How to Start a Medicaid Home Care Program: A Michigan Family's Checklist

Caring for an aging parent or a disabled family member at home is a full-time job, and most families do it without any pay at all. Michigan Medicaid has a program built specifically to change that. If you're already doing the hands-on work (bathing, dressing, meal preparation, medication reminders, wound care), you may be able to get paid for it through the state's Medicaid Home Help program (opens in new tab), without giving up your role as the primary family caregiver.

This checklist walks a Michigan family through the entire process, from Medicaid eligibility to submitting your first hours for payment. We'll cover the paperwork, the home visit, Home Help versus Michigan's other Medicaid waiver program, what the job pays as of 2026, and what's covered. Every dollar figure and rule below was checked against Michigan Department of Health and Human Services (MDHHS) (opens in new tab) publications current as of September 2026. Since these numbers change yearly, we've noted the source year next to each one.

What Is Michigan's Home Help Program?

The Medicaid Home Help program is a Michigan Medicaid-funded program that pays for non-medical support and personal care services so a person can keep living safely in their own Michigan home instead of moving into a nursing home. It's run by the Michigan Department of Health and Human Services and administered at the county level by an MDHHS adult services worker.

The part that surprises most families: Home Help lets the person needing care choose their own caregiver, including, in most cases, a family member. An adult child, grandchild, niece, nephew, or another relative can become a paid caregiver for a loved one who qualifies (the two exceptions are a spouse and a parent for their minor child), doing many of the same daily tasks they may already be doing for free, while that person stays in their own Michigan home instead of an institutional setting.

Michigan's Medicaid Home Care Programs: Home Help, MI Choice, and MI Coordinated Health

Before you start the paperwork, know that Michigan runs more than one Medicaid home care program, and they work very differently.

Home Help Program: Michigan's Home Help program is an entitlement: meet the eligibility rules, and there is no waitlist for services. It's for anyone who needs help with everyday tasks and activities of daily living. People with higher needs, including nursing home level of care, are covered too; that level just isn't required. Family caregivers are allowed, with two exceptions: a spouse cannot be paid to care for their husband or wife, and a parent cannot be paid to care for their own minor child. Hours are set through a plan built around what the person needs help with.

MI Choice Waiver: MI Choice Waiver is a separate Medicaid waiver for individuals who require nursing facility level of care but want to stay in their own home instead of a nursing home. Because it's a waiver rather than an entitlement, MI Choice has limited capacity, and families may encounter a waiting list for the MI Choice Waiver depending on funding and regional openings. Eligibility requires meeting the Nursing Facility Level of Care, a higher clinical bar than Home Help requires. MI Choice coordination can also bring in skilled home health, skilled nursing, and physical therapy alongside the caregiving support. Because Home Help has no waitlist, it is always the faster path to approval, and it covers people who meet a nursing facility level of care too. Even if you know you eventually want MI Choice, apply for Home Help first and get started.

MI Coordinated Health (MICH): For people who have both Medicare and Medicaid and live in Wayne County, Macomb County, Southwest Michigan, or the Upper Peninsula, personal care comes through MI Coordinated Health, which replaced MI Health Link in 2026. A MICH plan covers medical care, prescriptions, and long-term care at home in one plan. An individual gets personal care either through Home Help or through their MICH plan, not both, so check which one applies before you apply.

Step-by-Step Checklist: How to Start the Application Process

Here's the process broken into steps, in the order most families move through it in Michigan.

Step 1: Confirm Michigan Residency and Rough Eligibility. Applicants must be Michigan residents to qualify for Home Help, and the person receiving care must already be enrolled in Michigan Medicaid, or apply as part of this process. If your family member isn't on Medicaid yet, that comes first.

Step 2: Apply for Medicaid. If the person needing care doesn't already have Medicaid, apply next. Michigan residents can apply online through MI Bridges (michigan.gov/mibridges), by mail, or in person at local Medicaid offices in their county. For the Medicaid application, you'll need proof of income, bank statements or other asset documentation, proof of Michigan residency, and identification, and the care recipient must meet Michigan Medicaid's income and asset limits. Once Medicaid is in place, the rest of this checklist is about applying for the Home Help benefit itself.

Step 3: Submit the Home Help Application. Once Medicaid status is active, complete the Adult Services Application (DHS-390) and submit it to your local MDHHS office.

Step 4: Complete the Medical Needs Certification (Form MDHHS-6200). Home Help also requires a medical needs certification from a physician, physician's assistant, or nurse practitioner, documented on Michigan's official Medical Needs form, MDHHS-6200. It confirms the applicant's medical condition and functional limitations and supports the hours recommended after the home visit. Most doctors can complete it during a routine check-up, and if your loved one has seen the doctor recently, you can usually ask the office to fill it out and submit it without a new appointment.

Step 5: Complete the Home Assessment. Once both the application and the medical form are in, an adult services worker will schedule a home visit, the Adult Services Comprehensive Assessment, to determine the level of in-home assistance required and how many hours are appropriate. MDHHS usually won't schedule this visit until both are in place.

Step 6: Decide How the Caregiver Will Be Paid. Choose whether the caregiver will enroll directly with the state or work through a home care agency. Going direct means a lower rate paid once a month by mailed check, and handling enrollment, time tracking, and billing yourself. Through an agency like Family Love Care, caregivers can earn $18 or more per hour, are paid bi-weekly by direct deposit, and get help with every step that follows.

Step 7: Wait for Approved Hours. After the home visit and medical certification are reviewed, MDHHS finalizes a service plan listing the approved hours per month and the daily tasks the caregiver is authorized to help with. How many hours a family gets approved for depends on documented need; there's no flat number.

Step 8: Enroll the Caregiver in CHAMPS. This is the step that gets a family member paid. Before payment can begin, the chosen caregiver must complete the CHAMPS provider enrollment application (opens in new tab) (Michigan's Community Health Automated Medicaid Processing System) through MILogin, including a background check and electronic visit verification registration. When it is done correctly, CHAMPS enrollment can be finished in as little as 24 to 48 hours, whether the caregiver goes direct or through an agency. Delays happen when caregivers have to figure out the registration on their own and make mistakes, which is where an experienced agency helps.

Step 9: Set Up Electronic Visit Verification and Start Logging Hours. Michigan requires electronic visit verification (EVV) for Home Help, meaning the caregiver clocks in and out for every visit, and how that works depends on how the caregiver is enrolled. A caregiver working directly with the state has to set up the HHAeXchange app to clock in and out, and then separately log into CHAMPS to enter the work performed each day in order to get paid. A caregiver working through an agency is set up and trained on the agency's clock-in system and doesn't need to submit anything in CHAMPS to get paid.

Step 10: Get Paid. Once EVV records are submitted and matched to the approved hours, MDHHS processes payment on a regular schedule. Caregivers paid directly by the state receive a paper check once a month, mailed to the care recipient's home, while caregivers who work through an agency like Family Love Care are paid bi-weekly by direct deposit. Tax treatment can depend on your situation, especially if you live with the care recipient, so check with a tax professional.

Eligibility Requirements for Michigan's Home Help Program

To qualify for Home Help, the person receiving care generally needs to meet all of the following, checked against MDHHS's 2026 figures:

• Michigan residency. Applicants must be Michigan residents.
• Michigan Medicaid enrollment. The care recipient must be enrolled in Michigan Medicaid, either already or through the application described above, which includes meeting Michigan Medicaid's income and asset limits.
• Functional need. Applicants must need help with at least one Activity of Daily Living, such as bathing, dressing, toileting, or mobility, as documented in the home visit and the MDHHS-6200 medical certification.

A quick note: if your family member's income or assets are above Michigan Medicaid's limits, don't assume they're automatically disqualified. Michigan has planning tools that can affect Medicaid status. This is exactly the situation where an elder law attorney is worth the cost.

What Home Help Actually Covers

Home Help is a Medicaid-funded program built around personal care and in-home personal care support, not skilled treatment. Covered services typically include bathing and grooming, dressing and undressing, toileting and continence care, meal preparation, medication reminders, light housekeeping tied to personal care (not general home upkeep), and mobility assistance, including help getting in and out of bed.

Home Help does not cover home repairs or yard work, and isn't a substitute for skilled nursing or physical therapy from licensed home health agencies. Those fall under Michigan's home health benefit or, for a higher clinical bar, MI Choice. If your family member needs both daily personal care and skilled home health visits, say after a hospital stay, it's common to pair a Home Help caregiver with a separate skilled home health agency for nursing visits or therapy. Home health agencies handle the medical side; Home Help handles the daily side.

How Much Does Medicaid Pay Family Caregivers in Michigan?

As of January 1, 2026, Michigan's Home Help individual caregiver pay rate is $17.13 per hour, according to MDHHS's own numbered letter announcing the rate change, built from the state's $13.73 minimum wage plus a $3.40 direct care worker wage supplement. Caregivers who work through an agency like Family Love Care (opens in new tab) rather than going direct with the state can often earn more, $18 or more per hour, with pay deposited bi-weekly, compared with the once-a-month paper check, mailed to the care recipient's home, that caregivers get when they enroll directly with the state. Starting in 2026, individual caregivers paid directly by the state also have union dues deducted from their pay.

To put that in perspective: a caregiver approved for roughly 180 hours a month (purely an illustration, not a guarantee) would earn somewhere around $3,083 a month at the 2026 state rate. Actual pay depends entirely on the hours approved for your family member, set by MDHHS based on documented need. Because this rate is reviewed periodically, always check the current MDHHS figure before budgeting around it.

A few other things worth knowing:

• Caregivers enrolled directly with the state submit hours through HHAeXchange EVV and CHAMPS, matched against approved hours before payment, while agency caregivers clock in only through the agency's system of choice.
• Caregivers who work through an agency get help with CHAMPS enrollment, EVV setup, and ongoing paperwork, and are paid bi-weekly instead of monthly.
• Private pay arrangements remain an option for hours or services outside what Home Help approves, but without the same wage floor or oversight.

Can a Family Member Get Paid to Be a Caregiver in Michigan?

Yes. Under Michigan's Home Help program, an adult child, grandchild, niece, nephew, or other qualifying family member can be hired and paid as the designated caregiver for a Medicaid-eligible relative, as long as the caregiver enrolls through CHAMPS, passes background checks, and follows electronic visit verification (EVV) rules. The two exceptions are a spouse caring for their husband or wife, and a parent caring for their own minor child, a common point of confusion for Michigan families starting the process.

When a spouse or the parent of a minor child is the legally responsible person, another relative can only be paid to provide the care if that spouse or parent can't do it themselves, either because of their own physical limitations or because they have a job and aren't available. These situations are easy to get wrong, so it helps to work with an agency that has handled them before and can help prevent an incorrect denial. A parent can be paid to care for their child once the child turns 18.

Frequently Asked Questions

How much does Medicaid pay for family caregivers in Michigan?

As of 2026, Michigan's Medicaid home help program pays individual caregivers $17.13 per hour, based on the state's minimum wage plus a direct care worker wage supplement. Caregivers who work through an agency like Family Love Care can earn $18 or more per hour. Actual monthly pay depends on approved hours, which MDHHS sets based on documented need; there's no fixed amount for every family.

Does Medicaid pay for home care in Michigan?

Yes. Michigan Medicaid pays for home care through several programs. The two most common are Home Help, for daily living tasks, and MI Coordinated Health, for people with both Medicare and Medicaid in covered regions. The MI Choice Waiver is another option for people who meet Nursing Facility Level of Care but want to remain home. Michigan Medicaid also covers skilled home health services from licensed home health agencies after a hospital stay or for a specific medical condition, separate from personal-care-focused Home Help.

Can a family member get paid to be a caregiver in Michigan?

In most cases, yes. Home Help lets the Medicaid recipient choose a family caregiver (an adult child, grandchild, niece, or nephew) who enrolls in CHAMPS and is paid an hourly rate for approved personal care services. Spouses and parents for their minor children are the exceptions.

Is it better to go through an agency or directly through the state?

For most families, an agency is the better route. The family member is still the caregiver, but the agency helps with the application, CHAMPS enrollment, and EVV setup. Caregivers who work through Family Love Care can earn $18 or more per hour, paid bi-weekly by direct deposit, instead of the state's $17.13 per hour paid once a month by mailed check.

A Few Practical Notes Before You Start

• Keep copies of everything. The home visit paperwork, the MDHHS-6200 form, income and asset documentation, and your CHAMPS confirmation are worth having on hand later.
• Expect the process to take time. Between the application, home visit, medical certification, and CHAMPS enrollment, the process typically takes about 45 to 60 days from first call to first paycheck. Starting the Medicaid application and requesting the MDHHS-6200 form together can shave time off the entire process. Working with a good agency will help avoid unnecessary delays.
• Ask questions early and often. Your assigned adult services worker is your official point of contact, but if you work with a good agency, most of your contact will be with the agency's enrollment and support team, who are usually easier to reach than a caseworker.
• Consider professional help for complex situations. If finances are complicated, or you're weighing nursing home Medicaid planning alongside Home Help, an elder law attorney can help.
• Know when skilled care is also involved. Some families work with licensed home health agencies for nursing visits alongside a Home Help caregiver, especially after a hospital stay.

How Family Love Care Can Help

Navigating Michigan's Medicaid home care system (the application, the home visit, the MDHHS-6200 form, CHAMPS provider enrollment, and electronic visit verification setup) is a lot to manage on top of caring for someone you love. Family Love Care (opens in new tab) is a home care agency that works with families across Michigan every week to walk through this exact checklist, from the first Medicaid question to getting a family caregiver enrolled and paid. If you're ready to find out whether your loved one qualifies for Michigan's Home Help program, reach out to Family Love Care, and we'll help you sort out the next step.