Home Health Aide in Michigan: Medicare vs Medicaid Coverage

A home health aide in Michigan helps people who are ill, disabled, or recovering with bathing, dressing, toileting, mobility, and other daily needs at home. Medicare pays for an aide only briefly, alongside skilled nursing. Michigan Medicaid’s Home Help program pays for ongoing aide care and can pay a family member to be the aide.

On this page

1. What does a home health aide do?
2. Home health aide vs personal care assistant
3. Does Medicare or Medicaid pay for a home health aide in Michigan?
4. How to get a home health aide through Home Help
5. Can a family member provide this care and get paid?
6. Become a home health aide in Michigan
7. Frequently asked questions

What does a home health aide do?

Home health aides (HHAs) provide hands-on personal care. A typical visit includes:

• Bathing, grooming, dressing, toileting, and incontinence care.
• Safe transfers from bed to chair and help walking or using a wheelchair.
• Meal preparation and feeding assistance.
• Watching for changes and reporting concerns to family or a supervising nurse.
• Light housekeeping, laundry, shopping, and medication reminders.

Aides do not give injections or change sterile dressings; a nurse does.

Home health aide vs personal care assistant

The tasks overlap almost completely; the setting and the payer differ.

• A home health aide traditionally works for a Medicare-certified agency under a nurse, has completed federally required training, and visits only while skilled care is in place.
• A personal care assistant provides the same hands-on care on an ongoing basis, paid by Medicaid Home Help, MI Choice, or the family. No state license is required.

Michigan families use “home health aide” for both. We will work out which program should pay. See personal care assistance for the full ADL list.

Does Medicare or Medicaid pay for a home health aide in Michigan?

	Medicare home health	Michigan Medicaid Home Help
Who is covered	People on Medicare who are homebound and need skilled nursing or therapy	People on Michigan Medicaid who need hands-on help with daily activities
What the aide does	Personal care as part of a nurse-supervised plan	Bathing, dressing, toileting, transfers, meals, housework, shopping
How long	Short term; ends when skilled care ends	Ongoing as long as need and Medicaid eligibility continue
Who can be the aide	Employee of a Medicare-certified agency	Agency caregiver or a family member, friend, or neighbor enrolled through CHAMPS
How to get it	Doctor’s order and referral to a home health agency	Apply through the MDHHS county office; in-home assessment sets hours

Medicare: short-term and skilled only

Medicare covers home health aide visits only when a doctor certifies that you are homebound and need intermittent skilled nursing or therapy. The aide is part of that plan, and visits stop when the skilled need ends. Medicare never pays for long-term custodial care or a family caregiver.

Medicaid Home Help: ongoing personal care

Home Help, run by the Michigan Department of Health and Human Services (MDHHS), pays for a home health aide day after day. Your loved one must be on Michigan Medicaid and need hands-on help with at least one activity of daily living. An adult services worker assesses each task at home and authorizes monthly hours. Our Michigan Home Help program page covers eligibility and the application.

MI Choice Waiver: nursing-home level of care

If the assessment shows a nursing-home level of need, the MI Choice Waiver can fund more aide hours plus respite and adult day care. Apply through your Area Agency on Aging. For a plain-language comparison, read home care vs home health care in Michigan.

How to get a home health aide through Home Help

1. Confirm Medicaid. Use our free Medicaid eligibility check, or apply through MI Bridges.
2. Request a Home Help assessment. Contact your county MDHHS office, or let us make the call. A doctor signs a medical needs form, and an adult services worker visits the home to set monthly hours.
3. Choose the aide and begin. A family member enrolls through CHAMPS, or we place a screened aide. Visits are logged with Electronic Visit Verification (EVV) and MDHHS pays the aide.

Can a family member provide this care and get paid?

Yes, through Medicaid Home Help. The person receiving care chooses their own aide, and an adult child, sibling, grandchild, friend, or neighbor can enroll as an individual provider in CHAMPS. After a background check, MDHHS pays the family aide for authorized hours logged through EVV. Under current MDHHS rules, a spouse or the parent of a minor child generally cannot be paid as the Home Help provider.

If the family aide lives with the client, Home Help payments may be excludable from federal income tax under IRS Notice 2014-7. Start at become a paid caregiver, and see how to get paid to take care of a family member in Michigan.

Become a home health aide in Michigan

Supportive Solutions Homecare is hiring home health aides and caregivers across Michigan. No CNA certificate is required to start; we provide paid orientation and training. Aides who speak Arabic or Spanish are in high demand. See open roles on our careers page, or read our guide on how to become a home health aide in Michigan.

We provide home health aide services in Detroit, Dearborn, Warren, Sterling Heights, Ann Arbor, Flint, Lansing, and Grand Rapids, and nearby communities.

Frequently asked questions

What is the difference between a home care agency and a home health agency?

A home care agency like Supportive Solutions Homecare provides non-medical help with daily living, paid by Medicaid Home Help, MI Choice, or private pay. A home health agency is Medicare-certified and sends nurses and therapists for skilled, doctor-ordered care after an illness or hospital stay. Many Michigan families use both at different times.

Does Medicare pay for a home health aide in Michigan?

Only in limited situations. Medicare covers part-time aide visits when a doctor certifies that you are homebound and also need skilled nursing or therapy from a Medicare-certified agency. The aide visits end when the skilled care ends. Medicare does not pay for ongoing daily personal care; that is where Michigan Medicaid’s Home Help program comes in.

Does Medicaid pay for a home health aide in Michigan?

Yes, through the Home Help program run by MDHHS. If your loved one is on Michigan Medicaid and needs hands-on help with at least one activity of daily living, MDHHS authorizes monthly aide hours and pays the caregiver directly. The MI Choice Waiver adds hours and services for people who qualify for a nursing-home level of care.

Can a family member be a paid home health aide in Michigan?

Yes, under Medicaid Home Help. The relative enrolls as an individual provider through CHAMPS, passes a background check, logs visits with EVV, and is paid by MDHHS for the authorized hours. Spouses and parents of minor children are generally excluded. Medicare does not pay family members at all.

Do you need a certification to be a home health aide in Michigan?

It depends on the employer. Medicare-certified home health agencies must use aides who completed federally required training and a competency evaluation. Michigan does not require a state license or CNA certificate for Home Help individual providers or agency personal care aides. Supportive Solutions Homecare provides paid orientation and skills training; a CNA is a plus.