Post-Surgery Home Care in Michigan: What Medicaid and Medicare Cover

Post-surgery home care in Michigan is paid for in two different ways. Medicare covers short-term skilled home health (nursing, therapy) when a doctor orders it and you are homebound. Michigan Medicaid’s Home Help program covers the non-medical help most people actually need after surgery: bathing, dressing, meals and getting around, and it can pay a family member to provide it.

On this page

1. What kind of help do people need after surgery?
2. Does Medicare cover home care after surgery?
3. Does Medicaid pay for home care after surgery in Michigan?
4. Can a family member be paid to help during recovery?
5. What about the MI Choice Waiver?
6. How to line up post-surgery home care in Michigan
7. Post-surgery home care across Michigan
8. Frequently asked questions

What kind of help do people need after surgery?

Joint replacements, heart surgery and abdominal procedures all send people home sooner than they once did. Recovery needs fall into two groups, and the difference decides who pays.

Skilled needs

• Wound and incision checks, dressing changes, drain care
• IV medications or injections
• Physical or occupational therapy to regain strength and range of motion
• Monitoring vitals, blood sugar or oxygen after a complication

Personal care needs

• Bathing and showering without slipping or getting the incision wet
• Dressing, especially with lifting or bending restrictions
• Getting from bed to chair, to the bathroom and up stairs
• Meals, groceries, laundry and light housekeeping
• Medication reminders and rides to follow-up appointments

Skilled needs usually last a few weeks; personal care needs often last longer. Our post-surgery care service page lists everything a caregiver can help with at home.

Does Medicare cover home care after surgery?

Medicare Part A and Part B cover home health care after surgery, but only under specific conditions. A doctor must certify that you need intermittent skilled nursing or therapy, that you are homebound, and that a Medicare-certified home health agency will provide the care under a plan the doctor reviews.

When those conditions are met, Medicare pays for nurse and therapist visits and, during the same period, a limited number of home health aide visits for personal care tied to the skilled plan.

What Medicare does not cover is the part families struggle with most: a caregiver in the home several hours a day to help with bathing, meals and supervision once the skilled visits end. Medicare calls this custodial care and excludes it, whether you are recovering from surgery or not.

For a side-by-side look at the two types of care, read home care vs home health care in Michigan.

Does Medicaid pay for home care after surgery in Michigan?

Yes, through the Home Help program run by the Michigan Department of Health and Human Services (MDHHS). Home Help pays for exactly the custodial care Medicare leaves out.

To qualify, the person recovering must:

• Have active Michigan Medicaid (apply through MI Bridges if not)
• Need hands-on help with at least one activity of daily living, confirmed by a doctor, physician assistant or nurse practitioner on the medical needs form
• Live in their own home or a family member’s home, not a hospital, nursing facility or other setting where Medicaid already pays for care
• Complete an in-home assessment with an MDHHS adult services worker, who scores each task and sets the approved hours

Home Help is not limited to seniors; an adult under 65 with Medicaid can qualify the same way. If you are not sure whether your loved one meets the income rules, use our Medicaid eligibility check first.

One thing to know about timing

Home Help was built for ongoing need, and approval involves a form, a home visit and a case decision. That takes time. If the surgery is planned, start the Medicaid application and the Home Help request before the operation date. If the person already has Home Help, call the caseworker after surgery to request a reassessment, because needs usually go up during recovery and hours can be increased.

The full application process, from the first call to the first paid hour, is in our Michigan Home Help program guide.

Can a family member be paid to help during recovery?

Yes. Michigan lets the person receiving Home Help choose their own caregiver, and that caregiver can be a spouse, adult child, sibling, friend or neighbor. This matters after surgery, because the family member who takes time off work to help is often the one losing income.

To be paid, the caregiver must:

• Be 18 or older and pass a criminal background check
• Enroll as an individual provider in CHAMPS, Michigan’s Medicaid provider system
• Complete the required provider training
• Clock in and out of each visit with Electronic Visit Verification (EVV)

Pay is an hourly rate set by MDHHS, multiplied by the approved hours. Payments to a caregiver who lives with the person may qualify as difficulty-of-care payments under IRS Notice 2014-7 and be excluded from federal income tax; check the IRS guidance or a tax professional.

Our step-by-step post on getting paid to take care of a family member in Michigan covers enrollment in detail, and become a paid caregiver lists the documents you will need.

What about the MI Choice Waiver?

If recovery reveals long-term needs at a nursing-facility level of care, the MI Choice Waiver, applied for through your Area Agency on Aging or waiver agent, can fund a broader package of in-home services. It is slower to start and can have a waiting list, so it rarely helps with a short recovery on its own.

How to line up post-surgery home care in Michigan

1. Get the surgeon’s restrictions in writing. No lifting, no stairs, no showering for a set number of days: this shapes both the Medicare order and the Home Help assessment.
2. Request a Medicare home health referral. Have the discharge planner send orders to a Medicare-certified agency for nursing and therapy visits.
3. Confirm Medicaid or apply through MI Bridges. Do this before surgery if possible.
4. Request Home Help from the MDHHS county office. Ask for the medical needs form and have the doctor sign it at the pre-op visit.
5. Choose the caregiver and enroll them in CHAMPS. Background check and training can be done while the assessment is pending.
6. Complete the home assessment. Show the worker every task that is hard, including the ones the person is embarrassed about.
7. Start care and log visits with EVV. Request a reassessment if needs change.

Post-surgery home care across Michigan

Supportive Solutions Homecare helps families arrange recovery care in Detroit, Dearborn, Warren, Sterling Heights, Ann Arbor, Flint, Lansing and Grand Rapids. We enroll family caregivers in Home Help or match you with a trained aide, in English, Arabic and Spanish.

Frequently asked questions

Does Medicaid cover care after surgery at home?

Yes. Michigan Medicaid’s Home Help program covers personal care after surgery, including bathing, dressing, meals, transfers and housekeeping, when the person has active Medicaid and a doctor confirms the need. An MDHHS assessment sets the approved hours. Skilled nursing and therapy are covered separately by Medicare or Medicaid through a home health agency.

How long will Medicare pay for home health after surgery?

Medicare pays as long as the doctor certifies you still need intermittent skilled nursing or therapy and you remain homebound. Care is authorized in periods that the agency and doctor review and can renew. Once the skilled need ends, Medicare stops paying, even if you still need help with daily tasks.

Can my daughter be paid to be my caregiver while I recover?

Yes. Under Michigan Home Help, an adult child can be your paid caregiver if you have Medicaid, an MDHHS assessment approves hours, and she passes a background check and enrolls in CHAMPS. She is paid the state hourly rate for approved hours and records each visit with EVV. Living together is not required.

How long does Home Help approval take?

There is no fixed timeline. Approval depends on how quickly the medical needs form is returned, when the MDHHS worker can schedule the home visit, and whether Medicaid is already active. Starting the paperwork before a planned surgery and returning forms the same day are the best ways to shorten the wait.

What if my loved one needs more hours after surgery than they had before?

Call the MDHHS adult services worker and request a reassessment. Explain which tasks have become harder, bring the surgeon’s restrictions, and be specific about how long each task now takes. Hours are based on assessed need, so a documented change in need can raise the authorization.