Home care for traumatic brain injury in Michigan: who pays

Home care for traumatic brain injury in Michigan means a trained caregiver, or a family member who is paid as one, helps at home with daily routines, safety, memory and personal care. If your loved one has Michigan Medicaid, programs such as Home Help and the MI Choice Waiver can pay for that care. Car-crash injuries may also involve no-fault auto insurance.

On this page

1. What does in home care for brain injury look like day to day?
2. Which Michigan programs pay for TBI home care?
3. Does no-fault auto insurance pay for TBI home care in Michigan?
4. Can a family member get paid to care for someone with a brain injury?
5. How does Supportive Solutions help families after a brain injury?
6. When does someone with a brain injury need more than home care?
7. Frequently asked questions

What does in home care for brain injury look like day to day?

Every brain injury is different, so a good caregiver for a brain injury patient adapts to the person rather than a generic checklist.

Cueing, routines and supervision

Many survivors lose track halfway through a task. A caregiver gives short, clear prompts: “Next, rinse your hair.” They keep routines consistent, use written schedules and reminders, and watch for risks such as a stove left on.

Behavior and memory changes

Brain injuries can change mood, patience and judgment. Irritability, fatigue, impulsive choices and trouble with noise or crowds are common. Caregivers keep the home calm, break tasks into steps, build in rest, follow the rehab team’s strategies and report changes to the family.

Help with daily activities

Hands-on care can include bathing, dressing, grooming, toileting, eating, getting in and out of bed, and walking safely around the house. Meals, laundry, light housework and shopping can be included too. See personal care assistance.

Which Michigan programs pay for TBI home care?

Program	Who it is for	What it pays for
Home Help (MDHHS)	Full Medicaid members who need help with at least one daily activity and live in a private home	A caregiver, including many family members, for personal care and household tasks
MI Choice Waiver	Adults 65+, or 18+ with a physical disability, who meet nursing facility level of care and Medicaid rules	Personal care, respite, home changes and other in-home supports
Community Mental Health (CMH)	People who meet CMH criteria, such as a developmental disability or serious mental illness	Community living supports, respite and self-determination options
No-fault auto insurance (PIP)	People hurt in a motor vehicle crash	Attendant care, rehab and other allowable expenses, depending on the policy

Home Help

Home Help is based on functional need. The person must have full Medicaid, live in a private home rather than a nursing home or adult foster care home, need help (or documented cueing) with at least one activity such as bathing, dressing, eating, toileting, transferring or mobility, and have a medical needs form (DHS-54A) signed by a doctor, physician assistant or nurse practitioner. See who qualifies for Home Help.

MI Choice Waiver

Adults 18 and older with a physical disability, which can include a brain injury, may qualify for MI Choice if they meet nursing facility level of care and Medicaid financial rules. You apply through your local Area Agency on Aging or waiver agent, and there may be a waitlist. Supportive Solutions is an enrolled MI Choice provider.

Community Mental Health

If the brain injury happened in childhood, or the person also lives with a serious mental illness, county CMH services may be available. Call your county CMH access line to ask about eligibility.

Does no-fault auto insurance pay for TBI home care in Michigan?

Michigan no-fault personal injury protection (PIP) may pay for attendant care, and that care can be provided by family members, not only by agencies.

The 2019 no-fault reform changed the rules. For many claims, insurers only have to pay for about 56 hours per week of in-home attendant care given by a relative, a household member or someone the injured person knew before the crash. A 2023 Michigan Supreme Court decision held that this limit does not apply to people injured before the reform took effect. What applies to you depends on the date of the crash, the PIP coverage level chosen and your policy.

Because these rules are complex, please confirm your benefits directly with your auto insurer or an attorney who handles no-fault claims. Our role is Medicaid-funded care: we can help you with Home Help and MI Choice, which may fill gaps when no-fault benefits are limited or unavailable.

Can a family member get paid to care for someone with a brain injury?

Yes, in many cases. Under Home Help, the person receiving care chooses their provider. Adult children, parents of adult children, siblings, grandchildren, friends and neighbors can all be paid.

Two groups cannot be paid Home Help providers: a spouse, and a parent caring for a child under 18. See can a spouse be paid as a caregiver in Michigan for other options. To start the process, visit get paid to care.

How does Supportive Solutions help families after a brain injury?

We work with Michigan families in two ways. We help a family member get paid for the care they already give, or we find and place a background-verified caregiver who is enrolled with MDHHS in CHAMPS. We only place trained caregivers whose certifications match the person’s condition and needs.

• We check eligibility and help you apply for Medicaid if needed. See how to apply through MI Bridges.
• We help you prepare for the Home Help or MI Choice assessment, including how to describe hands-on help, prompting and behavior needs accurately. Read what happens at the assessment visit.
• We handle CHAMPS enrollment, EVV setup and paying the caregiver. The first paycheck typically arrives about 30 days after approval.
• We stay involved with ongoing support, reassessments and appeals.

We answer new inquiries within 24 hours. Our dedicated team of associates is available every day from 8 AM to 8 PM, and our staff speak English, Arabic and Spanish. We serve all of Michigan. See how it works.

When does someone with a brain injury need more than home care?

Home care is non-medical. When a survivor needs skilled rehabilitation, it comes from therapists and nurses. Options include Medicare or insurance home health, outpatient rehab and post-acute brain injury programs. Michigan Medicaid also has a Brain Injury Services benefit for post-acute rehabilitation after a moderate or severe injury; ask the hospital or rehab team whether it applies.

Medicare does not pay for ongoing personal care at home, so many families pair short-term skilled services with Medicaid-funded home care. Our guide to home care vs home health care explains the difference. If behavior becomes unsafe at home or round-the-clock nursing is needed, ask the doctor about a specialized residential program.

For emotional support, education and local support groups, contact the Brain Injury Association of Michigan. If your family is also caring for someone after a stroke, see our page on home care after a stroke, or browse all care by condition.

Frequently asked questions

Does Medicaid pay for home care after a traumatic brain injury in Michigan?

Yes, if the person has full Michigan Medicaid and needs help with daily activities. Home Help pays a caregiver for hands-on help with tasks such as bathing, dressing, eating and moving around the house. Adults who need nursing-home-level care may qualify for the MI Choice Waiver instead. Eligibility is based on functional need, not the diagnosis itself.

Can I get paid to take care of my adult son or daughter with a brain injury?

In most cases, yes. A parent of an adult child (18 or older) can be the paid Home Help provider, as can siblings, grandchildren, other relatives, friends and neighbors. The two exceptions are a spouse and the parent of a minor child under 18, who are responsible relatives and cannot be paid through Home Help.

Will no-fault auto insurance pay a family member for attendant care?

Michigan no-fault personal injury protection may pay for attendant care after a car crash, including care given by family. Since the 2019 reform, many claims limit family-provided care at home to about 56 hours per week, while people injured before the reform may be treated differently. Your coverage level matters, so confirm the details with your insurer or an attorney.

Does Home Help pay for supervision of someone with a brain injury?

Home Help pays for help with specific daily tasks. To qualify, the assessment has to find a need for hands-on help with at least one of them; reminders or verbal prompting on their own are ranked below that level. General standby supervision on its own is not a separate paid task. During the assessment, describe both the hands-on help and the step-by-step prompting your loved one needs for each activity, so the full picture is documented.

Who provides therapy after a brain injury: home care or home health?

Physical, occupational and speech therapy come from therapists through Medicare or insurance home health, outpatient rehab, or brain injury rehabilitation programs. Home care is non-medical: a caregiver helps with routines, personal care, meals and safety. Many families use both, with the caregiver supporting the exercises and strategies the therapy team sets.

Where can Michigan families find brain injury support groups?

The Brain Injury Association of Michigan runs a helpline, support groups across the state and education for survivors and caregivers. Hospital rehab programs and your county Community Mental Health office can also point you to local resources. For help with Medicaid-funded home care, call Supportive Solutions at (313) 977-6888.