Medicaid Long-Term Care Guide in Michigan
Long-term care eligibility, benefits, and how to apply through the Michigan Department of Human Services.
What makes Michigan Medicaid different
In Michigan, Medicaid is often called Medical Assistance (MA). While jointly funded by the state and federal government, it is administered by the state under federally set parameters. In addition to care services in nursing homes, assisted living facilities, and adult foster care homes, MI Medicaid pays for non-medical services and supports to help frail seniors remain living in their homes.
Administered by the Michigan Department of Human Services.
Program Types
Institutional / Nursing Home Medicaid
An entitlement; anyone who is eligible will receive assistance. Benefits are provided in Medicaid-certified nursing homes.
Level of care: Nursing Facility
Medicaid Waivers / Home and Community Based Services
Not an entitlement; there are a limited number of participants and waiting lists may exist. Benefits are intended to delay nursing home admissions and may be provided at home, adult day care, adult foster care, or in assisted living.
Level of care: Nursing Facility
Regular Medicaid / Aged and Disabled (AD Care)
An entitlement; meeting the eligibility requirements ensures one will receive assistance. While Regular Medicaid is not Long-Term Care Medicaid, some long-term care services, such as personal care assistance or adult day care, may be available.
Level of care: Help with ADLs
2026 Michigan Medicaid Long-Term Care Eligibility for Seniors
Institutional / Nursing Home Medicaid*
Medicaid Waivers / Home and Community Based Services†
Regular Medicaid / Aged and Disabled (AD Care)‡
*All of a beneficiary's monthly income, with the exception of a Personal Needs Allowance of $60.00 / month, Medicare premiums, and possibly a Needs Allowance for a non-applicant spouse, must go towards nursing home costs. This is called a Patient Liability.
†Based on one's living setting, one may not be able to keep monthly income up to this level.
‡Another pathway to Medicaid eligibility is through SSI. In Michigan, persons eligible for SSI are automatically approved for Regular Medicaid, including long-term services and supports given functional criteria are met.
Explore Michigan Medicaid Programs
Compare programs, see caregiver pay rates, get step-by-step application guidance, and check your eligibility — all specific to Michigan.
Long-term care Medicaid guide
Eligibility · Caregiver pay · How to apply · 2026 data
Important: Rates vary — contact your state Medicaid office for current figures. This tool provides general guidance, not legal or financial advice.
Compare Medicaid Programs — Michigan
How the main LTC programs available in Michigan compare side by side.
| Program | Pay | Pay type | Tax-free? | Spouse OK? | Waitlist? |
|---|---|---|---|---|---|
| Consumer-directed HCBS | $15–18/hr | Hourly wage | No | Usually no | Often |
| Structured Family Caregiving (SFC) | Not in Michigan | Daily stipend | Yes | Usually no | Often |
| Personal Care Agreement | Market rate (from assets) | Private pay | No | Yes | No |
| VA Aid & Attendance | Up to $2,874/mo | Monthly pension | Yes | Yes | No |
Michigan Medicaid programs
MI Choice Waiver
Aidaly (via Meridian/Molina plans)
Sources: KFF (Jan 2026), medicaidplanningassistance.org (Feb 2026). Programs and rates change — verify with your state Medicaid office.
How Family Caregivers Get Paid Through Medicaid in Michigan
If you're a family member providing care, you may be able to get paid through Medicaid — often at rates comparable to a home care agency.
Consumer-directed care — hourly pay
Available in MichiganHow it works: The person receiving care becomes the "employer" — they hire you and a fiscal intermediary handles payroll, taxes, and paperwork on their behalf. You receive a paycheck just like a regular job.
How to apply: MDHHS · michigan.gov/mdhhs
Personal Care Agreement — private pay from assets
Available to any familySources: KFF Medicaid Home Care Survey 2025 (Jan 2026), Careforth FAQ (Jan 2026), IRS Notice 2014-7.
How to Apply for Medicaid Long-Term Care in Michigan
What to expect when applying for LTC Medicaid and getting family caregiver pay set up in Michigan. The process typically takes 45–90 days from application to first paycheck.
Apply in Michigan: MDHHS · michigan.gov/mdhhs
Medicaid Eligibility Screener — Michigan
Answer 7 quick questions — we'll check the financial and care requirements for Michigan and explain what each one means.
What is the marital status of the person who needs care?
Medicaid looks at only the applicant's income and assets — but being married triggers special protections that let the healthy spouse keep significantly more money.
Sources
- CMS Medicaid — eligibility, HCBS waivers, and long-term services medicaid.gov/medicaid/eligibility
- CMS Medicaid — Home & Community-Based Services (HCBS) medicaid.gov/medicaid/home-community-based-services
- Social Security Administration — SSI Federal Benefit Rate (2026 figures) ssa.gov/oact/cola/SSI.html
- CMS — Spousal Impoverishment standards (CSRA & MMMNA) medicaid.gov/medicaid/eligibility/spousal-impoverishment
- CMS — Estate Recovery and the 5-year lookback period medicaid.gov/medicaid/eligibility/estate-recovery
- IRS Notice 2014-7 — Tax treatment of Medicaid caregiver payments irs.gov/individuals/certain-medicaid-waiver-payments-may-be-excludable-from-income
Educational guidance only — not legal or financial advice. Your state Medicaid office determines actual eligibility.
Key Rules at a Glance
- Nearly any income from any source is counted, including employment wages, alimony, pension payments, SSDI, SSI, IRA withdrawals, and stock dividends.
- Nationally, Holocaust restitution payments are not counted as income.
- In MI, the VA Aid & Attendance and Housebound Pensions, which are above and beyond the Basic VA Pension, do not count.
- When only one spouse applies for Nursing Home Medicaid or a Waiver, only the applicant's income is counted.
- The MMMNA is $2,643.75 (eff. 7/1/25 – 6/30/26). If a non-applicant's income falls under this amount, income can be transferred from the applicant spouse.
- A non-applicant spouse can increase their Spousal Income Allowance if housing/utility costs exceed a shelter standard of $793.13 / month (eff. 7/1/25 – 6/30/26), up to a Maximum MMMNA of $4,066.50 / month.
- For Regular Medicaid, both spouses' income is counted. There is no MMMNA for a non-applicant spouse.
- SSI recipients are automatically approved for Regular Medicaid in Michigan.
- Countable assets include cash, stocks, bonds, investments, cryptocurrency, bank accounts (money market, savings, checking), and real estate in which one does not reside.
- In Michigan, IRAs are counted as assets.
- Non-countable (exempt) assets include personal belongings, household furnishings, an automobile, and generally one's primary home.
- Michigan's asset limit is $9,950 for an individual — significantly higher than most states.
- All assets of a married couple are considered jointly owned regardless of the Medicaid program.
- The CSRA allows the non-applicant spouse to retain 50% of the couple's assets, up to $162,660 (2026). If the non-applicant's share is under $32,532, up to $32,532 can be retained.
- There is no CSRA for Regular Medicaid.
- The home is automatically exempt if the applicant's spouse, child under 21, or permanently blind or disabled child (of any age) lives in it.
- If this is not the case, there is a home equity interest limit of $730,000 (in 2026).
- Home equity is the value of the home minus any outstanding debt. Equity interest is the amount of equity owned by the applicant.
- If neither the applicant nor qualifying family live in the home, the applicant must have Intent to Return.
- There is no home equity interest limit for Regular Medicaid.
- The home is NOT exempt from Medicaid's Estate Recovery Program. After a beneficiary's death, Michigan's Medicaid agency attempts reimbursement of care costs through the deceased's estate.
- Michigan has a 60-month (5-year) Look-Back Period for Nursing Home Medicaid and Medicaid Waiver applications.
- Assets cannot be given away or sold under fair market value within this period — violations result in a Penalty Period of Medicaid disqualification.
- There is no Look-Back Period for Regular Medicaid.
- The U.S. Federal Gift Tax Rule ($19,000 per recipient in 2026) does not extend to Medicaid eligibility — gifting under this rule still violates the Look-Back Period.
- MMMNA: $2,643.75 · CSRA: $162,660 · CSRA Min: $32,532
- When only one spouse applies for Nursing Home Medicaid or a Waiver, only the applicant's income is counted.
- The MMMNA is $2,643.75 (eff. 7/1/25 – 6/30/26). Income can be transferred from the applicant spouse if the non-applicant's income is below this level.
- A non-applicant can increase their Spousal Income Allowance if housing/utility costs exceed the shelter standard of $793.13 / month, up to a maximum of $4,066.50 / month.
- The CSRA allows the non-applicant spouse to retain 50% of assets up to $162,660 (min $32,532) in 2026.
- For Regular Medicaid, both spouses' income is counted and there is no MMMNA or CSRA.
- Medically Needy Pathway — Michigan has a Spend-Down program. The protected income level (PIL) is $1,305 / month (individual, eff. 4/1/25) and $1,763 / month (couple). The spend-down is calculated monthly. For Nursing Home Medicaid, one may qualify if care costs exceed monthly income. The medically needy asset limit is $9,950 (individual) and $14,910 (couple).
- Asset Spend-Down — Spend excess assets on non-countable items such as home repairs (fixing a leaking roof), home modifications (wheelchair ramps, walk-in tubs), and paying off debt. Keep documentation as proof the Look-Back Rule was not violated.
- Medicaid Planning — Work with a Medicaid Planning Professional to employ strategies to become eligible and protect your home from Medicaid's Estate Recovery Program.
Michigan does not use Qualified Income Trusts (Miller Trusts). The Medically Needy / Spend-Down program is available for persons over the income limit.
Michigan Medicaid Programs
MI Choice Waiver Program
An HCBS Waiver for nursing home qualified elderly and disabled persons providing supportive services to avoid nursing home placement. Benefits may include adult day care, home modifications, respite care, independent living skills training, and many other supports. Enrollment is limited.
MI Health Link
A managed care program for persons dually eligible for Medicaid and Medicare, offering personal care assistance, meal delivery, chore services, and personal emergency response systems. Not available statewide.
Home Help Program
A benefit under Regular Medicaid providing personal care, laundry, and housekeeping in one's home. This is an entitlement for those who qualify.
Program of All-Inclusive Care for the Elderly (PACE)
Combines Medicaid (including long-term care) and Medicare benefits into one program. Additional benefits such as dental and eye care may be available.
Community Transition Services (CTS)
Helps nursing home residents move back home, or into assisted living or adult foster care homes. Benefits may include security deposit and utility set-up assistance, home modifications, personal emergency response systems, and short-term personal care services.
How to Apply
- Contact your Michigan Department of Health & Human Services county office to apply
- Contact a local Area Agency on Aging for program information or application assistance
When applying for Medicaid in Michigan, it is extremely important that seniors are certain they meet all eligibility criteria. Medicaid Planning becomes crucial for those over the income/asset limits or unsure of eligibility.
More Michigan Long-Term Care Resources
Take the Next Step for Michigan Medicaid
Find out if you qualify or see how Medicaid fits into your overall long-term care plan.
Sources & references
Verified May 2026- Centers for Medicare & Medicaid Services — Long-Term Services & Supports
- Administration for Community Living — State Medicaid Agencies
- Centers for Medicare & Medicaid Services — Medicaid Eligibility
- American Council on Aging — About Medicaid Planning Assistance
- Michigan Department of Human Services — Michigan Medicaid — Official site