Michigan Medicaid HCBS Waivers (2026): Get on One

In 2026, Michigan runs four Section 1915(c) Home and Community-Based Services (HCBS) waivers, plus the state-plan Home Help personal care program. Each one serves a specific population: seniors, adults with intellectual or developmental disabilities, children with severe disabilities, or children with serious emotional disturbance.

This guide explains who each Michigan waiver serves, what it covers, how the waitlist works, and how to apply. If you are looking specifically for the senior waiver, skip to MI Choice below.

In This Guide

• The five Michigan Medicaid waivers and pathways
• MI Choice Waiver (seniors and adults with disabilities)
• Habilitation Supports Waiver (HSW)
• Children's Waiver Program (CWP)
• Children's Serious Emotional Disturbance Waiver (SEDW)
• State-plan HCBS: Home Help
• Money Follows the Person
• Choosing the right Michigan Medicaid waiver
• How to find your local contacts
• Frequently asked questions

The Five Michigan Medicaid Waivers and Home-Care Pathways

Michigan's HCBS infrastructure is built around five programs. The fastest way to find yours is to match the person's age and disability type to the population each program serves.

Only one row in that table is an entitlement. Home Help is a Medicaid state-plan personal care benefit rather than a capped waiver, so it has no enrollment cap and no waiting list, and any Medicaid-eligible adult who meets the functional criteria must be offered services.2 A 1915(c) waiver can cap enrollment instead, and MI Choice does: it is capped at the number of participants set in its approved waiver application, with slots allocated to each waiver agency by fiscal year.1 For the three waivers run through the mental health system, ask the local CMHSP how its capacity stands rather than assuming a wait or assuming there is none.

Two related programs are sometimes mentioned but are not 1915(c) waivers:

• Community First Choice (Section 1915(k)): a separate federal attendant-care option some states have taken up. In Michigan, ask MDHHS whether it is available before counting on it; the state-plan and waiver routes described here are Home Help and MI Choice.
• Nursing Facility Transition (Money Follows the Person): not a standalone waiver. It is federal transition support for nursing home residents returning to the community, used alongside MI Choice. Ask your Waiver Agency what it currently funds.

1. MI Choice Waiver (Seniors and Adults with Disabilities)

Who it serves: Adults 65 and older, and adults 18 and older with disabilities, who meet Michigan's nursing facility level of care.1

Administered by: MDHHS, through a network of enrolled waiver agencies. The approved waiver application describes twenty waiver agencies, fourteen of which are Area Agency on Aging (AAA) organizations, and MDHHS publishes a Waiver Agency Region Map so you can find the one serving your community.1

What it covers: Community Living Supports (personal care with ADLs and IADLs), home modifications, respite, adult day health, private duty nursing, personal emergency response, home-delivered meals, non-emergency transportation, chore services, and other home- and community-based supports.4

Waitlist: Yes. MI Choice is not an open entitlement: capacity is capped at the number set in the approved waiver application, each Waiver Agency is allocated a specific number of slots each fiscal year, and screened applicants who exceed capacity are placed on that agency's waiting list, ordered by priority category and then by service-request date. That ranking is not a guarantee of enrollment order: the approved waiver application states that because of unique circumstances pertaining to each applicant, actual enrollment may vary from an individual's waiting list ranking. Wait times vary significantly by region.1

Eligibility: Nursing facility level of care, determined through the online Michigan Medicaid Nursing Facility Level of Care Determination (LOCD); the applicant must require at least two waiver services, one of which must be Supports Coordination, and those services must be provided at least monthly, or, where the need is less than monthly, the participant must receive regular monthly monitoring documented in the service plan.1 The 2026 income limit for the MI Choice category is $2,982 per month for a single applicant (300% of the federal Supplemental Security Income benefit rate), and the asset limit is $9,950, effective January 1, 2026.5

Income above the limit is not an automatic bar. Michigan is a medically needy state: a Group 2 applicant whose income exceeds the limit can "spend down" by incurring medical expenses to the applicable Protected Income Level, which is $341 to $408 per month for a fiscal group of one depending on county shelter area (and a $37-per-month special level for a person in long-term care the entire month).5

How to apply: Contact your regional MI Choice Waiver Agency, or visit the Michigan Department of Health and Human Services (MDHHS) MI Choice page for the Waiver Agency map serving your county. The Waiver Agency must conduct the LOCD in person with the applicant, or adopt an existing LOCD completed by another provider.1

See the full MI Choice Waiver guide.

2. Habilitation Supports Waiver (HSW)

Who it serves: Adults of any age with intellectual or developmental disabilities (I/DD) who meet the ICF/IID (Intermediate Care Facility for Individuals with Intellectual Disabilities) level of care.

Administered by: Michigan's regional Prepaid Inpatient Health Plans (PIHPs), which MDHHS contracts with to manage the state's specialty behavioral health benefit and the network of Community Mental Health Service Providers (CMHSPs).6

What it covers: Community living supports, supported employment, supports coordination, out-of-home non-vocational habilitation, assistive technology, environmental modifications, goods and services, and other supports needed for community living, on top of the standard Medicaid State Plan behavioral health benefit.

Waitlist: Ask your CMHSP whether it is holding a waiting list for HSW in your region, where a new applicant would land on it, and whether any priority category applies. Brevy has no MDHHS source stating a statewide HSW wait, so treat any figure you see elsewhere with caution.

Eligibility:

• Enrolled in Michigan Medicaid
• An intellectual or developmental disability that began before adulthood
• Meets ICF/IID level of care
• Needs at least one HSW service

How to apply: Contact your local CMHSP (find it through MDHHS at michigan.gov/mdhhs or by calling 2-1-1).

3. Children's Waiver Program (CWP)

Who it serves: Children under 18 with intellectual or developmental disabilities who would otherwise need institutional placement.

Administered by: Michigan's regional Prepaid Inpatient Health Plans (PIHPs) and the Community Mental Health Service Providers (CMHSPs) in their networks, which MDHHS contracts with for the state's specialty behavioral health benefit.6

What it covers: Community living supports, respite, family home care training, family support and training, home care training for non-family caregivers, enhanced medical equipment and supplies, environmental modifications, goods and services, specialty services, and other community-based supports that let the child stay at home.

Waitlist: Ask your CMHSP where its list stands before you assume a wait, or assume there is none.

Eligibility:

• Michigan Medicaid. CWP has its own rules for how a child qualifies, so ask the CMHSP how parental income is treated before assuming the family earns too much
• Under age 18
• A severe developmental disability
• Meets ICF/IID level of care
• Would otherwise need institutional placement

How to apply: Through the local CMHSP. Families often start through their child's special education team at school.

4. Children's Serious Emotional Disturbance Waiver (SEDW)

Who it serves: Children up to age 21 with a Serious Emotional Disturbance (SED) who would otherwise require psychiatric inpatient care.

Administered by: Michigan's regional PIHPs and the CMHSPs in their networks, which MDHHS contracts with for the state's specialty behavioral health benefit.6

What it covers: Services beyond the Medicaid State Plan, including child therapeutic foster care, community living supports, community transition, family home care training, family support and training, therapeutic activities, therapeutic overnight camping, and wraparound services.

Waitlist: Ask your CMHSP.

Eligibility:

• Michigan Medicaid
• Age 0 to 21
• A Serious Emotional Disturbance diagnosis
• Meets hospital level of care (would otherwise require psychiatric hospitalization)

How to apply: Through the local CMHSP.

State-Plan HCBS: Home Help

Home Help is not a waiver. It is a Medicaid state-plan personal care benefit under the Social Security Act, so it is an entitlement: there is no enrollment cap and no waitlist, and any Medicaid-eligible adult who meets the functional criteria must be offered services. For many Michigan seniors, Home Help is the right program when MI Choice has a waitlist or is not the right fit.2

To qualify, the applicant must be eligible for fee-for-service Medicaid and need hands-on help with at least one Activity of Daily Living. An MDHHS Adult Services Worker conducts an in-home Home Help Comprehensive Assessment (form MDHHS-5534) to determine functional need and reassesses every six months.2

Home Help covers:

• Personal care with ADLs (bathing, dressing, toileting, transferring, eating)
• Selected IADLs (meal preparation, light housekeeping, laundry, shopping)

Family members eligible to be hired include adult children, grandchildren, siblings, aunts, uncles, nieces, nephews, and cousins, as well as qualified unrelated individuals such as friends and neighbors. A spouse cannot be hired under Home Help, and a parent cannot be paid to care for their own minor child. The 2026 Home Help individual caregiver pay rate is $17.13 per hour, effective January 1, 2026.2

MI Choice is not a workaround for the spouse rule. MDHHS's Self-Determination in Long Term Care guidelines state that a participant cannot choose a legal spouse, guardian, or representative as a paid worker, and MDHHS's May 2025 material on Structured Family Caregiving lists spousal pay as "TBD" for that service and allowed "in limited situations" for Community Living Supports, so the policy is restrictive and unsettled rather than settled either way. If paying a spouse is the goal, confirm current policy with your regional MI Choice Waiver Agency before building a plan around it.3

See the full Michigan Home Help Program guide.

Money Follows the Person (Nursing Facility Transition)

Michigan operates the federal Money Follows the Person (MFP) demonstration under the name Nursing Facility Transition. MFP is not a standalone waiver; it is transition support that runs alongside a waiver such as MI Choice for a person leaving a nursing home.

What to ask your Waiver Agency about:

• What one-time move-in costs the program can currently cover
• Whether a nursing facility resident falls into one of the MI Choice waiting list's priority categories. MI Choice places screened applicants by priority category and then by date of request, and MDHHS's approved waiver application cautions that because of circumstances unique to each applicant, actual enrollment may vary from a person's waiting list ranking1
• Who coordinates the move and on what timeline

Best for: A nursing home resident who wants to come home. Ask your MI Choice Waiver Agency about Nursing Facility Transition.

Choosing the Right Michigan Medicaid Waiver

Most Michigan families working through senior care decisions are choosing among:

• Home Help (immediate, no waitlist, personal care only, no spouse paid)2
• MI Choice (waitlist possible, broader services, spouse still barred as a paid worker)3
• Nursing Home Medicaid (always available as an entitlement, but full nursing facility care)
• Private pay (while waiting for MI Choice)

A common pattern: apply for Home Help today to get some paid care immediately, and apply for MI Choice at the same time to claim a slot when one opens. If the person is already in a nursing facility, ask the Waiver Agency about Nursing Facility Transition and about how the MI Choice waiting list's priority categories apply.

How to Find Your Local Contacts

Each program is reached through a local or regional agency.

Common Misconceptions

"Most Michigan Medicaid members are in MI Choice." They are not. MI Choice serves a capped number of people who meet nursing facility level of care and want home-based services, while Michigan Medicaid overall covers a far larger general population.1

"Home Help is a waiver." It is not. Home Help is a state-plan personal care benefit. This matters because waivers carry enrollment caps and Home Help does not.2

"I can't be on two programs at once." In some combinations you can. A qualified applicant may enroll in only one long-term services and supports program at a time, so ask your Waiver Agency whether Home Help continues once MI Choice starts,1 but an MI Choice member still receives the basic services Michigan Medicaid covers alongside their waiver services,6 and Nursing Facility Transition runs alongside MI Choice rather than replacing it.

"Waivers cover room and board in assisted living." They do not. MI Choice does not pay for room and board: Community Living Supports specifically excludes room and board costs, and respite excludes them too, except when the respite is furnished in a facility approved by MDHHS that is not a private residence.4

Related Terms

• HCBS waiver: The federal 1915(c) authority behind the four Michigan waivers above.
• Nursing Facility Level of Care (NFLOC): The clinical threshold for MI Choice.
• Consumer Directed Services (CDS): The national term for MI Choice's Self-Determination Option.
• Activities of Daily Living (ADLs): The functional measures used in the LOCD and Home Help assessments.

Learn More

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.