Michigan Medicaid for seniors and long-term care

Last verified: June 2026

How Michigan Medicaid covers seniors

Michigan Medicaid covers nursing facility care for seniors who meet both income and asset requirements. Beyond nursing facilities, Michigan has built out several programs that allow seniors to receive care at home or in community settings instead of an institution — typically at lower cost and with better outcomes for the enrollee.

Income limits for aged, blind, and disabled Medicaid programs follow separate rules from MAGI-based programs. SSI-related income standards apply. MDHHS determines eligibility based on countable income after certain deductions — the calculation is specific to each individual's situation and is best confirmed through an MDHHS eligibility specialist.

Asset limit: individuals seeking nursing facility Medicaid are limited to $2,000 in countable resources. Married couples where both spouses are applying are limited to $3,000. The primary residence, one vehicle, and some personal property are excluded.

MI Choice Waiver: home and community-based services

Michigan's primary alternative to nursing facility placement is the MI Choice Waiver, authorized under Section 1915(c) of the Social Security Act. MI Choice serves individuals who meet nursing facility level of care but prefer — and can safely receive — services in a home or community setting. MDHHS administers MI Choice through regional waiver agents, often Prepaid Inpatient Health Plans (PIHPs).

Services covered under MI Choice include adult foster care, home help and homemaker assistance, personal care, adult day health services, respite care for family caregivers, and care coordination. The waiver covers what nursing facilities cover for daily living — bathing, dressing, meals, medication management — but in the person's home or a smaller residential setting.

Demand for MI Choice frequently exceeds available waiver slots. A waitlist exists in some Michigan regions. MDHHS processes requests in the order received; applicants on the waitlist remain in the queue until a slot opens or their condition changes. Nursing facility placement does not require a waiver slot — it is available to anyone who meets the clinical and financial criteria.

PACE: for seniors who qualify for nursing facility level of care

PACE — the Program of All-Inclusive Care for the Elderly — is available in several Michigan counties. PACE serves individuals age 55 and older who meet nursing facility level of care and can safely live in the community with PACE supports. Participating counties include Wayne, Oakland, Macomb, Ingham, Genesee, and Kent, among others.

PACE replaces both Medicare and Medicaid for enrolled members. The PACE organization becomes the single point of care — providing primary care, specialist care, hospital care, physical therapy, prescription drugs, meals, transportation, and personal care through one coordinated plan. There is no separate billing between Medicare and Medicaid once enrolled.

PACE enrollment is separate from standard Medicaid enrollment. Contact the PACE organization serving your county for eligibility assessment and enrollment information.

MI Health Link: integrated care for dual eligibles

Many Michigan seniors qualify for both Medicare and Medicaid — called dual eligibles. Michigan operates MI Health Link, an integrated care program that coordinates medical care, behavioral health, and long-term services for dual eligibles in select counties. MI Health Link assigns enrollees to an integrated plan that handles all Medicare and Medicaid services through one care team and one plan.

MI Health Link is distinct from standard Healthy Michigan Plan managed care plans. Dual eligibles in participating counties may be auto-enrolled in MI Health Link and can opt out if they prefer to keep separate Medicare and Medicaid coverage.

Spousal protection and estate recovery

When one spouse enters a nursing facility and the other remains at home, Michigan applies spousal impoverishment protections. The community spouse (the one remaining at home) can retain a Community Spouse Resource Allowance (CSRA) — a portion of the couple's combined assets above the nursing facility enrollee's $2,000 limit. The CSRA amount is set under federal law and updated annually; MDHHS calculates it at the time of application. The community spouse also retains a Minimum Monthly Maintenance Needs Allowance from the institutionalized spouse's income.

Long-term care options in Michigan Medicaid

• MI Choice Waiver — home and community-based services (HCBS) administered through local Waiver Agents; alternative to nursing facility for eligible seniors and adults with disabilities
• Nursing facility coverage — MDHHS pays the facility after the patient contributes nearly all income toward care (patient pay/spend-down)
• PACE (Program of All-Inclusive Care for the Elderly) — available in select Michigan counties; combines all medical and LTC services into one capitated plan
• Adult foster care (AFC) homes — small group residential settings; Medicaid-funded through specialized programs
• Medicaid Estate Recovery — Michigan recovers LTC costs from estates of deceased enrollees age 55+ who received nursing facility or HCBS waiver services

Michigan Medicaid long-term care financial eligibility

Source: MDHHS. CSRA and MMMNA amounts are adjusted annually. Consult an elder law attorney for complex asset planning situations.