD) Medicaid and nursing home Medicaid. But MDHHS has significantly increased these asset limits to match the limits of the Medicare Savings Program (MSP)—$9,660 for singles and $14,470 for couples (as of February 1, 2025).
Some property doesn't count toward the limit. For example, Michigan exempts one car plus your personal belongings and household goods.
Your primary residence is also an exempt resource. But, if you need Medicaid for long-term care, then you can't have more than $730,000 in equity in your home in 2025. Any equity over that limit counts as an asset in Michigan.
Michigan's Medicaid program also counts retirement accounts (including IRAs and Keogh plans) as assets.
For nursing home Medicaid in Michigan, your spouse's income won't affect your eligibility. The state disregards your spouse's income entirely and, in some cases, your spouse can keep some of your income when you go into a nursing home.
The federal spousal impoverishment rule protects spouses who continue to live independently when the other spouse receives nursing home Medicaid. This means that a spouse who has a low income is entitled to some of the resources of the spouse who enters a nursing home, and those resources won't count toward Medicaid eligibility.
The amount of monthly income your spouse can keep will depend on your spouse's separate income and monthly expenses. In 2025, your spouse can keep enough of your income to have a monthly income of $2,555 to $3,948. If your spouse needs more than Michigan's Department of Health & Human Services (DHHS) decides to allow, you can go to court and ask a judge to order more.
Your spouse can also keep up to half of your combined assets, up to a maximum of $157,920. If half of your joint assets falls below $31,584, your spouse can keep up to $31,584 in assets. That's called the minimum "Protected Spouse Amount" (PSA) or "Community Spouse Resource Allowance" (CSRA). When you apply for Medicaid, your PSA is subtracted from your countable assets.
When you're admitted to a nursing home, you'll complete a form called an "Assets Declaration," and the staff will ask you about all of your assets in an "Initial Asset Assessment" (IAA). Michigan assumes that half of your assets belong to your spouse, subject to a limit that changes annually.
Medicaid will pay for a nursing home only when it's medically necessary. You must show that you require a "nursing home level of care," meaning that you have a physical or mental condition that requires nursing supervision and assistance with activities of daily living (ADLs).
Before you're admitted to the nursing home, Medicaid requires that you have a "Level of Care" (LOC) determination. In Michigan, nursing facility staff perform the LOC determination using an online state system.
To determine the level of care you need, nursing facility staff will ask you questions to determine how much assistance you need with your ADLs. The ADLs that Michigan uses to determine whether you meet the nursing home level of care are:
For each, the assessor will decide how much assistance you need and assign you one of the following functional levels:
For example, if you usually can't get up from a chair without someone helping you, then the assessor might say that you need limited assistance with transfers. The assessor will also evaluate your short-term memory and how well you can make yourself understood.
When assigning a functional level, the assessor will look at your activities in the last seven days. The assessor will also look at whether you need skilled nursing services to treat a medical condition or need physical therapy or other therapy services.
Medicaid uses the information in your screening to decide whether you need a nursing home and, if so, what kind of nursing home is appropriate for you. In general, for a nursing home to be considered medically necessary, you must have a medical condition that is so serious that you need the level of nursing care that is only available in an institution.
To apply for Medicaid in Michigan, contact your local office of the Michigan Department of Health & Human Services. You can also apply for benefits online. If you qualify for Medicaid and have unpaid bills for medical expenses from the three months before you applied for Medicaid, you might be eligible for retroactive benefits that could pay those bills. But you'll need to submit a separate application for retroactive benefits (Form DHS3243) and show proof of the bills.
To learn about applying for Medicaid for assisted living or home health care, read our article on when Michigan Medicaid covers assisted living facilities and home care.
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