Six separate Michigan paid family caregiver programs let you get paid to 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.
The Short Version
If you're caring for a Medicaid-eligible adult in Michigan and you are not their spouse, start with the Home Help Program: the client chooses their own caregiver, and the 2026 rate is $17.13 per hour.Centers for Medicare & Medicaid Services. (n.d.). Michigan State Plan Amendment MI-25-0022 — CMS approval letter and approved pages. medicaid.gov. Retrieved Oct 15, 2026, from https://www.medicaid.gov/medicaid/spa/downloads/MI-25-0022.pdf
If you're a spouse, Home Help won't pay you and MI Choice pays a spouse only in the narrow case covered below,Centers for Medicare & Medicaid Services. (n.d.). Michigan State Plan Amendment MI-25-0022 — CMS approval letter and approved pages. medicaid.gov. Retrieved Oct 15, 2026, from https://www.medicaid.gov/medicaid/spa/downloads/MI-25-0022.pdf,Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov - MI Choice Waiver (0233.R06.00). medicaid.gov. Retrieved Sep 3, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/82076 so look at the VA programs (PCAFC and Veteran-Directed Care both pay spouses) or a private caregiver agreement.
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.
For how paid caregiving fits alongside respite and the state's other caregiver supports, see the Michigan caregiver pillar guide.
Six Ways to Get Paid as a Family Caregiver in Michigan
1. Michigan Home Help Program (Medicaid)
Who it pays: A caregiver the client chooses; the client, not the State of Michigan, is the employer. MDHHS does not pay a responsible relative (a spouse caring for a spouse, or a parent caring for a minor child), a minor (17 and under), or an incarcerated caregiver.Centers for Medicare & Medicaid Services. (n.d.). Michigan State Plan Amendment MI-25-0022 — CMS approval letter and approved pages. medicaid.gov. Retrieved Oct 15, 2026, from https://www.medicaid.gov/medicaid/spa/downloads/MI-25-0022.pdf Responsible relatives must also be unable or unavailable for the client to be eligible, so a client whose spouse is able and available to give the care does not qualify.Centers for Medicare & Medicaid Services. (n.d.). Michigan State Plan Amendment MI-25-0022 — CMS approval letter and approved pages. medicaid.gov. Retrieved Oct 15, 2026, from https://www.medicaid.gov/medicaid/spa/downloads/MI-25-0022.pdf
2026 pay rate: $17.13/hour, up from $15.88: the $13.73 hourly state minimum wage plus the current $3.40 hourly direct care worker wage increase.Centers for Medicare & Medicaid Services. (n.d.). Michigan State Plan Amendment MI-25-0022 — CMS approval letter and approved pages. medicaid.gov. Retrieved Oct 15, 2026, from https://www.medicaid.gov/medicaid/spa/downloads/MI-25-0022.pdf
What it covers: Hands-on assistance with activities of daily living (ADLs) and assistance with instrumental activities of daily living (IADLs).Centers for Medicare & Medicaid Services. (n.d.). Michigan State Plan Amendment MI-25-0022 — CMS approval letter and approved pages. medicaid.gov. Retrieved Oct 15, 2026, from https://www.medicaid.gov/medicaid/spa/downloads/MI-25-0022.pdf
Eligibility:
- Recipient must have active Michigan Medicaid.Centers for Medicare & Medicaid Services. (n.d.). Michigan State Plan Amendment MI-25-0022 — CMS approval letter and approved pages. medicaid.gov. Retrieved Oct 15, 2026, from https://www.medicaid.gov/medicaid/spa/downloads/MI-25-0022.pdf
- Recipient must need hands-on help with ADLs, as determined in an in-person assessment at home (form MDHHS-5534) by an MDHHS Adult Services Worker.Centers for Medicare & Medicaid Services. (n.d.). Michigan State Plan Amendment MI-25-0022 — CMS approval letter and approved pages. medicaid.gov. Retrieved Oct 15, 2026, from https://www.medicaid.gov/medicaid/spa/downloads/MI-25-0022.pdf
- A medical provider must certify the medical need (form MDHHS-6200, DHS-54A, or VA Form 10-10M).Centers for Medicare & Medicaid Services. (n.d.). Michigan State Plan Amendment MI-25-0022 — CMS approval letter and approved pages. medicaid.gov. Retrieved Oct 15, 2026, from https://www.medicaid.gov/medicaid/spa/downloads/MI-25-0022.pdf
Caregiver requirements: The caregiver must be 18 or older, pass a criminal history screen before being paid, show picture ID, and enroll in CHAMPS, MDHHS's Medicaid provider system.Centers for Medicare & Medicaid Services. (n.d.). Michigan State Plan Amendment MI-25-0022 — CMS approval letter and approved pages. medicaid.gov. Retrieved Oct 15, 2026, from https://www.medicaid.gov/medicaid/spa/downloads/MI-25-0022.pdf
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
Who it pays: Self-direction lets a participant hire and supervise their own workers; whether a relative may be paid depends on the federal authority and the state's own rules.U.S. Government Publishing Office. (1915). 42 CFR 441.450 — Basis, scope, and definitions (Self-Directed PAS, 1915(j)) — eCFR current edition. ecfr.gov. Retrieved Oct 15, 2026, from https://www.ecfr.gov/current/title-42/section-441.450 MI Choice self-determination does not pay a spouse: MDHHS's Self-Determination in Long Term Care guidelines state that the participant cannot choose legal spouses, guardians, or representatives as paid workers. A spouse can be paid only as a Community Living Supports provider hired through a home care agency, and only when the participant requires extraordinary care (care beyond what a spouse would ordinarily do in the household for a same-age person without a disability or chronic illness, needed for the participant's health and welfare and to avoid institutionalization) and the arrangement is in the participant's best interest. MDHHS has said more policy would follow CMS approval of the waiver renewal; ask your regional waiver agency what applies now.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov - MI Choice Waiver (0233.R06.00). medicaid.gov. Retrieved Sep 3, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/82076 Adult children and other non-spouse relatives remain the usual hires.
2026 pay rate: There is no published statewide MI Choice caregiver rate, so ask your regional waiver agency how the wage is set.Centers for Medicare & Medicaid Services. (n.d.). Michigan Waiver Factsheet. medicaid.gov. Retrieved Oct 19, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/MI For participants who choose self-determination, the waiver's Fiscal Intermediary handles budget management and payroll.U.S. Government Publishing Office. (n.d.). 42 CFR 441.310 — Limits on Federal financial participation (FFP) (eCFR, current). ecfr.gov. Retrieved Sep 3, 2026, from https://www.ecfr.gov/current/title-42/section-441.310
What it covers: Personal care (community living supports), respite, and the other MI Choice services when the participant self-directs. Respite is the one service with a stated ceiling: 30 days per calendar year for respite provided outside the home.U.S. Government Publishing Office. (n.d.). 42 CFR 441.310 — Limits on Federal financial participation (FFP) (eCFR, current). ecfr.gov. Retrieved Sep 3, 2026, from https://www.ecfr.gov/current/title-42/section-441.310
Eligibility:
- Recipient must be financially eligible for Medicaid, categorically eligible as aged or disabled, and functionally eligible (nursing facility level of care) through Michigan's online Nursing Facility Level of Care Determination (LOCD).Centers for Medicare & Medicaid Services. (n.d.). Michigan Waiver Factsheet. medicaid.gov. Retrieved Oct 19, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/MI
- Recipient must meet Michigan's long-term-care Medicaid limits: a monthly income limit of $2,982 (300% of the 2026 SSI federal benefit rate) and a countable-asset limit of $9,950 for a single applicant in 2026.Centers for Medicare & Medicaid Services. (2026). CMS CMCS Informational Bulletin: 2026 SSI, Spousal Impoverishment, and Medicare Savings Program Resource Standards (Dec 9, 2025). medicaid.gov. Retrieved Oct 12, 2026, from https://www.medicaid.gov/federal-policy-guidance/downloads/cib12092025.pdf Income above $2,982 rules out MI Choice: waiver income eligibility cannot be established with a patient-pay amount or by meeting a deductible.U.S. Government Publishing Office. (2024). 42 U.S.C. 1396r-5 (Social Security Act sec. 1924, spousal impoverishment), United States Code 2024 Edition, U.S. Government Publishing Office (govinfo) — the CSRA is the GREATEST of four alternatives; the dollar cap binds only clauses (i) and (ii)(II); the (e)(2) hearing and (f)(3) court-order routes carry no dollar amount. govinfo.gov. Retrieved Oct 13, 2026, from https://www.govinfo.gov/content/pkg/USCODE-2024-title42/html/USCODE-2024-title42-chap7-subchapXIX-sec1396r-5.htm
- Recipient must need at least two waiver services, one of which must be Supports Coordination, and the need cannot be fully met by existing State Plan or other services. The applicant must also agree to receive MI Choice services on a regular basis, at least every 30 days, and must keep meeting these requirements to stay enrolled.U.S. Government Publishing Office. (n.d.). 42 CFR 441.310 — Limits on Federal financial participation (FFP) (eCFR, current). ecfr.gov. Retrieved Sep 3, 2026, from https://www.ecfr.gov/current/title-42/section-441.310
- Recipient enrolls in MI Choice, a capacity-capped program. When enrollment exceeds capacity, screened applicants go on a priority-ranked waiting list (below).Centers for Medicare & Medicaid Services. (n.d.). Michigan Waiver Factsheet. medicaid.gov. Retrieved Oct 19, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/MI
- A person may be enrolled in only one Medicaid long-term services and supports program at a time, so MI Choice is an alternative to Home Help, not an addition to it.Centers for Medicare & Medicaid Services. (n.d.). Michigan Waiver Factsheet. medicaid.gov. Retrieved Oct 19, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/MI
If MI Choice is full, the waiting list is not first-come, first-served. MDHHS's approved waiver application ranks applicants in four priority categories and enrolls them in that order:
- Young adults who aged out of State Plan Private Duty Nursing services and still need that nursing care.
- Nursing facility residents who meet program requirements and want to return to a home or community setting.
- Qualified applicants diverted from an imminent nursing facility admission, including anyone with an active Adult Protective Services (APS) case.
- All other qualified applicants, in chronological order by date of inquiry.
Inside a category, order is by date of request. If the person you care for is in a nursing facility and wants to come home, or is close to admission, tell the waiver agency: it can be the difference between Category 2 or 3 and the back of the queue. Individual circumstances can shift the order, and someone lower on the list who is ready to enroll can take an open slot.Centers for Medicare & Medicaid Services. (n.d.). Michigan Waiver Factsheet. medicaid.gov. Retrieved Oct 19, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/MI
Being told the program is full is not a closed door. The MDHHS Medicaid Provider Manual states that the enrollment process for MI Choice "is not ever actually or constructively closed," requires each waiver agency to keep the list "actively maintained and managed," and calls it "the only approved method of accessing waiver services when the waiver program is at capacity." Ask to be screened and placed on the list with your request date recorded. Slot allocations are not fixed either: MDHHS reserves the right to reallocate agencies' fiscal-year slots to meet program demand.Centers for Medicare & Medicaid Services. (n.d.). Michigan Waiver Factsheet. medicaid.gov. Retrieved Oct 19, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/MI
How the caregiver gets paid: Through the waiver's Fiscal Intermediary, which handles budget management and payroll and tax handling for participants who choose self-determination.U.S. Government Publishing Office. (n.d.). 42 CFR 441.310 — Limits on Federal financial participation (FFP) (eCFR, current). ecfr.gov. Retrieved Sep 3, 2026, from https://www.ecfr.gov/current/title-42/section-441.310
Best for: Families with nursing-facility-level need that goes beyond what Home Help covers, where the caregiver is an adult child or another non-spouse relative.
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. The caregiver must be at least 18 and either a spouse, adult child, parent, stepfamily or extended-family member, or someone who lives full time with the veteran (or is willing to).U.S. Government Publishing Office. (2018). Program of Comprehensive Assistance for Family Caregivers Improvements and Amendments Under the VA MISSION Act of 2018 — Proposed Rule, 85 FR 13356 (March 6, 2020) (govinfo.gov / Federal Register). govinfo.gov. Retrieved Sep 2, 2026, from https://www.govinfo.gov/content/pkg/FR-2020-03-06/pdf/2020-04464.pdf
2026 stipend: A monthly stipend VA has described as nontaxable, not a flat national figure. The VA divides the federal OPM GS-4, step-1 annual rate for the veteran's locality by 12, then multiplies by a factor. 38 CFR 71.40(c)(4)(i) sets five rungs using three multipliers (0.625, 1.00 and 0.25), not one:U.S. Government Publishing Office. (2018). Program of Comprehensive Assistance for Family Caregivers Improvements and Amendments Under the VA MISSION Act of 2018 — Proposed Rule, 85 FR 13356 (March 6, 2020) (govinfo.gov / Federal Register). govinfo.gov. Retrieved Sep 2, 2026, from https://www.govinfo.gov/content/pkg/FR-2020-03-06/pdf/2020-04464.pdf
- Current program (veteran meets 38 CFR 71.20(a)): 0.625, or 1.00 if the VA finds the veteran unable to self-sustain in the community.U.S. Government Publishing Office. (2018). Program of Comprehensive Assistance for Family Caregivers Improvements and Amendments Under the VA MISSION Act of 2018 — Proposed Rule, 85 FR 13356 (March 6, 2020) (govinfo.gov / Federal Register). govinfo.gov. Retrieved Sep 2, 2026, from https://www.govinfo.gov/content/pkg/FR-2020-03-06/pdf/2020-04464.pdf
- Legacy participant or applicant (38 CFR 71.20(b) or (c)): the factor comes from the sum of the veteran's 2019 clinical ratings instead, 1.00 at 21 or higher, 0.625 at 13 to 20, 0.25 at 1 to 12, with no self-sustain finding required.U.S. Government Publishing Office. (2018). Program of Comprehensive Assistance for Family Caregivers Improvements and Amendments Under the VA MISSION Act of 2018 — Proposed Rule, 85 FR 13356 (March 6, 2020) (govinfo.gov / Federal Register). govinfo.gov. Retrieved Sep 2, 2026, from https://www.govinfo.gov/content/pkg/FR-2020-03-06/pdf/2020-04464.pdf
A veteran meeting both is paid the higher amount. A legacy participant is also held at no less than the caregiver's rate the day before October 1, 2020, while the veteran stays at the address on record. The legacy schedule lapses October 1, 2028.U.S. Government Publishing Office. (2018). Program of Comprehensive Assistance for Family Caregivers Improvements and Amendments Under the VA MISSION Act of 2018 — Proposed Rule, 85 FR 13356 (March 6, 2020) (govinfo.gov / Federal Register). govinfo.gov. Retrieved Sep 2, 2026, from https://www.govinfo.gov/content/pkg/FR-2020-03-06/pdf/2020-04464.pdf
What it covers: Besides the stipend, the VA provides caregiver education and training, mental health counseling, at least 30 days of respite care per year, and, if the caregiver is not otherwise insured, health coverage through CHAMPVA.U.S. Government Publishing Office. (2018). Program of Comprehensive Assistance for Family Caregivers Improvements and Amendments Under the VA MISSION Act of 2018 — Proposed Rule, 85 FR 13356 (March 6, 2020) (govinfo.gov / Federal Register). govinfo.gov. Retrieved Sep 2, 2026, from https://www.govinfo.gov/content/pkg/FR-2020-03-06/pdf/2020-04464.pdf
Eligibility: VA's first screen has four requirements, and all of them must be true for the veteran:U.S. Government Publishing Office. (2018). Program of Comprehensive Assistance for Family Caregivers Improvements and Amendments Under the VA MISSION Act of 2018 — Proposed Rule, 85 FR 13356 (March 6, 2020) (govinfo.gov / Federal Register). govinfo.gov. Retrieved Sep 2, 2026, from https://www.govinfo.gov/content/pkg/FR-2020-03-06/pdf/2020-04464.pdf
- A VA disability rating (individual or combined) of 70% or higher.U.S. Government Publishing Office. (2018). Program of Comprehensive Assistance for Family Caregivers Improvements and Amendments Under the VA MISSION Act of 2018 — Proposed Rule, 85 FR 13356 (March 6, 2020) (govinfo.gov / Federal Register). govinfo.gov. Retrieved Sep 2, 2026, from https://www.govinfo.gov/content/pkg/FR-2020-03-06/pdf/2020-04464.pdf
- Discharged from the U.S. military, or has a date of medical discharge.U.S. Government Publishing Office. (2018). Program of Comprehensive Assistance for Family Caregivers Improvements and Amendments Under the VA MISSION Act of 2018 — Proposed Rule, 85 FR 13356 (March 6, 2020) (govinfo.gov / Federal Register). govinfo.gov. Retrieved Sep 2, 2026, from https://www.govinfo.gov/content/pkg/FR-2020-03-06/pdf/2020-04464.pdf
- Needs at least 6 months of continuous, in-person personal care services.U.S. Government Publishing Office. (2018). Program of Comprehensive Assistance for Family Caregivers Improvements and Amendments Under the VA MISSION Act of 2018 — Proposed Rule, 85 FR 13356 (March 6, 2020) (govinfo.gov / Federal Register). govinfo.gov. Retrieved Sep 2, 2026, from https://www.govinfo.gov/content/pkg/FR-2020-03-06/pdf/2020-04464.pdf
- Enrolled in VA health care.U.S. Government Publishing Office. (2018). Program of Comprehensive Assistance for Family Caregivers Improvements and Amendments Under the VA MISSION Act of 2018 — Proposed Rule, 85 FR 13356 (March 6, 2020) (govinfo.gov / Federal Register). govinfo.gov. Retrieved Sep 2, 2026, from https://www.govinfo.gov/content/pkg/FR-2020-03-06/pdf/2020-04464.pdf
Those four are necessary but not sufficient. You and the veteran apply together, and 38 CFR 71.20(a) adds conditions: participation must be in the veteran's best interest, the veteran must get care at home and ongoing primary-care-team care (or will once a caregiver is designated), and the Family Caregiver's personal care must not be simultaneously and regularly provided by or through another individual or entity.U.S. Government Publishing Office. (2018). Program of Comprehensive Assistance for Family Caregivers Improvements and Amendments Under the VA MISSION Act of 2018 — Proposed Rule, 85 FR 13356 (March 6, 2020) (govinfo.gov / Federal Register). govinfo.gov. Retrieved Sep 2, 2026, from https://www.govinfo.gov/content/pkg/FR-2020-03-06/pdf/2020-04464.pdf
How the caregiver gets paid: Monthly, after approval; the caregiver must enroll in direct deposit through the VA customer engagement portal.U.S. Government Publishing Office. (2018). Program of Comprehensive Assistance for Family Caregivers Improvements and Amendments Under the VA MISSION Act of 2018 — Proposed Rule, 85 FR 13356 (March 6, 2020) (govinfo.gov / Federal Register). govinfo.gov. Retrieved Sep 2, 2026, from https://www.govinfo.gov/content/pkg/FR-2020-03-06/pdf/2020-04464.pdf
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 receives a flexible monthly budget set by a VA assessment of their care needs, and pays the caregiver from it at a rate the veteran sets. There is no fixed statewide budget or hourly figure.
What it covers: Home-based care designed to avoid nursing home placement.
Eligibility:
- Veteran must be enrolled in VA health care.
- Veteran must need help with ADLs.
- VDC is not offered at every VA Medical Center. Confirm availability with your local Michigan VAMC before counting on it.
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 maximum annual pension rate:
- Single veteran with A&A: $29,093/year.U.S. Department of Veterans Affairs. (n.d.). Current Pension Rates For Veterans. va.gov. Retrieved Sep 29, 2026, from https://www.va.gov/pension/veterans-pension-rates/
- Veteran with one dependent (such as a spouse) with A&A: $34,488/year.U.S. Department of Veterans Affairs. (n.d.). Current Pension Rates For Veterans. va.gov. Retrieved Sep 29, 2026, from https://www.va.gov/pension/veterans-pension-rates/
- Surviving spouse with no dependents, with A&A: $18,697/year.U.S. Department of Veterans Affairs. (n.d.). Current Survivors Pension Benefit Rates. va.gov. Retrieved Jul 31, 2026, from https://www.va.gov/family-and-caregiver-benefits/survivor-compensation/survivors-pension/rates/,U.S. Department of Veterans Affairs. (n.d.). Current Pension Rates For Veterans. va.gov. Retrieved Sep 3, 2026, from https://www.va.gov/pension/veterans-pension-rates/
These are the 2026 Maximum Annual Pension Rates, effective December 1, 2025 through November 30, 2026. The rate is a ceiling, not a payment: the VA pays the difference between the beneficiary's countable income and the applicable rate, generally in 12 equal monthly payments.U.S. Department of Veterans Affairs. (n.d.). Current Pension Rates For Veterans. va.gov. Retrieved Sep 29, 2026, from https://www.va.gov/pension/veterans-pension-rates/,U.S. Department of Veterans Affairs. (n.d.). Current Survivors Pension Benefit Rates. va.gov. Retrieved Jul 31, 2026, from https://www.va.gov/family-and-caregiver-benefits/survivor-compensation/survivors-pension/rates/
What it covers: A monthly payment added to the VA pension of a wartime veteran or surviving spouse who meets one of the A&A tests below (Housebound is a separate benefit).U.S. Department of Veterans Affairs. (n.d.). Current Pension Rates For Veterans. va.gov. Retrieved Sep 29, 2026, from https://www.va.gov/pension/veterans-pension-rates/
Eligibility:
- No dishonorable discharge, plus wartime service: active duty starting before September 8, 1980, with at least 90 days served and at least 1 day during wartime; enlisted service starting after September 7, 1980, of at least 24 months or the full period called to duty (with some exceptions), with at least 1 wartime day; or officer service starting after October 16, 1981, without having previously served at least 24 months on active duty with at least 1 day during wartime. A surviving spouse who hasn't remarried qualifies on the deceased veteran's service.U.S. Department of Veterans Affairs. (n.d.). Current Pension Rates For Veterans. va.gov. Retrieved Sep 29, 2026, from https://www.va.gov/pension/veterans-pension-rates/,U.S. Department of Veterans Affairs. (n.d.). Current Survivors Pension Benefit Rates. va.gov. Retrieved Jul 31, 2026, from https://www.va.gov/family-and-caregiver-benefits/survivor-compensation/survivors-pension/rates/
- The veteran must also meet one of the pension's non-service tests: age 65 or older, a permanent and total disability, a nursing home patient for long-term care because of a disability, or receiving SSDI or SSI. A&A is an add-on to a VA pension, so the underlying pension has to be payable first.U.S. Department of Veterans Affairs. (n.d.). Current Pension Rates For Veterans. va.gov. Retrieved Sep 29, 2026, from https://www.va.gov/pension/veterans-pension-rates/
- Net worth at or below $163,699 in 2026: assets (a married veteran's include the spouse's; the home and up to 2 acres of its lot, the car, and basic home items like appliances don't count) plus annual income after deductible expenses such as unreimbursed medical costs above 5% of the MAPR.U.S. Department of Veterans Affairs. (n.d.). Current Pension Rates For Veterans. va.gov. Retrieved Jun 24, 2026, from https://www.va.gov/pension/veterans-pension-rates/
- At least one A&A test: needing help with daily activities like bathing, feeding and dressing; staying in bed for much of the day because of illness; being a nursing home patient due to lost mental or physical abilities related to a disability; or eyesight of 5/200 or less in both eyes even with correction, or a visual field of 5 degrees or less.U.S. Department of Veterans Affairs. (n.d.). Current Pension Rates For Veterans. va.gov. Retrieved Sep 29, 2026, from https://www.va.gov/pension/veterans-pension-rates/
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: A fair market rate for the geographic area and service type. As a benchmark, the 2025 median cost of non-medical in-home care in Michigan was about $35 per hour (CareScout 2025 Cost of Care Survey). A caregiver agreement should set a reasonable, documented rate in line with local market wages, not an inflated one.assets.carescout.com. (2025). CareScout — Cost of Care Survey 2025, Median Cost Data Tables (Michigan and USA National rows: annual, monthly, daily, and home-care hourly/visit medians). Retrieved Aug 1, 2026, from https://assets.carescout.com/x/8fcb50422f/282102.pdf
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: Michigan applies a 60-month (5-year) asset-transfer look-back to nursing home Medicaid, MI Choice, PACE, and Home Help, and an uncompensated transfer creates a penalty period. During the penalty Medicaid won't pay for long-term care, MI Choice, PACE, Home Help or home health, but other covered services continue, and MDHHS does not apply a penalty that creates an undue hardship.U.S. Government Publishing Office. (2024). 42 U.S.C. 1396r-5 (Social Security Act sec. 1924, spousal impoverishment), United States Code 2024 Edition, U.S. Government Publishing Office (govinfo) — the CSRA is the GREATEST of four alternatives; the dollar cap binds only clauses (i) and (ii)(II); the (e)(2) hearing and (f)(3) court-order routes carry no dollar amount. govinfo.gov. Retrieved Oct 13, 2026, from https://www.govinfo.gov/content/pkg/USCODE-2024-title42/html/USCODE-2024-title42-chap7-subchapXIX-sec1396r-5.htm Paying a family member without a contract can look like exactly that kind of transfer. A written agreement, in effect before services begin, with a reasonable rate and time records, documents the payments as wages for services rather than gifts.
Best for: Families who can private-pay a caregiver and want to plan for eventual Medicaid eligibility. Always work with a Michigan elder-law attorney to draft the contract.
Michigan Paid Family Caregiver Programs Compared
| Pathway | Pay spouses? | 2026 rate | Waitlist | Functional threshold |
|---|---|---|---|---|
| Home Help (Medicaid) | No | $17.13/hr | Ask MDHHS | ADL needs |
| MI Choice self-direction (Medicaid) | No under self-determination; only as an agency-hired CLS provider for extraordinary care | No statewide rate; ask your waiver agency | Possible; priority categories enroll first | NFLOC |
| VA PCAFC | Yes | Stipend VA describes as nontaxable (GS-4 locality basis) | Assessment-based | 70%+ rating |
| VA Veteran-Directed Care | Yes | Veteran-set budget | Not offered at every VAMC | ADL needs |
| VA Aid & Attendance | Paid to veteran, not caregiver | Up to $34,488/yr | VA claim process | A&A criteria |
| Private Caregiver Agreement | Yes | Market rate | None | Family choice |
The Home Help rate and the A&A maximum above are the verified 2026 figures;Centers for Medicare & Medicaid Services. (n.d.). Michigan State Plan Amendment MI-25-0022 — CMS approval letter and approved pages. medicaid.gov. Retrieved Oct 15, 2026, from https://www.medicaid.gov/medicaid/spa/downloads/MI-25-0022.pdf,U.S. Department of Veterans Affairs. (n.d.). Current Pension Rates For Veterans. va.gov. Retrieved Sep 29, 2026, from https://www.va.gov/pension/veterans-pension-rates/ the amounts shown as budget-set, stipend, or veteran-set vary by locality and budget, as detailed in each pathway.
How to Choose
Check VA eligibility first
If your loved one is a wartime veteran or surviving spouse, look at the VA before anything else. PCAFC can pay a spouse caregiver, which Home Help cannot.U.S. Government Publishing Office. (2018). Program of Comprehensive Assistance for Family Caregivers Improvements and Amendments Under the VA MISSION Act of 2018 — Proposed Rule, 85 FR 13356 (March 6, 2020) (govinfo.gov / Federal Register). govinfo.gov. Retrieved Sep 2, 2026, from https://www.govinfo.gov/content/pkg/FR-2020-03-06/pdf/2020-04464.pdf
Then check Medicaid, if the caregiver is not the spouse
If the person is on Medicaid or likely to qualify and the caregiver is a non-spouse family member, start with Home Help, where the client chooses their own caregiver.Centers for Medicare & Medicaid Services. (n.d.). Michigan State Plan Amendment MI-25-0022 — CMS approval letter and approved pages. medicaid.gov. Retrieved Oct 15, 2026, from https://www.medicaid.gov/medicaid/spa/downloads/MI-25-0022.pdf If the care need is nursing-facility level and calls for services Home Help doesn't cover (adult day, home modifications, respite), apply for MI Choice instead. A spouse caregiver should see the narrow MI Choice spouse route above, then step 3 and the VA options.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov - MI Choice Waiver (0233.R06.00). medicaid.gov. Retrieved Sep 3, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/82076
Consider a private caregiver agreement
If the family is private-paying, have a Michigan elder-law attorney draft one before care begins.
Fall back to non-pay supports
If none of the above fit, check the Area Agency on Aging's National Family Caregiver Support Program (NFCSP) for respite grants, training, and other non-pay supports.
Not sure which program fits your family? Chat with Brevy's care navigator for a side-by-side comparison based on your situation.
Tax Considerations
How caregiver pay is taxed depends on the program:
- Home Help: the client, not the State of Michigan, is the caregiver's employer, so ask a tax preparer how the wages are reported.Centers for Medicare & Medicaid Services. (n.d.). Michigan State Plan Amendment MI-25-0022 — CMS approval letter and approved pages. medicaid.gov. Retrieved Oct 15, 2026, from https://www.medicaid.gov/medicaid/spa/downloads/MI-25-0022.pdf
- MI Choice self-direction pays through the waiver's Fiscal Intermediary, which handles payroll and tax withholding for the participant.U.S. Government Publishing Office. (n.d.). 42 CFR 441.310 — Limits on Federal financial participation (FFP) (eCFR, current). ecfr.gov. Retrieved Sep 3, 2026, from https://www.ecfr.gov/current/title-42/section-441.310
- VA PCAFC stipend: VA's 2020 proposed PCAFC rule called the stipend a nontaxable benefit.U.S. Government Publishing Office. (2018). Program of Comprehensive Assistance for Family Caregivers Improvements and Amendments Under the VA MISSION Act of 2018 — Proposed Rule, 85 FR 13356 (March 6, 2020) (govinfo.gov / Federal Register). govinfo.gov. Retrieved Sep 2, 2026, from https://www.govinfo.gov/content/pkg/FR-2020-03-06/pdf/2020-04464.pdf
- VA Veteran-Directed Care pays W-2 wages through a Financial Management Services 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. 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.
"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 can count as an uncompensated transfer, which can create a penalty period under Michigan Medicaid's 60-month look-back.U.S. Government Publishing Office. (2024). 42 U.S.C. 1396r-5 (Social Security Act sec. 1924, spousal impoverishment), United States Code 2024 Edition, U.S. Government Publishing Office (govinfo) — the CSRA is the GREATEST of four alternatives; the dollar cap binds only clauses (i) and (ii)(II); the (e)(2) hearing and (f)(3) court-order routes carry no dollar amount. govinfo.gov. Retrieved Oct 13, 2026, from https://www.govinfo.gov/content/pkg/USCODE-2024-title42/html/USCODE-2024-title42-chap7-subchapXIX-sec1396r-5.htm
Frequently Asked Questions
Can I get paid to take care of my spouse in Michigan?
Usually not through Michigan Medicaid. Home Help does not pay a spouse, and a client whose spouse is able and available to give the care is not eligible for Home Help.Centers for Medicare & Medicaid Services. (n.d.). Michigan State Plan Amendment MI-25-0022 — CMS approval letter and approved pages. medicaid.gov. Retrieved Oct 15, 2026, from https://www.medicaid.gov/medicaid/spa/downloads/MI-25-0022.pdf MI Choice's self-determination guidelines bar a legal spouse as a paid worker; its one spouse route is Community Living Supports through a home care agency when the participant requires extraordinary care.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov - MI Choice Waiver (0233.R06.00). medicaid.gov. Retrieved Sep 3, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/82076 The other routes for a spouse in Michigan are the VA (PCAFC and Veteran-Directed Care both allow a spouse caregiver) or a private caregiver agreement funded by the family's own assets or long-term care insurance.U.S. Government Publishing Office. (2018). Program of Comprehensive Assistance for Family Caregivers Improvements and Amendments Under the VA MISSION Act of 2018 — Proposed Rule, 85 FR 13356 (March 6, 2020) (govinfo.gov / Federal Register). govinfo.gov. Retrieved Sep 2, 2026, from https://www.govinfo.gov/content/pkg/FR-2020-03-06/pdf/2020-04464.pdf
What does Home Help pay in 2026?
Michigan Home Help pays $17.13/hour in 2026, based on the $13.73 hourly state minimum wage plus the current $3.40 hourly direct care worker wage increase. The client, not the State of Michigan, is the caregiver's employer.Centers for Medicare & Medicaid Services. (n.d.). Michigan State Plan Amendment MI-25-0022 — CMS approval letter and approved pages. medicaid.gov. Retrieved Oct 15, 2026, from https://www.medicaid.gov/medicaid/spa/downloads/MI-25-0022.pdf
Do I need to be a CNA or have training to be a paid family caregiver?
Home Help lists these caregiver requirements: be 18 or older, pass a criminal history screen, show picture ID, enroll in CHAMPS and be willing to take available training if necessary.Centers for Medicare & Medicaid Services. (n.d.). Michigan State Plan Amendment MI-25-0022 — CMS approval letter and approved pages. medicaid.gov. Retrieved Oct 15, 2026, from https://www.medicaid.gov/medicaid/spa/downloads/MI-25-0022.pdf Check each other program's own rules.
Will getting paid as a caregiver affect my family member's Medicaid eligibility?
Payments through Home Help or MI Choice self-direction are Medicaid-authorized service payments to the caregiver, not income or assets of the care recipient, so they are not what puts eligibility at risk. What can is paying a family member informally from private funds, which can count as an uncompensated transfer under Michigan's 60-month look-back and create a penalty period.U.S. Government Publishing Office. (2024). 42 U.S.C. 1396r-5 (Social Security Act sec. 1924, spousal impoverishment), United States Code 2024 Edition, U.S. Government Publishing Office (govinfo) — the CSRA is the GREATEST of four alternatives; the dollar cap binds only clauses (i) and (ii)(II); the (e)(2) hearing and (f)(3) court-order routes carry no dollar amount. govinfo.gov. Retrieved Oct 13, 2026, from https://www.govinfo.gov/content/pkg/USCODE-2024-title42/html/USCODE-2024-title42-chap7-subchapXIX-sec1396r-5.htm For how the caregiver's wages are taxed, see Tax Considerations above.
Can I stack VA benefits and Medicaid caregiver pay?
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. PCAFC is the one to watch: its caregiver's personal care must not also be regularly provided through another individual or entity, so regular paid care through Home Help or MI Choice can affect PCAFC eligibility.U.S. Government Publishing Office. (2018). Program of Comprehensive Assistance for Family Caregivers Improvements and Amendments Under the VA MISSION Act of 2018 — Proposed Rule, 85 FR 13356 (March 6, 2020) (govinfo.gov / Federal Register). govinfo.gov. Retrieved Sep 2, 2026, from https://www.govinfo.gov/content/pkg/FR-2020-03-06/pdf/2020-04464.pdf The rules get complex, talk to your VA Caregiver Support Coordinator and a Michigan elder-law attorney before layering programs.
Where to Get Help in Michigan
Related Terms
- HCBS waiver: MI Choice is a 1915(c) waiver;Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov - MI Choice Waiver (0233.R06.00). medicaid.gov. Retrieved Sep 3, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/82076 Home Help is a separate Medicaid-funded personal care program.Centers for Medicare & Medicaid Services. (n.d.). Michigan State Plan Amendment MI-25-0022 — CMS approval letter and approved pages. medicaid.gov. Retrieved Oct 15, 2026, from https://www.medicaid.gov/medicaid/spa/downloads/MI-25-0022.pdf
- Activities of Daily Living (ADLs): The functional basis for Home Help eligibility.
- Nursing Facility Level of Care (NFLOC): The higher clinical threshold required for MI Choice.
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The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.
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