Michigan Medicaid Long Term Care Programs, Benefits & Eligibility Requirements

Summary
Medicaid’s rules, benefits and name can all vary by state. In Michigan, Medicaid is sometimes called Medical Assistance. This article focuses on Michigan Medicaid Long Term Care for seniors, which will pay for care in nursing homes, beneficiary’s homes, assisted living residences and other settings through one of three programs – Nursing Home Medicaid, HCBS Waivers or ABD Medicaid. These programs are different from the regular Medicaid that is for financially limited people of all ages.

Michigan Medicaid Long Term Care Programs

Nursing Home / Institutional Medicaid

Michigan Nursing Home Medicaid will cover the cost of long-term care in a nursing home for financially limited Michigan seniors who require a Nursing Facility Level of Care. Coverage includes payment for room and board, as well as all necessary medical and non-medical goods and services, such as:

• Personal care assistance with the Activities of Daily Living (mobility, bathing, dressing, eating, toileting)
• Skilled nursing care
• Physician’s visits
• Prescription medication
• Medication management
• Mental health counseling
• Social activities

Items not covered include a private room, specialized food, comfort items not considered routine (tobacco, sweets and cosmetics, for example) and any care services not considered medically necessary.

Michigan Nursing Home Medicaid beneficiaries are required to give most of their income to the state to help cover care expenses. They are only allowed to keep a “personal needs allowance” of $60/month, which can be spent on personal items such as clothes, snacks, books, haircuts, flowers, etc. They can also keep enough of their income to make Medicare premium payments if they are “dual eligible,” and enough to make any Medicaid-approved spousal income allowance payments to financially needy spouses who are not Medicaid applicants or recipients.

Michigan Nursing Home Medicaid is an entitlement. This means all qualified applicants are guaranteed by law, aka “entitled,” to receive benefits without wait. However, not all nursing homes accept Medicaid, and those that do may not have any available spaces when you or your loved one needs care. So, eligible applicants are guaranteed nursing home coverage without wait, but they are not guaranteed coverage in any facility they choose.

Home and Community Based Services (HCBS) Waivers

Michigan Home and Community Based Services (HCBS) Waivers will pay for long-term care services and supports that help Michigan Medicaid recipients who require a Nursing Facility Level of Care remain living in the community instead of moving to a nursing home. The word “waiver” means something like voucher in this instance. Think of it as a voucher that will pay for long-term care services for Michigan residents who live in their own home, the home of a relative, an adult foster care home, or a home for the aged, which is a type of assisted living residence. While Michigan HCBS Waivers may cover long-term care benefits in those settings, it will not pay for room and board costs such as mortgage payments, rent, facility fees, utility bills or food expenses.

The HCBS Waivers relevant to Michigan seniors are the MI Choice Waiver Program and MI Health Link.

1. MI Choice Waiver Program
The MI Choice Waiver Program provides long-term care supports and services to qualified elderly Michigan residents (65 and over) who require a Nursing Facility Level of Care but live in their own home, the home of a relative, an adult foster care home or a home for the aged, which is like an assisted living residence. While the MI Choice Waiver Program will pay for some long-term care benefits in all those settings, it will not cover room and board costs.

MI Choice Waiver benefits can include adult day care, home modifications, nursing services, specialized medical equipment, transportation and personal care assistance with the Activities of Daily Living (mobility, bathing, dressing, eating, toileting). Benefits are provided depending on the needs and circumstances of each individual, and they are delivered by one of the MI Choice Waiver agencies, which are spread across the state and have a network of care providers. You can find the waiver agency closest to you by clicking here.

MI Choice Waiver Program participants can also self-direct their care by hiring caregivers of their choice for some benefits, like personal care assistance and housekeeping. This includes family members such as adult children and grandchildren, but spouses can not be hired as MI Choice Waiver caregivers. If the program participant chooses to self-direct, a financial management services agency will be provided to handle the monetary aspects of employing a caregiver, such as withholding taxes and making payments.

Unlike Nursing Home Medicaid, the MI Choice Waiver is not an entitlement. Instead, it has a limited number of enrollment spots (about 20,200 per year as of 2024). Once those spots are full, additional applicants are placed on a waitlist.

2. MI Health Link
MI Health Link is a managed care program for Michigan residents who require a Nursing Facility Level of Care, live in the community and are eligible for both Medicaid and Medicare, which is also known as “dual eligible.” A portion of this program is known as the MI Health Link HCBS Waiver and it provides long-term care services and supports to beneficiaries who live in their own home, the home of a family member, an adult foster care home or a home for the aged. While the MI Health Link HCBS Waiver will provide benefits in those settings, it will not cover room and board costs.

MI Health Link HCBS Waiver benefits can include adult day care, home modifications, medical equipment, nursing services, transportation and personal care assistance with the Activities of Daily Living (mobility, bathing, dressing, eating, toileting). Benefits will be made available depending on the needs and circumstances of each individual.

MI Health Link delivers all benefits through an Integrated Care Organization (ICO) that has its own network of care providers. This includes all medical care and non-medical services and supports from both Medicaid and Medicare. MI Health Link beneficiaries can also go outside that network of care providers for some benefits, like personal care assistance, by hiring caregivers of their choice. This includes family members such as adult children or siblings, but spouses can not be hired as MI Health Link caregivers. If the program participant chooses to self-direct their care, a financial management services agency will be provided to handle the monetary aspects of employing a caregiver, such as withholding taxes and making payments.

MI Health Link is currently available in 25 counties in Michigan – Alger, Baraga, Barry, Berrien, Branch, Calhoun, Cass, Chippewa, Delta, Dickinson, Gogebic, Houghton, Iron, Kalamazoo, Keweenaw, Luce, Mackinac, Macomb, Marquette, Menominee, Ontonagon, Schoolcraft, St. Joseph, Van Buren and Wayne.

There are a limited number of enrollment spots for the MI Health Link HCBS Waiver (about 5,400 per year as of 2024). Once those spots are full, additional applicants will be placed on a waitlist.

Aged, Blind, and Disabled Medicaid

Michigan’s Aged, Blind, and Disabled (ABD) Medicaid provides healthcare coverage and long-term care services and supports to low-income Michigan residents who are aged (65 and over), blind or disabled and live in the community. ABD Medicaid can sometimes be referred to as state Medicaid or regular Medicaid for seniors, but it should not be confused with the regular Medicaid that is available for low-income people of all ages. ABD Medicaid is an entitlement, which means that anyone who meets the requirements is guaranteed by law to receive the benefits without any wait.

Michigan ABD Medicaid beneficiaries who show a functional need for long-term care benefits can receive some of those benefits through the Home Help Program and the Program for All-Inclusive Care for the Elderly (PACE).

1. Home Help Program
Michigan’s Home Help Program provides long-term care services to ABD Medicaid beneficiaries who live in their own home or the home of a loved one and need hands-on help with one Activity of Daily Living (mobility, bathing, dressing, eating, toileting). The reason for needing this help is not important. It could be due to aging, illness or cognitive issues.

Home Help Program benefits can include housekeeping, shopping, meal prep, medication management and personal care assistance with the Activities of Daily Living. These benefits can be provided by licensed caregivers, or program participants have the option to self-direct their care by hiring caregivers of their choice. This includes family members, although spouses can not be hired as Home Help Program caregivers. If beneficiaries choose to self-direct, a financial management services agency will be provided to handle the monetary aspects of employing a caregiver, such as withholding taxes and making payments.

Like ABD Medicaid itself, the Home Help Program is an entitlement. This means that all eligible applicants are guaranteed by law to receive benefits without any wait.

2. Program of All-Inclusive Care for the Elderly (PACE)
Michigan residents who are age 55 or older and have ABD Medicaid can cover their medical, social service and long-term care needs with one comprehensive plan and delivery system using the Program of All-Inclusive Care for the Elderly (PACE). PACE program participants are required to need a Nursing Facility Level of Care, but they must live in the community. Michigan’s PACE programs can be used by people who are “dual eligible” for Medicaid and Medicare, and it will coordinate the care and benefits from those two programs into one plan. PACE also administers vision and dental care, and PACE day centers provide meals, social activities, exercise programs and regular health checkups and services to program participants. Michigan has 14 PACE programs located throughout the state – Battle Creek (Senior Care Partners P.A.C.E.), Flint (Ascension Living PACE Michigan), Fort Gratiot (Sunrise PACE), Grand Rapids (Care Resources), Jackson (Thome PACE), Lansing (Senior CommUnity Care of Michigan), Mount Pleasant (PACE Central Michigan), Newyago (Community PACE at Home, Inc.), Norton Shores (LifeCircles PACE), Saginaw (Great Lakes PACE), Saint Joseph (PACE of Southwest Michigan), Southfield (PACE Southeast Michigan), Traverse City (PACE North) and Ypsilanti (Huron Valley PACE). To learn more about PACE, click here.

Eligibility Criteria For Michigan Medicaid Long Term Care Programs

To be eligible for Michigan Medicaid, a person has to meet certain financial requirements and functional (medical) requirements. The financial requirements vary by the applicant’s marital status, if their spouse is also applying for Medicaid, and what program they are applying for – Nursing Home Medicaid, Home and Community Based Services (HCBS) Waivers or Aged, Blind, and Disabled (ABD) Medicaid Medicaid.

Michigan Medicaid Nursing Home Medicaid Eligibility Criteria

Financial Requirements
Michigan residents have to meet an asset limit and an income limit in order to be financially eligible for Nursing Home Medicaid. For a single applicant in 2024, the asset limit is $2,000, which means they must have $2,000 or less in countable assets. Countable assets include bank accounts, retirement accounts, stocks, bonds, certificates of deposit, cash and any other assets that can be easily converted to cash. An applicant’s home does not always count as an asset (see the How Medicaid Treats the Home section below for more details), and there are other non-countable assets, like Irrevocable Funeral Trusts and Medicaid Compliant Annuities.

The 2025 income limit for Michigan Nursing Home Medicaid for a single applicant is $2,901/month. Almost all income is counted – IRA payments, pension payments, Social Security benefits, property income, alimony, wages, salary, stock dividends, etc. However, Michigan Medicaid beneficiaries who reside in nursing homes must give most of their income to the state to help pay for the cost of care. They are only allowed to keep $60/month of their income as a “personal needs allowance,” and they are allowed to make Medicare premium payments if they are “dual eligible“.

For married applicants with both spouses applying, the 2025 asset limit for Michigan Nursing Home Medicaid is a combined $3,000, and the income limit is $2,901/month per spouse. For a married applicant with just one spouse applying, the 2025 asset limit is $2,000 for the applicant spouse and $157,920 for the non-applicant spouse, thanks to the Community Spouse Resource Allowance. The income limit is $2,901/month for the applicant, and the income of the non-applicant spouse is not counted. Married Michigan Nursing Home Medicaid recipients are also required to give most of their income to the state. They are allowed to keep $60/month as a personal needs allowance and enough to make Medicare premium payments. In addition, they are allowed to keep enough income to make any allowable spousal income allowance payments to financially needy spouses who are not enrolled in Medicaid.

Functional Requirements
The functional, or medical, criteria for Nursing Home Medicaid in Michigan is needing a Nursing Facility Level of Care (NFLOC), which means the applicant requires the kind of full-time care that is normally associated with a nursing home. To determine if an applicant requires a NFLOC, the state will evaluate their ability to complete the Activities of Daily Living (mobility, bathing, dressing, eating, toileting), as well as any cognitive or behavioral issues. This can include Alzheimer’s disease and other dementias, but a diagnosis of Alzheimer’s or dementia does not guarantee a NFLOC designation.

Michigan Home and Community Based Services (HCBS) Waivers Eligibility Criteria

Financial Requirements
Michigan residents have to meet an an asset limit and an income limit in order to be financially eligible for Home and Community Based Services (HCBS) Waivers. For a single applicant in 2025, the asset limit for HCBS Waivers in Michigan is $2,000, which means they must have $2,000 or less in countable assets. Countable assets include bank accounts, retirement accounts, stocks, bonds, certificates of deposit, cash and any other assets that can be easily converted to cash. An applicant’s home does not always count as an asset (see the How Medicaid Treats the Home section below for more details), and there are other non-countable assets, like Irrevocable Funeral Trusts and Medicaid Compliant Annuities.

The 2025 income limit for HCBS Waivers in Michigan for a single applicant is $2,901/month. Almost all income is counted – IRA payments, pension payments, Social Security benefits, property income, alimony, wages, salary, stock dividends, etc. To understand exactly how your income might impact Medicaid eligibility, consult with a professional like a Certified Medicaid Planner or Elder Law Attorney.

For married applicants with both spouses applying, the 2025 asset limit for HCBS Waivers in Michigan is a combined $3,000, and the income limit is $2,901/month per spouse. For a married applicant with just one spouse applying, the 2025 asset limit is $2,000 for the applicant spouse and $157,920 for the non-applicant spouse, thanks to the Community Spouse Resource Allowance. The 2025 income limit is $2,901/month for the applicant, and the income of the non-applicant spouse is not counted.

Functional Requirements
The functional, or medical, criteria for Home and Community Based Services (HCBS) Waivers in Michigan is needing a Nursing Facility Level of Care (NFLOC), which means the applicant requires the kind of full-time care that is normally associated with a nursing home. To determine if an applicant requires a NFLOC, the state will evaluate their ability to complete the Activities of Daily Living (mobility, bathing, dressing, eating, toileting), as well as any cognitive or behavioral issues. This can include Alzheimer’s disease and other dementias, but a diagnosis of Alzheimer’s or dementia does not guarantee a NFLOC designation.

Michigan Aged, Blind, and Disabled Medicaid Eligibility Criteria

Financial Requirements
Michigan residents have to meet an asset limit and an income limit in order to be financially eligible for Aged Blind and Disabled (ABD) Medicaid Medicaid. For a single applicant in 2025, the asset limit is $2,000, which means they must have $2,000 or less in countable assets. Countable assets include bank accounts, retirement accounts, stocks, bonds, certificates of deposit, cash and any other assets that can be easily converted to cash. An applicant’s home does not always count as an asset (see the How Medicaid Counts the Home section below for more details), and there are other non-countable assets, like Irrevocable Funeral Trusts and Medicaid Compliant Annuities.

The income limit for Michigan ABD Medicaid for a single applicant is $1,255/month, effective April 1, 2024. Almost all income is counted – IRA payments, pension payments, Social Security benefits, property income, alimony, wages, salary, stock dividends, etc.
For married applicants, the asset limit for Michigan ABD Medicaid is a combined $3,000, and the income limit is a combined $1,763/month, effective April 1, 2024. These limits are used for both married couples with both spouses applying for ABD Medicaid and married couples with only one spouse applying.
The Look-Back Period does not apply to ABD Medicaid. However, ABD Medicaid applicants should be careful about Look-Back violations because they might eventually need Nursing Home Medicaid or HCBS Waivers, and those violations will make them ineligible for either of those programs.

Functional Requirements
The only functional requirement for receiving basic healthcare coverage – physician’s visits, prescription medication, emergency room visits and short-term hospital stays – through ABD Medicaid in Michigan is being age 65 or over, blind or disabled. For ABD Medicaid beneficiaries who need long-term care services and supports, the state will administer a functional assessment of their ability to perform Activities of Daily Living (mobility, bathing, dressing, eating, toileting) to determine the kind of long-term care benefits the state will cover. Behavior and cognitive issues will also be considered.

How Michigan Medicaid Treats the Home for Eligibility Purposes

One’s home is often their most valuable asset, and if counted toward Medicaid’s asset limit, it would likely cause them to be over the limit. However, in many situations the home is not counted against the asset limit:

• If the applicant lives in their home and the home equity interest (the portion of the home’s equity value that the applicant owns minus any outstanding mortgage/debt) is less than $730,000 (as of 2025) then the home is exempt.
• If the applicant’s spouse, minor child, or blind or disabled child of any age lives there, the home is exempt regardless of the applicant’s home equity interest, and regardless of where the applicant lives.
• If none of the above-mentioned people live in the home, the home can be exempt if the applicant/beneficiary files an “intent to return” home and the home equity interest is at or below $730,000.

These rules apply to all three types of Medicaid, with one important exception – ABD Medicaid applicants can disregard the home equity limit. Value does not matter regarding their home’s exempt status. To learn more about the impact of home ownership on Medicaid eligibility, click here.

Michigan Medicaid Long Term Care applicants and recipients may also want to consider protecting their home (and other assets) from estate recovery. States (and the District of Columbia) are required by law to try and collect reimbursement for long-term care after the death of Medicaid recipients. They do this through their Medicaid Estate Recovery Programs (MERPs). The rules and regulations regarding estate recovery can vary greatly by state, but all states have a MERP. To learn more about the MERP in Michigan and how you can protect your home from it, click here.

Qualifying with Medicaid Planning

Even if Michigan residents don’t meet their financial limits for Medicaid eligibility, there are still ways they can qualify. If they are over their asset limit, they can reduce their assets by “spending down” or using a Medicaid Asset Protection Trust. While the Look-Back Period prevents Nursing Home Medicaid and HCBS Waivers applicants from simply giving away their home, they could use the Child Caregiver Exemption or Sibling Exemption to transfer their home to a qualified family member, which would prevent the home from counting against the asset limit.

Michigan ABD Medicaid applicants/beneficiaries who are over their income limit can use the Medically Needy Pathway to reduce their income and become eligible. It works like an insurance deductible. They must pay for their medical expenses during their “spend down period” until they meet their “spend down” amount, which is calculated using their income and Michigan’s Medically Needy Income Limit, which (as of April 1, 2024) is $1,255 for an individual and $1,703 for a couple. Once they have reached their spend down amount, Medicaid will cover their medical expenses for the remainder of the spend down period, which is one month in Michigan.

These Medicaid Planning strategies tend to be complicated, so consulting with a professional like a Certified Medicaid Planner or an Elder Law Attorney before attempting any of them on your own is recommended.

Applying For Michigan Medicaid Long Term Care Programs

The first step in applying for a Michigan Medicaid Long Term Care program is deciding which of the three programs discussed above you or your loved one wants to apply for – Nursing Home Medicaid, Home and Community Based Services (HCBS) Waivers or Aged, Blind, and Disabled (ABD) Medicaid.

The second step is determining if the applicant meets the financial and functional criteria, also discussed above, for that Long Term Care program. Applying for Michigan Medicaid when not financially eligible will result in the application, and benefits, being denied.

During the process of determining financial eligibility, it’s important to start gathering documentation that clearly details the financial situation for the Michigan Medicaid applicant. These documents will be needed for the official Michigan Medicaid application. Necessary documents may include tax forms, Social Security benefits letters, deeds to the home, proof of life insurance and quarterly statements for all bank accounts, retirement accounts and investments. For a complete list of documents you might need to submit with your Medicaid Long Term Care application, go to our Medicaid Application Documents Checklist.

After financial eligibility requirements are checked and double checked, documentation is gathered, and functional eligibility is clarified, Michigan residents can apply for Medicaid online at MI Bridges. They can also contact their local Michigan Department of Health & Human Services office.

For step-by-step guides to applying for each of the 3 types of Medicaid Long Term Care, just click on the name: 1) Nursing Home Medicaid 2) HCBS Waivers 3) ABD Medicaid.

Choosing a Michigan Medicaid Nursing Home

After being approved for Nursing Home Medicaid through Michigan Medicaid, seniors have to choose which Medicaid-accepting nursing home best fits their needs. Even though Nursing Home Medicaid is an entitlement, not all nursing homes accept Medicaid, and those that do may not have available beds. Finding just the right facility can be difficult, especially if you’re looking in a specific location.

Michigan has about about 475 total nursing homes. They are spread out around the state but clustered around the major population areas, and most of them accept Medicaid. There are roughly 100 nursing homes within 25 miles of Detroit that accept Medicaid, and about 50 more around Ann Arbor. Grand Rapids has about 35 nursing homes within 25 miles that accept Medicaid, and there are approximately 20 in the Kalamazoo/Battle Creek area. The options thin in the northern part of the state, although there are about 20 nursing homes around Saginaw. Traverse City has about five facilities, and there are around five more nursing homes within 25 miles of Ishpeming on the Upper Peninsula.

Residents in some Michigan communities may regularly cross the state border for personal and business reasons, including healthcare. But Medicaid coverage does not cross state lines. So, someone with Michigan Medicaid is not covered for a nursing home in South Bend, Indiana, or Toledo, Ohio, even if there are well-suited and convenient facilities in those cities for a Michigan resident.

When you’ve found nursing homes in your area that accept Medicaid, you can start comparing them, if you have multiple options. The search on Nursing Home Compare can be filtered by staffing, health inspections, quality measures and overall rating, which can be a good place to start. The healthcare professionals who work with you can be a great source of information. You can also contact your local Area Agency on Aging to find out more information about nursing homes in the state.

After doing some research, you or someone you trust should visit any nursing homes you’re considering before making a final decision. Call first to make an appointment for the visit, and arrive with a list of questions, like: Does the residence offer social activities? How does it handle vision and dental care? Who are the staff doctors? What is the food like? CMS has a comprehensive “Nursing home checklist” you can use to evaluate a nursing home while visiting.

Data collected by CMS from 2018-2023 shows that nursing homes in Michigan are below national standards when it comes to health inspections. Michigan nursing homes averaged 36.4 health deficiencies that led to citations during a sample within that time frame, while the national average was just 27.2 during the same sample. This doesn’t mean all Michigan nursing homes have excessive, or any, health deficiencies. But it does mean you should do your research about a facility’s health history before making a final decision.