Michigan runs four Section 1915(c) Home and Community-Based Services waivers plus several state-plan HCBS programs. Each waiver 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, what the waitlist looks like, and how to apply. If you're looking specifically for the senior waiver, skip to MI Choice.
The Five Pathways (Four Waivers + Home Help)
Michigan's HCBS infrastructure is built around five programs:
| Program | Authority | Population | Waitlist? |
|---|---|---|---|
| MI Choice Waiver | 1915(c) | Adults 65+ or 18-64 disabled | Yes (regional, variable) |
| Habilitation Supports Waiver (HSW) | 1915(c) | Adults with I/DD | Yes (long) |
| Children's Waiver Program (CWP) | 1915(c) | Children under 18 with I/DD | Yes |
| Children's SED Waiver (SEDW) | 1915(c) | Children with serious emotional disturbance | Yes |
| Home Help Program | State plan | Medicaid-eligible adults with ADL needs | No |
Two additional programs are mentioned in policy but aren't technically waivers:
- Community First Choice (Section 1915(k)): Michigan does not currently operate CFC. Applicants seeking CFC-type services look to Home Help or MI Choice instead.
- Nursing Facility Transition (Money Follows the Person): not a standalone waiver. MFP funding helps nursing home residents transition back to the community and is layered on top of MI Choice for the first year.
1. MI Choice Waiver (Seniors and Adults with Disabilities)
Who it serves: Adults 65+ and adults 18-64 with disabilities who meet Nursing Facility Level of Care.
Administered by: 20 regional Waiver Agencies, most of which are Area Agencies on Aging (AAAs).
What it covers: Personal care, home modifications, respite, adult day health, private duty nursing, personal emergency response, home-delivered meals, non-emergency transportation, chore services, and 15+ other categories.
Waitlist: Yes. The waiver is capped at approximately 20,543 annual slots. Regional waitlists form when slots fill. Wait times vary significantly by Waiver Agency.
Eligibility: NFLOC via the LOCD assessment; income up to $2,982/month; assets up to $9,950.
How to apply: Call the statewide entry point at 1-800-803-7174 or contact your regional Waiver Agency directly.
See the full MI Choice Waiver guide.
2. Habilitation Supports Waiver (HSW)
Who it serves: Adults of any age with intellectual or developmental disabilities who meet ICF/IID level of care.
Administered by: Michigan's 10 Prepaid Inpatient Health Plans (PIHPs) working with county Community Mental Health Services Programs (CMHSPs).
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 services needed for community living. Builds on state plan Medicaid services under Michigan's 1115 Pathway to Integration.
Waitlist: Yes. HSW has historically had a multi-year waitlist. Priority typically goes to people transitioning out of institutional settings and those in crisis.
Eligibility:
- Michigan Medicaid
- I/DD diagnosis that developed before age 22
- Meets ICF/IID level of care (substantial functional limitations in at least 3 major life activities)
- Need at least one HSW service
How to apply: Contact your local CMHSP (find it via michigan.gov/mdhhs or the 211 Michigan line).
3. Children's Waiver Program (CWP)
Who it serves: Children under 18 with intellectual or developmental disabilities.
Administered by: PIHPs and CMHSPs.
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 enable the child to remain at home.
Waitlist: Yes.
Eligibility:
- Michigan Medicaid (the child's eligibility is determined without counting parental income under CWP rules)
- Under 18
- Severe developmental disability
- Meets ICF/IID level of care
- Would otherwise need institutional placement
How to apply: Through the local CMHSP. Families typically engage 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 Serious Emotional Disturbance (SED) who would otherwise require psychiatric inpatient care.
Administered by: PIHPs and CMHSPs.
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: Varies by region.
Eligibility:
- Michigan Medicaid
- Age 0-21
- 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's a state-plan personal care benefit. Because it's a state plan option, it has no enrollment cap and no waitlist. For many Michigan seniors, Home Help is the right program when MI Choice has a waitlist or isn't the right fit.
Home Help covers:
- Personal care with ADLs (bathing, dressing, toileting, transferring, eating)
- Selected IADLs (meal prep, medication reminders, light housekeeping)
Family caregivers eligible to be hired include adult children, grandchildren, siblings, nieces, nephews, friends, and neighbors. Spouses cannot be hired under Home Help. For the spousal pathway, use MI Choice with the Self-Determination Option.
See the full Michigan Home Help Program guide.
Money Follows the Person (Nursing Facility Transition)
Michigan participates in the federal Money Follows the Person demonstration under the name Nursing Facility Transition. MFP isn't a standalone waiver. It provides enhanced federal funding for the first year after a nursing-home resident transitions back to the community, usually through MI Choice or HSW.
Key features:
- Enhanced funding for one-time transition costs (first month's rent, deposit, furniture, utilities)
- Priority placement on MI Choice if the person is currently in a nursing facility and wants to return home
- Transition coordinator who helps bridge the move
Best for: A nursing home resident who wants to come home. Call 1-800-803-7174 and ask about Nursing Facility Transition.
Choosing the Right Waiver
Most Michigan families working through senior care decisions are choosing among:
- Home Help (immediate, no waitlist, personal care only, no spouse paid)
- MI Choice (waitlist possible, broader services, spouse paid under SDO)
- 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 level of paid care immediately, and simultaneously apply for MI Choice to secure slots when they open. If the person is already in a nursing facility, ask about Nursing Facility Transition to bypass the MI Choice waitlist.
Trying to decide between Home Help, MI Choice, and Nursing Facility Transition? Chat with Brevy for a custom recommendation based on your family's situation, timeline, and whether a spouse needs to be the caregiver.
How to Find Your Local Contacts
Each waiver is accessed through a local agency. Finding yours:
- MI Choice: call 1-800-803-7174 or visit michigan.gov/mdhhs for the Waiver Agency map.
- HSW, CWP, SEDW: contact your county Community Mental Health Services Program (CMHSP). Find it via michigan.gov/mdhhs or call 211.
- Home Help: contact your county MDHHS office (michigan.gov/mdhhs).
- Nursing Facility Transition: contact 1-800-803-7174 or the MI Choice Waiver Agency serving your area.
Common Misconceptions
"All Michigan Medicaid members are in MI Choice." No. MI Choice serves roughly 20,000 people at any time; Michigan Medicaid overall covers more than 2 million. MI Choice is specifically for people who meet nursing-facility level of care and want home-based services.
"Home Help is a waiver." It isn't. Home Help is a state plan personal care benefit. This matters because waivers have enrollment caps and Home Help doesn't.
"I can't be on two programs at once." In some combinations you can. MI Choice and Home Help typically don't run simultaneously for one person, but MI Choice Waiver members can receive Medicare services and state plan services in parallel. Nursing Facility Transition layers on top of MI Choice for the first year.
"Waivers cover room and board in assisted living." They don't. MI Choice covers care services in an Adult Foster Care home or Home for the Aged; the resident still pays room and board from their own income.
Frequently Asked Questions
The MI Choice Waiver serves adults 65+ (and adults 18-64 with disabilities) who meet Nursing Facility Level of Care. It's administered by 20 regional Waiver Agencies, most of which are Area Agencies on Aging. Call 1-800-803-7174 to start.
No. Home Help is a state-plan personal care benefit, not a 1915(c) waiver. Because it's a state plan option, it has no enrollment cap and no waitlist — which makes it the right program for many seniors while waiting for MI Choice.
The waiver is capped at approximately 20,543 annual slots, and wait times vary significantly by regional Waiver Agency. If the applicant is currently in a nursing home, ask about Nursing Facility Transition (Money Follows the Person) for priority placement.
Yes, but only under MI Choice's Self-Determination Option (SDO). Home Help does not allow spouses to be hired — only adult children, grandchildren, siblings, nieces, nephews, friends, and neighbors.
MI Choice covers home and community-based services that help a nursing-facility-eligible person stay at home: personal care, home modifications, respite, adult day health, private duty nursing, personal emergency response, home-delivered meals, non-emergency transportation, chore services, and 15+ other categories.
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 DHS-1183 assessments.
Learn More
- Michigan Medicaid Programs for Seniors (Hub)
- MI Choice Waiver Program
- Michigan Home Help Program
- How to Apply for Michigan Medicaid
- Michigan Medicaid Nursing Home Coverage
Find personalized help choosing the right Michigan Medicaid waiver at brevy.com.
The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Michigan waiver structures, enrollment caps, and covered services change. Always verify current details with your regional Waiver Agency, county CMHSP, or MDHHS. Brevy is not a law firm, financial advisor, or healthcare provider.