Six separate Michigan programs pay family members to provide care for an aging parent, spouse, or loved one. Some pay through Medicaid, some through the VA, and some through private funding sources. Eligibility rules and pay rates differ sharply across them.

This guide lays out every legitimate pathway in Michigan for 2026, who can actually be hired under each (spouses, adult children, friends), what the pay rates look like, and how to choose the right program for your family's situation.

By Brevy Care Team · Last verified April 16, 2026

The Short Version

If you're an adult child, sibling, grandchild, niece, nephew, friend, or neighbor of a Medicaid-eligible adult in Michigan, the Home Help Program is usually the fastest path to being paid. 2026 rate: $17.13 per hour. No waitlist.

If you're a spouse of a Medicaid-eligible adult, Home Help doesn't work. You need the MI Choice Waiver Self-Determination Option. MI Choice has an enrollment cap and possible waitlist but allows spousal caregivers.

If your loved one is a wartime veteran, VA programs (Aid & Attendance, Veteran-Directed Care, PCAFC) often pay more and can be stacked with Medicaid options.

If your loved one has long-term care insurance or enough private assets, a written caregiver agreement with fair-market wages can pay you while reducing the estate for eventual Medicaid planning.

The details matter. Below is the full map.

The Six Pathways

1. Michigan Home Help Program (Medicaid State Plan)

Who it pays: Adult children, adult grandchildren, siblings, nieces, nephews, in-laws, friends, and neighbors. Not spouses. Not parents of a minor care recipient.

2026 pay rate: $17.13/hour ($13.73 Michigan minimum wage plus a $3.40 pass-through).

What it covers: Personal care with ADLs (bathing, dressing, toileting, transferring, eating) and selected IADLs (meal prep, medication reminders, light housekeeping, laundry, shopping).

Eligibility:

  • Recipient must be on Michigan Medicaid.
  • Recipient must need help with ADLs (assessed via DHS-1183).
  • No NFLOC requirement.
  • No waitlist.

How the caregiver gets paid: Caregivers enroll in CHAMPS (Michigan's Medicaid provider portal), pass a criminal background check, and submit hours through MI Time for Electronic Visit Verification. MDHHS pays via W-2 direct deposit.

Best for: Adult children caring for a parent, or any non-spouse family member.

See the full Michigan Home Help Program guide.

2. MI Choice Waiver: Self-Determination Option (SDO)

Who it pays: Adult children, grandchildren, siblings, nieces, nephews, friends, neighbors, and spouses.

2026 pay rate: Varies by regional Waiver Agency, typically $13 to $17 per hour for personal care attendants under the Self-Determination Option in 2026.

What it covers: Personal care, respite, chore services, and most other MI Choice services when the participant elects the Self-Determination Option.

Eligibility:

  • Recipient must meet Nursing Facility Level of Care (NFLOC) via the LOCD assessment.
  • Recipient must meet the 300% SSI income test ($2,982/month) and $9,950 asset limit.
  • Recipient enrolls in MI Choice (note: capped program with possible waitlists).
  • Recipient elects the SDO.

How the caregiver gets paid: Through a Financial Management Services (FMS) agency contracted by the Waiver Agency. The FMS handles payroll, tax withholding, background checks, and provider enrollment.

Best for: Spouses caring for a spouse; families with nursing-facility-level need that goes beyond what Home Help covers.

See the full MI Choice Waiver guide.

3. VA Program of Comprehensive Assistance for Family Caregivers (PCAFC)

Who it pays: A designated "primary family caregiver" of an eligible veteran. Can include a spouse, adult child, sibling, parent, or other close family member.

2026 stipend: A monthly tax-free stipend based on the GS-4 federal pay grade in the caregiver's geographic area, adjusted for the veteran's level of care need. Typically $2,500 to $4,500+ per month depending on locality and tier.

What it covers: PCAFC is a stipend program; it doesn't pay hourly. The caregiver provides round-the-clock care at home; the VA provides a monthly payment, health coverage (through CHAMPVA if the caregiver isn't already insured), mental health services, respite, and travel reimbursement for the veteran's appointments.

Eligibility (Tier 1, expanded in 2020 and 2022 to cover veterans of all eras):

  • Veteran must have a serious injury or illness (incurred or aggravated in the line of duty).
  • Veteran must need in-person personal care services for at least 6 continuous months.
  • Veteran must be enrolled in VA health care.

How the caregiver gets paid: Direct deposit from the VA after PCAFC application approval.

Best for: Families of eligible veterans willing to commit to full-time caregiving.

See the Michigan VA Senior Care Benefits guide.

4. VA Veteran-Directed Care (VDC)

Who it pays: Any caregiver the veteran hires, including spouses, adult children, friends, and professional aides.

2026 pay rate: The veteran is given a monthly budget (typically $1,500 to $3,000+ depending on need), from which they pay the caregiver. Hourly rate is set by the veteran, usually $14 to $20+ per hour.

What it covers: Home-based care designed to avoid nursing home placement. The veteran directs who to hire, when, and for what tasks.

Eligibility:

  • Veteran must be enrolled in VA health care.
  • Veteran must need help with ADLs.
  • VDC must be available at the veteran's VA Medical Center (currently offered at Ann Arbor, Battle Creek, Detroit, Iron Mountain, and Saginaw VAMCs in Michigan; verify availability with your VAMC).

How the caregiver gets paid: Through a Financial Management Services agency under contract with the VA.

Best for: Veterans enrolled in VA care who want more flexibility than PCAFC offers and whose family caregivers aren't full-time.

5. VA Aid & Attendance Pension

Who it pays: The veteran or surviving spouse directly (not the caregiver as an employee). Families can use the pension to pay a caregiver under a private arrangement.

2026 monthly maximum (roughly):

  • Single veteran with A&A: ~$2,358/month
  • Married veteran with A&A: ~$2,795/month
  • Surviving spouse with A&A: ~$1,515/month

What it covers: A monthly pension benefit on top of any other VA pension, paid to the wartime veteran or surviving spouse when they need help with ADLs, are housebound, are in a nursing facility, or are legally blind.

Eligibility:

  • Wartime veteran (90 days active duty including 1+ day during a recognized wartime period) OR surviving spouse.
  • Limited net worth (2026 threshold around $159,240) and countable income.
  • A&A-specific functional criteria.

How it works for caregivers: The pension goes to the veteran. Family caregivers are typically paid from it under a written caregiver agreement.

See the Michigan VA Aid & Attendance guide.

6. Private Caregiver Agreements (Personal Services Contracts)

Who it pays: Anyone, including spouses, with no Medicaid or VA involvement.

Pay rate: Fair market rate for the geographic area and service type. In Michigan, this typically falls between $16 and $30 per hour depending on whether the care is non-medical, CNA-level, or specialized.

What it is: A written, arms-length contract between the care recipient (or their legal representative) and the family caregiver, outlining services, hourly rate, hours, duties, and payment terms.

Why it matters for Medicaid planning: Paying a family member without a proper contract can look like a gift, triggering the Medicaid 5-year transfer penalty. A properly structured caregiver agreement converts the payment into a legitimate personal services contract, preserving the estate and avoiding penalties. Must be in writing and in effect before services are delivered. Michigan courts and MDHHS look for written contracts, reasonable hourly rates, time records, and tax compliance.

Best for: Families with enough assets to private-pay a caregiver, who want to preserve the estate and plan for eventual Medicaid eligibility. Always work with a Michigan elder-law attorney to draft the contract.

Comparison Table

Pathway Pay spouses? 2026 rate Waitlist Functional threshold
Home Help (Medicaid) No $17.13/hr None ADL needs
MI Choice SDO (Medicaid) Yes $13–$17/hr Possible NFLOC
VA PCAFC Yes ~$2,500–$4,500+/month stipend Assessment-based VA Tier 1 criteria
VA Veteran-Directed Care Yes Budget-based, typically $14–$20+/hr VA waitlist possible ADL needs
VA Aid & Attendance Paid to veteran, not caregiver Up to $2,795/mo 90–180 days to process A&A criteria
Private Caregiver Agreement Yes Market rate None Family choice

How to Choose

Start with the care recipient's situation:

  1. Veteran or surviving spouse? Check VA first. A&A combined with PCAFC or VDC often pays more than Medicaid-side programs.
  2. Already on Medicaid or likely to qualify? If the caregiver will be a non-spouse family member, start with Home Help (fastest, no waitlist). If the caregiver is a spouse OR the care need is intensive (nursing-facility level, adult day, home modifications, respite), apply for MI Choice.
  3. Private pay with substantial assets? Talk to a Michigan elder-law attorney about a caregiver agreement, both to generate caregiver income now and to preserve the estate for future Medicaid planning.
  4. None of the above? Check the AAA's National Family Caregiver Support Program (NFCSP) for respite grants, training, and non-pay supports.

Not sure which program fits your family? Chat with Brevy for a side-by-side comparison based on your specific situation: veteran status, Medicaid eligibility, relationship to the care recipient, and care need.

Tax Considerations

All Michigan caregiver pay programs generate reportable income. Key rules:

  • Home Help pays W-2 wages. MDHHS is the employer of record.
  • MI Choice SDO pays W-2 wages through the FMS agency.
  • VA PCAFC stipend is tax-free federal income; not reported on a W-2.
  • VA Veteran-Directed Care pays W-2 wages through the FMS agency.
  • Private caregiver agreements pay W-2 wages if the caregiver is an employee; 1099 income if truly independent (risk of misclassification).

IRS Notice 2014-7: If the Medicaid-paid caregiver lives in the same home as the care recipient and provides care to that person, the wages may be excluded from federal gross income. This is a common and valuable exclusion. Talk to a tax preparer familiar with the rule before filing.

Michigan income tax: Wages that are federally excluded under Notice 2014-7 may or may not be excluded for Michigan income tax purposes. Consult a Michigan tax preparer.

Common Misconceptions

"If my mother has Medicare, I can get paid through Medicare." Medicare does not pay family caregivers. Medicare only pays for short-term skilled home health through a certified agency. Family caregiver pay in Michigan comes through Medicaid (Home Help, MI Choice), VA, or private arrangements.

"My spouse can't be paid at all in Michigan." Wrong. Spouses can be paid under MI Choice SDO and under VA programs. They just can't be paid under Home Help.

"I can pay myself with my parent's Social Security." Not without a proper arrangement. An informal transfer of Social Security to a family "caregiver" without a written contract is treated as a gift under Medicaid rules, which can trigger the 5-year transfer penalty.

"I need a CNA license to be paid as a family caregiver." Not for Home Help, MI Choice SDO, or most VA programs. You need to be 18+, pass a background check, and complete any program-specific training. A CNA license is valuable but not required.

"If I start getting paid, my family loses Medicaid." Paying a family caregiver from Medicaid funds does not jeopardize the care recipient's Medicaid. The payments come out of Medicaid-authorized hours, not the recipient's personal budget.

Frequently Asked Questions

Yes, but not through Home Help. Michigan Home Help explicitly does not pay spouses. Spouses can be paid through the MI Choice Waiver's Self-Determination Option (SDO), which allows the participant to hire their spouse as a paid personal care attendant once enrolled in MI Choice. VA programs (PCAFC and Veteran-Directed Care) also allow spouses to be paid for caring for an eligible veteran.

Michigan Home Help pays $17.13/hour in 2026 — that's the $13.73 Michigan minimum wage plus a $3.40 pass-through. Caregivers are paid as W-2 employees with MDHHS as the employer of record. There is no waitlist for Home Help.

Not for most Michigan pathways. Home Help, MI Choice SDO, and most VA programs require the caregiver to be 18+, pass a criminal background check, and complete any program-specific training — but not a CNA license. Training may be required to enroll in CHAMPS (Michigan's Medicaid provider portal) and to submit hours through MI Time for Electronic Visit Verification.

No. Payments through Home Help or MI Choice SDO come out of Medicaid-authorized hours — not the recipient's personal budget — so they don't jeopardize eligibility. What can jeopardize Medicaid is paying a family member informally (without a written caregiver agreement) from private funds, which Medicaid's 5-year look-back can treat as a disqualifying gift.

Often yes. For example, a veteran receiving Aid & Attendance can also have a non-spouse family caregiver paid through Home Help. And a veteran's family caregiver may receive a PCAFC stipend while the veteran receives A&A pension. The rules get complex — talk to your VA Caregiver Support Coordinator and a Michigan elder-law attorney before layering programs.

Learn More

Find personalized help figuring out how to get paid as a family caregiver at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or tax advice. VA and Medicaid benefit amounts change annually; caregiver eligibility rules are program-specific and complex. Always verify with the relevant agency, your MDHHS Adult Services Worker, your VA caregiver support coordinator, or a Michigan elder-law attorney. Brevy is not a law firm, financial advisor, or healthcare provider.

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Brevy Care Team

Expert eldercare guidance from Brevy's team of healthcare professionals and researchers.