Long-Term Care Medicaid in Michigan: 2026 Guide

In Michigan, Long-Term Care Medicaid is run by the Michigan Department of Health and Human Services (MDHHS), and eligibility is decided by your local MDHHS office. It can pay for nursing home care and for care at home through the MI Choice Waiver, PACE and other programs. This guide explains the 2026 rules in plain language.

At a glance: Michigan 2026 figures

Figures last updated for 2026. Sources are listed at the end of this page.

Figures change periodically. Double-check current amounts with Michigan MDHHS before relying on them.

What Long-Term Care Medicaid covers in Michigan

Nursing home care. Medicaid pays for care in a certified nursing facility. You pay most of your income toward the cost each month (your “patient-pay amount”), and Medicaid pays the rest.

MI Choice Waiver. This is Michigan’s main home and community-based program for older adults and adults with disabilities who need a nursing facility level of care. Local waiver agencies arrange services such as personal care, homemaker help, respite, home-delivered meals, adult day care and changes to the home. MI Choice can have a waiting list in some areas.

PACE (Program of All-Inclusive Care for the Elderly). For people 55 and older who live in a PACE service area and need a nursing facility level of care. A PACE team provides and coordinates all care, often at a PACE center.

MI Coordinated Health. On January 1, 2026, the MI Health Link program ended and was replaced by MI Coordinated Health (MICH). It is a single health plan for adults 21 and older who have both Medicare and Medicaid and live in certain counties (Barry, Berrien, Branch, Calhoun, Cass, Kalamazoo, Macomb, St. Joseph, Van Buren, Wayne and most of the Upper Peninsula). It covers Medicare and most Medicaid benefits, including long-term services and supports.

Assisted living. Medicaid does not pay for room and board in assisted living or adult foster care. MI Choice may pay for some care services in those settings.

Who qualifies

A person generally must:

• be 65 or older, or blind or disabled;
• live in Michigan and be a U.S. citizen or qualified non-citizen;
• need a nursing facility level of care. Michigan uses the Nursing Facility Level of Care Determination (LOCD), done by the nursing home, the MI Choice waiver agency or the PACE organization;
• meet the income and asset rules below, as decided by MDHHS.

Income rules

Michigan does not print one simple income limit for nursing home Medicaid. People with higher income can often still qualify, because their income is compared with the cost of their care and most of it goes toward that cost. The exact income test, and how it works for MI Choice, should be checked with MDHHS before you rely on it.

Once you are on Medicaid in a nursing home, most of your income goes to the facility as your patient-pay amount. You keep a personal needs allowance of $60 a month, and money can be set aside for a spouse at home and for health insurance premiums.

Asset rules

In 2026, a single applicant can have up to $9,950 in countable assets. Michigan tests this on any one day of the month: if your assets are at or below the limit on one day, you meet the asset test for that month. When both spouses are in a nursing home or on MI Choice, each is treated as an individual and may keep up to $9,950.

Countable assets include cash, checking and savings accounts, CDs, stocks, bonds, mutual funds, retirement accounts that can be cashed in, life insurance cash value and real estate other than the home.

Usually exempt:

• Your home (equity up to $752,000) if you live there or plan to return, or a spouse or dependent relative lives there
• One vehicle
• Household goods and personal belongings
• Funeral and burial arrangements, within MDHHS rules

Spousal protections

• Assets: MDHHS adds up the couple’s countable assets at the start of the first continuous stay in a nursing home or waiver program. The spouse at home keeps a protected spousal amount: the greater of $32,532 or half of that total, up to $162,660 in 2026. A higher amount can be set by a hearing or a court order.
• Income: The spouse at home keeps their own income. If it is below a basic allowance of $2,705 a month (from July 1, 2026), part of the applicant’s income can go to them. Extra is allowed for high housing costs, up to $4,066.50 a month.

Look-back and penalties

When you apply, Michigan looks back at the 60 months (5 years) before the application date. This is called the look-back period. The state checks whether you, or your spouse, gave away money or property, or sold something for less than it was worth, during that time.

Common examples of transfers that can cause a problem:

• Cash gifts to children or grandchildren, even small yearly gifts. (A gift that is fine for federal gift-tax purposes can still count for Medicaid.)
• Adding a child’s name to a house deed or bank account in a way that gives them part ownership.
• Selling a house or car to a relative for much less than it is worth.
• Paying a family member for care without a written agreement made at the time.

Some transfers are allowed, such as transfers between spouses, or transferring a home to a child who is blind or disabled.

How the penalty works. If the state finds a transfer that is not allowed, it does not deny Medicaid forever. Instead, it sets a penalty period: a stretch of time when Medicaid will not pay for long-term care. The state divides the amount given away by the penalty divisor ($12,216.30 a month).

Example: Suppose you gave your son $50,000 three years before applying. $50,000 divided by $12,216.30 is about 4.1 months without Medicaid payment for long-term care.

The penalty period starts only once you have applied, are otherwise eligible, and are in (or need) long-term care. This is why gifts made while someone is healthy can still matter years later. If a gift is returned in full, the penalty can be removed.

Estate recovery in Michigan

Michigan’s Estate Recovery Program is run by MDHHS.

• What is recovered: Medicaid paid for long-term care services, such as nursing facility care and home and community-based services, for people 55 and older.
• When it is put off: federal rules prevent recovery while a spouse is alive, or if there is a child under 21 or a child who is blind or disabled.
• Hardship waivers: MDHHS can exempt or reduce a claim in some situations, such as a home of modest value or when heirs would face undue hardship. Ask MDHHS for the current rules.
• Family members and personal representatives can contact the MDHHS Estate Recovery unit with questions.

How to apply

• Online: MI Bridges, Michigan’s benefits website
• In person or by mail: at your local MDHHS office
• For the MI Choice Waiver: contact the MI Choice waiver agency for your county. It does the level-of-care assessment and helps you through the Medicaid application.
• For PACE: contact the PACE organization that serves your area.

After you apply. MDHHS will send you a written notice saying whether you qualify, from what date, and how much of your income goes toward your care each month. If you disagree with a decision, you have the right to ask for a fair hearing. The notice explains how to ask and the deadline for asking. Keep copies of everything you send and receive, and report changes in income, assets or address when they happen.

Gather what you can before you apply. The caseworker may ask for:

• Photo ID, Social Security card and Medicare card
• Proof of age and of U.S. citizenship or immigration status
• Proof that you live in the state (for example, a utility bill or lease)
• Proof of all income: Social Security award letter, pension statements, annuity statements
• Bank, credit union and investment statements (often for the full 60-month look-back period)
• Deeds, property tax bills and the value of any real estate
• Life insurance policies (showing cash value) and prepaid funeral or burial contracts
• Vehicle titles
• Health insurance cards and long-term care insurance policies
• Power of attorney or guardianship papers, if someone is applying for you
• For a spouse at home: their income and assets too, since both spouses’ assets are counted at the start

If you cannot find a document, apply anyway and tell the caseworker. They can explain what else is accepted.

Free public help in Michigan

• MDHHS and your local office: Medicaid applications and eligibility.
• Area Agencies on Aging: local information on long-term care options.
• MMAP (Michigan Medicare/Medicaid Assistance Program): Michigan’s free Medicare counseling program (SHIP).
• Michigan Long Term Care Ombudsman Program: free advocates for residents of nursing homes, homes for the aged and adult foster care.

Recent and upcoming changes

A 2025 federal law (Public Law 119-21) makes two changes that affect Long-Term Care Medicaid in every state, including Michigan:

• Retroactive coverage gets shorter on January 1, 2027. Today, Medicaid can pay bills from up to 3 months before the month you apply, if you would have qualified then. For applications from January 1, 2027, this window shrinks to 2 months for older adults and people with disabilities. In plain terms: from 2027, it matters more to apply soon after care starts, so that earlier bills are not left unpaid.
• Home equity cap on January 1, 2028. States will no longer be able to set a home equity limit above $1,000,000 (except for some farm property). Michigan’s 2026 home equity limit, $752,000, is already below the new cap, so this change is not expected to affect Michigan’s limit.

The federal amounts that change each year (for example, the allowances for a spouse at home) will be updated on this page for 2027 once they are published.

State programs

Each program below has its own page with who qualifies, services, how to apply and waiting lists:

• Michigan MI Choice Waiver
• Michigan Home Help Program
• Michigan MI Coordinated Health (MICH)

Frequently asked questions

What is the asset limit in Michigan for 2026? $9,950 for a single applicant, tested on any one day of the month. The home, one car and personal belongings are usually not counted.

What happened to MI Health Link? It ended on December 31, 2025. Members moved to MI Coordinated Health, a combined Medicare and Medicaid plan in the same areas (except Chippewa, Gogebic and Menominee counties in 2026).

Is there a wait list for the MI Choice Waiver? There can be, depending on your area. Contact the MI Choice waiver agency for your county.

How much can my spouse keep? In 2026, at least $32,532 and up to $162,660 in assets, plus the home, a car and belongings, and income of at least $2,705 a month.

How long is the penalty for a gift? Divide the gift by $12,216.30 to get the number of months. A $20,000 gift would mean about 1.6 months without Medicaid payment for long-term care.

Will the state take my home after I die? MDHHS can seek repayment for long-term care paid after age 55, which can include the home. Recovery is put off while a spouse or a young or disabled child survives, and hardship exemptions exist.

Figures change periodically. Double-check current amounts with Michigan MDHHS before relying on them.

Sources

• MDHHS, Bridges Eligibility Manual (BEM) 400, Assets
• MDHHS, BEM 402, Special Medicaid Asset Rules
• MDHHS, BEM 405, Asset Transfers and Divestment
• MDHHS, BEM 546, Post-Eligibility Patient-Pay Amounts
• MDHHS, MI Health Link (program end notice)
• MDHHS, MI Coordinated Health program eligibility
• MI Bridges
• CMS, 2026 SSI and spousal impoverishment standards
• Public Law 119-21 (2025)

Last updated for 2026. General information only, not legal or financial advice. Medicaid Answers is a free educational resource published by Medicaid Answers Foundation.