MI Choice Waiver in Michigan: Eligibility, Services, and How to Apply

The MI Choice Waiver program is Michigan Medicaid’s home and community-based waiver for adults who qualify for nursing-facility care but want to stay at home. It covers services regular Medicaid does not, such as respite and home modifications, and can pay a family member to provide care. You apply through your regional waiver agency, usually the Area Agency on Aging.

On this page

1. What is the MI Choice Waiver program?
2. Who qualifies for the MI Choice Waiver?
3. What services does MI Choice cover?
4. Is there a waiting list, and how long is it?
5. How to apply for the MI Choice Waiver through your Area Agency on Aging
6. Can a family member be paid under MI Choice?
7. Frequently asked questions

What is the MI Choice Waiver program?

MI Choice is a Medicaid waiver run by the Michigan Department of Health and Human Services (MDHHS) and delivered through regional waiver agencies. The word “waiver” means the federal government has allowed Michigan to spend nursing-home Medicaid dollars on care at home instead, which most people prefer and which usually costs less.

Each participant gets a supports coordinator who builds a care plan and arranges services from enrolled agencies or, under self-determination, from workers the participant hires directly.

MI Choice is different from the Home Help program, Michigan’s basic Medicaid personal-care benefit. Home Help pays for hands-on help with daily activities; MI Choice adds a broader package for people with higher needs. Our post Home Help vs MI Choice vs CDPAP compares them side by side.

Who qualifies for the MI Choice Waiver?

There are three tests, and all three must be met.

Age or disability

• Adults 65 and older, or
• Adults 18 and older with a physical disability

Nursing-facility level of care

MDHHS uses a standard screening tool, the Michigan Medicaid Nursing Facility Level of Care Determination, to decide whether a person would qualify for nursing-home placement. Meeting the threshold in any one of seven areas qualifies the person:

• Activities of daily living, such as bathing, dressing, toileting, transferring, and eating
• Cognitive performance, including memory and decision-making
• Physician involvement, meaning frequent doctor visits or order changes
• Treatments and conditions, such as wound care or oxygen
• Skilled rehabilitation therapies
• Behavioral problems that require intervention
• Service dependency, meaning the person already receives waiver or facility-level services

Someone with advanced dementia who needs supervision for daily tasks often qualifies under the cognitive and ADL areas even if they are physically mobile.

Financial eligibility

MI Choice uses Medicaid’s special income limit for long-term care, set at 300 percent of the federal SSI benefit rate and updated every year. That is well above the regular Medicaid limit, which is why a parent who was “over the limit” for Home Help sometimes qualifies here. Countable assets for a single applicant are limited to about $2,000, not counting the home, one vehicle, and personal belongings.

Married couples get spousal impoverishment protections that let the spouse at home keep a share of income and assets. For the full picture, read Michigan Medicaid income and asset limits for home care, or run our free eligibility check.

What services does MI Choice cover?

The care plan is built around the participant’s needs. The waiver can cover:

• Personal care and homemaker services (bathing, dressing, meals, housework)
• Respite care so family caregivers can take a break
• Adult day health programs
• Home-delivered meals
• Personal emergency response systems
• Environmental modifications, such as ramps, grab bars, and walk-in showers
• Medical equipment and supplies not covered by regular Medicaid
• Non-medical transportation to appointments and community activities
• Chore services for heavy cleaning and yard work
• Private duty nursing and counseling
• Community transition services for people leaving a nursing facility
• Supports coordination and, under self-determination, a fiscal intermediary

Participants keep regular Medicaid for doctor visits, prescriptions, and hospital care. If respite is your most urgent need, our respite care page explains the options while you wait.

Is there a waiting list, and how long is it?

Usually, yes. Michigan funds a fixed number of MI Choice slots in each region, and when they are full, eligible applicants go on a waiting list held by the waiver agency.

Wait times differ by region and shift through the year as participants leave and new funding arrives. Priority goes to certain situations, including people moving home from a nursing facility and people referred by Adult Protective Services. Ask your waiver agency where your loved one sits on the list and whether they qualify for a priority category.

While you wait, apply for Home Help. It has no waiting list, pays a family caregiver for personal-care hours, and can run until the waiver slot opens. See our Michigan Home Help program page.

How to apply for the MI Choice Waiver through your Area Agency on Aging

1. Find your waiver agency. Every Michigan county is assigned to a regional waiver agency, most of which are Area Agencies on Aging. The MDHHS website lists them by county, including the agencies serving Detroit, Dearborn, Warren, Sterling Heights, Ann Arbor, Flint, Lansing, and Grand Rapids.
2. Complete the phone screening. An intake worker asks about age, health, daily needs, income, and assets, then decides whether to schedule a full assessment.
3. Gather financial documents. Bank statements, Social Security and pension letters, insurance policies, and property records. If your loved one does not have Medicaid yet, the waiver agency will help you apply through MI Bridges at the same time.
4. Complete the in-home assessment. A nurse and social worker visit, run the level-of-care determination, and talk through a care plan. Have a list of medications, diagnoses, and the tasks your loved one needs help with.
5. Choose your service model. Decide whether care will come from enrolled agencies, from workers you hire under self-determination, or a mix.
6. Start services or join the wait list. If a slot is available, the supports coordinator starts services. If not, you are placed on the list and the agency checks in periodically.

Can a family member be paid under MI Choice?

Yes, through one of two routes.

Self-determination

The participant receives an individual budget and hires their own workers. Pay is processed by a fiscal intermediary, which handles taxes and payroll. Adult children, siblings, grandchildren, other relatives, and friends can be hired. Spouses are generally excluded, and rules for court-appointed guardians vary by waiver agency, so ask before you count on it.

Agency employment

Some waiver agencies allow a relative to be hired by an enrolled provider agency and assigned to their own family member. The agency handles training, scheduling, and payroll. Supportive Solutions Homecare supports both routes; see how to become a paid caregiver.

Either way, MI Choice pays for the hours in the care plan, not for around-the-clock presence. Live-in caregivers may be able to exclude their pay from federal income tax under IRS Notice 2014-7 (see irs.gov).

Frequently asked questions

What is the MI Choice Waiver and who is eligible?

MI Choice is a Michigan Medicaid waiver that pays for in-home and community services for people who qualify for nursing-facility care but want to stay at home. It serves adults 65 and older and adults 18 and older with a disability. Eligibility requires meeting the nursing-facility level of care, Medicaid financial rules, and an available slot at your regional waiver agency.

What is the income limit for the MI Choice Waiver?

MI Choice uses a special income limit that is higher than regular Medicaid, set at a multiple of the federal SSI benefit rate and updated each year. Countable assets are also limited. Married couples benefit from spousal impoverishment rules that protect part of the household income and assets. Because the numbers change annually, confirm the current limits with MDHHS or your waiver agency.

Is there a waiting list for MI Choice?

Often, yes. Each regional waiver agency has a set number of funded slots, and when they are full, new applicants go on a waiting list. Wait times vary widely by region and change through the year. People leaving a nursing facility and people in urgent situations may be given priority. Ask your waiver agency where you stand and whether Home Help can start in the meantime.

How do I apply for the MI Choice Waiver?

Contact the waiver agency for your county, which is usually your Area Agency on Aging. A screener will take basic information over the phone and, if you appear eligible, schedule an in-home assessment by a nurse and social worker. They confirm the level of care, review finances, and build a care plan. If a slot is open, services begin; if not, you are placed on the list.

Can I be paid through MI Choice to care for a loved one?

In many cases, yes. MI Choice offers a self-determination option that lets the participant hire their own workers, including many family members, with pay handled by a fiscal intermediary. Some waiver agencies also allow relatives to work through an enrolled provider agency. Spouses are generally excluded, and rules for guardians vary, so confirm with your waiver agency before planning on it.