Michigan MI Choice Waiver
MI Choice is Michigan’s main home and community-based waiver for older adults and adults with disabilities who need a nursing facility level of care. It sits alongside our Michigan Long-Term Care Medicaid guide, which covers the nursing home rules.
Figures change periodically. Double-check current amounts before relying on them.
At a glance
| Item | Details |
|---|---|
| Type of program | Medicaid home and community-based services (HCBS) waiver |
| Who runs it | Michigan MDHHS, through local waiver agencies |
| Age | 65 and older, or 18 and older with a disability |
| Care need | Needs a nursing facility level of care |
| Michigan 2026 income rule (long-term care) | $2,982 a month for MI Choice (special income rule) |
| Michigan 2026 asset limit (single applicant) | $9,950 |
| Waiting list | Yes, in some areas |
MI Choice in brief
To sum up, Michigan MDHHS, through local waiver agencies oversees MI Choice. Its target group is 65 and older, or 18 and older with a disability; on care need, the rule is: Needs a nursing facility level of care. On waiting lists, the current picture is: Yes, in some areas. Each of these points is covered in more depth below, alongside the general Michigan rules from our state guide. If MI Choice is not the right fit, the related pages at the end point to other Michigan programs and general guides.
What the program is
MDHHS contracts with local waiver agencies, often Area Agencies on Aging or other community organizations, to run MI Choice. The waiver agency screens callers by phone, completes an in-person assessment, confirms the nursing facility level of care and writes a person-centered service plan. Participants can choose agency services or self-determination, which lets them hire and direct their own workers with a budget. MI Choice can pay for some care services in licensed settings such as homes for the aged, but not room and board.
Under federal law, Michigan can run home and community-based waivers like MI Choice, which bend some ordinary Medicaid rules so care can happen outside a facility. Slots are limited each year, every participant has an individual care plan, and a case manager or coordinator puts services in place. Waiver services sit on top of regular Medicaid, which still covers doctors, hospitals and prescriptions (after Medicare, for people who have it). See our overview of HCBS waivers.
Who qualifies in 2026
In Michigan, the basic requirements for MI Choice are that the person:
- Is 65 or older, or 18 or older with a disability
- Needs a nursing facility level of care
- Qualifies for full Medicaid under Michigan’s long-term care financial rules (see the money test below) (income up to $2,982 a month)
- Lives in Michigan and is a U.S. citizen or qualified non-citizen
Financial eligibility. The person must qualify for full Medicaid under Michigan’s rules for long-term care. The table’s figures are Michigan’s 2026 long-term care numbers, taken from our state guide. Michigan MDHHS’s countable assets do not usually include the home (within the equity limit, if the applicant or a spouse lives there or intends to return), one car, personal belongings and a small burial fund. Married couples get extra protection in Michigan: the spouse at home keeps a share of assets and may get some of the applicant’s income. See Spousal impoverishment rules.
What the care test means in practice. For MI Choice, an assessor checks how much help the person needs with bathing, dressing, eating, toileting, mobility and medications, and whether memory loss calls for supervision. For MI Choice, an assessor, usually a nurse or social worker, visits the person at home, in the hospital or in the facility. Families should describe the worst days honestly and bring a list of conditions and medicines. See Nursing home level of care and Activities of daily living.
What services it can pay for
Services depend on the person’s assessed needs and written care plan. Depending on the plan, they can include:
- Personal care
- Homemaker
- Respite
- Home-delivered meals
- Adult day care
- Home changes
- Supports coordination
- Private duty nursing
Not every participant gets every service; the plan reflects assessed need and the help family already gives. A change in health is a reason to request a reassessment.
How to apply
There are two tracks, a financial one and a care one, and both must say yes. The usual path for MI Choice is:
- Contact your local MI Choice waiver agency.
- Screening and assessment.
- Apply for Medicaid.
Before contacting Michigan MDHHS, see Applying for a waiver and the documents checklist for what to gather.
Waiting lists
Each MI Choice waiver agency keeps its own waiting list. Michigan gives priority to certain groups, such as people leaving a nursing facility and people referred by Adult Protective Services. Others are generally served in order of the date they were screened. Calling early and keeping the agency informed of changes helps.
General advice is in Waiver waiting lists.
How it relates to nursing home Medicaid
MI Choice uses the nursing facility level of care, so it is a direct alternative to a nursing home. For MI Choice, gross countable income must be at or below 300% of the SSI rate ($2,982 a month in 2026). There is no way around this cap: eligibility cannot be reached through a deductible (spend-down) or a patient-pay amount, and Michigan has no qualified income trust route. Michigan nursing home Medicaid has no fixed income cap and a higher asset limit ($9,950 in 2026), so a person can qualify for a nursing home but not MI Choice because of income.
Rules shared with nursing home Medicaid. Michigan’s financial rules for MI Choice track the nursing home rules closely. Gifts and below-value transfers in the five-year look-back can trigger a penalty period for home care as well as nursing home care. After death, estate recovery can reach services paid from age 55 on. People who keep income above a set allowance may have to pay part of it toward their care each month.
Personal needs allowance. If the person does move to a nursing home, Michigan’s 2026 personal needs allowance is $60 a month. Most of the rest of their income goes toward the cost of care. The state guide explains the nursing home side.
Tips for families
- Begin before it is urgent. Every step of MI Choice takes time, and an early request protects your place.
- Keep a paper trail: copies of forms and notices, plus the names and dates of every call to Michigan MDHHS.
- Use your appeal rights. Notices that deny or reduce services explain how to request a fair hearing; acting quickly can protect current services.
- Report changes promptly, including income, assets, a move or a new living arrangement.
- Plan for renewals. Medicaid and the care assessment are both renewed, usually once a year. See Renewals.
- Think about the spouse at home. Couples have extra protections, but they have to be claimed. A certified Medicaid planner or a legal aid office can explain how the rules apply to a particular family.
Common questions
Can family be paid? Through self-determination, participants can hire their own workers, which can include some family members.
Does MI Choice pay for assisted living? It may pay for some care services in licensed settings, not room and board.
Why is there a waiting list? MI Choice has limited funding and slots. Priority groups are served first.
What if income is over $2,982? Then the person cannot qualify for MI Choice. The cap is firm: no spend-down, patient-pay amount or income trust gets around it. Home Help and nursing home Medicaid have different income rules.
Related pages
- Michigan Long-Term Care Medicaid guide
- Michigan Home Help
- Three kinds of Long-Term Care Medicaid
- PACE programs
Last updated for 2026. General information only, not legal or financial advice. Medicaid Answers is a free educational resource published by Medicaid Answers Foundation.