Medicaid for nursing home and home care in Michigan

Who qualifies

You must be 65 or older, blind, or disabled, live in Michigan, and need the level of care a nursing facility gives. Michigan's manual calls nursing home and hospital stays "L/H" (long-term care or hospital).

The $2,982 test uses gross income, before most deductions.

What counts and what does not

Not counted:

• Your home (homestead), including the land and buildings on adjoining land, as long as your equity is no more than $752,000. The limit does not apply if your spouse, a child under 21, or a blind or disabled child lives there. If your equity is over the limit, Medicaid will not pay for nursing home care, MI Choice, PACE or Home Help.
• One vehicle owned by your household.
• Burial funds up to $1,500 for you and for your spouse.
• Life insurance if the total face value of policies on one person is $1,500 or less.

Counted: bank accounts, stocks, and retirement accounts. For a retirement account, MDHHS counts the amount you could withdraw now, minus any early withdrawal penalty.

Gifts and transfers ("divestment")

MDHHS looks back 60 months (five years) for anything you or your spouse gave away or sold for less than it was worth. A transfer causes a penalty: months when Medicaid will not pay for long-term care. MDHHS divides the value given away by the average monthly private cost of a nursing home in Michigan. For 2026 that figure is $12,216 a month.

If you are married

When one spouse needs long-term care and the other stays at home, MDHHS adds up the couple's countable assets at the start of the first continuous stay. This is called the initial asset assessment. You can ask for one even before you apply, using form DHS-4574-B, Assets Declaration.

The spouse at home keeps half of the couple's countable assets, within these limits. If their own income is low, part of the other spouse's income can go to them. The allowance can be higher when housing costs are high. MDHHS uses a shelter standard of $811.50 and a heat and utility allowance of $706.

What you pay in a nursing home

After you qualify, MDHHS figures a monthly patient-pay amount, which you pay to the nursing home. From your income it first takes out:

• A patient allowance of $60 a month for your personal needs ($90 for some veterans).
• An allowance for your spouse at home and for dependent family members.
• Health insurance premiums you pay.
• Up to $83 a month for a court-appointed guardian or conservator, if you pay one.
• A home maintenance disregard for up to six months if a doctor certifies you should return home in less than six months.

Care at home

• MI Choice Waiver: Medicaid services at home or in another residential setting for adults who need nursing-home-level care. A local waiver agency decides if you qualify for care and sets your start date.
• Home Help: Medicaid pays a caregiver to help with tasks like bathing, dressing and eating, and with housework and meals. Ask your local MDHHS office for an adult services assessment.
• PACE: for people 55 and older who need nursing-home-level care and live in a PACE service area. PACE combines medical and long-term care.

If you enter a nursing home, MI Choice ends automatically.

How to apply

1. Ask for a care review. For MI Choice, contact the waiver agency in your area (MI Options can help you find it). For Home Help, ask your MDHHS office.
2. Apply for Medicaid. Apply online at NewMiBridges.Michigan.gov, or use paper form MDHHS-1171 at your local MDHHS office.
3. List all assets and income for you and your spouse, and any gifts or sales in the past five years.
4. Answer requests quickly. MDHHS will send a list of papers it needs. If you are married, it will also send the initial asset assessment notice (DHS-4588).

After you apply

• Patient-pay amount: if you live in a nursing home, pay your monthly patient-pay amount to the nursing home.
• Report changes in income, assets or address to MDHHS.
• Appeals: you have 90 calendar days from the date of the notice to ask for a hearing. To keep your benefits during the appeal, your request must reach MDHHS within 10 calendar days of the notice date. Use form DHS-18, Request for Hearing, or another signed written request, and send it to your local MDHHS office marked "Attention Hearings Coordinator."
• Estate recovery: if you were 55 or older and got long-term care (nursing home, hospice, or home and community services), Michigan may seek repayment after you die, but only from property that goes through probate. Recovery waits while a spouse, a child under 21, or a blind or disabled child is living, and in some cases for a caregiver child or a sibling who lived in the home. Heirs can ask for a hardship waiver, for example for a home of modest value. Questions: 1-800-642-3195 or [email protected].

Common mistakes

• Waiting to apply because income seems too high. In a nursing home you may still qualify through Group 2 with a patient-pay amount.
• Giving money to children before applying. Gifts in the last five years can delay coverage.
• Not asking for the spouse's share. The spouse at home may keep up to $162,660.
• Assuming the home must be sold. It is not counted if equity is under the limit.

Free help

• MI Options (Michigan's free Medicare and long-term care counseling program): 1-800-803-7174, or email [email protected].
• Area Agencies on Aging: find yours through the Eldercare Locator, 1-800-677-1116.
• MDHHS Beneficiary Help Line: 1-800-642-3195.

See also paying for a nursing home, Medicare and all benefits in Michigan.

Phone numbers: Free help lines for Michigan agencies

Check what you may qualify for