Michigan Medicaid 2026: Eligibility, MI Choice, Nursing Home

Michigan Medicaid pays for long-term nursing and home care through a segmented managed-care system, with a 2026 long-term care income limit of $2,982 per month and an asset limit of $9,950 for a single applicant.

Michigan Medicaid is administered by the Michigan Department of Health and Human Services (MDHHS). Acute care flows through Medicaid Health Plans (MHPs); long-term services flow through the MI Choice Waiver and regional Waiver Agencies; behavioral health is carved out to regional Prepaid Inpatient Health Plans (PIHPs); and dual eligibles in select counties can choose MI Coordinated Health (MICH), the integrated Medicare-Medicaid plan that replaced MI Health Link on January 1, 2026.1 This guide maps every key question about Michigan Medicaid to the dedicated article that answers it.2

How This Guide Is Organized

This pillar is organized around the questions Michigan families ask first.

Eligibility and Income Limits

The key 2026 financial parameters, drawn from the MDHHS Bridges Eligibility Manual, are below.2

• Income limit (300% of the SSI Federal Benefit Rate): $2,982/month for a single applicant in 2026 (the special income level for nursing facility, MI Choice Waiver, and PACE categories), based on the 2026 SSI Federal Benefit Rate of $994.2
• Asset limit: $9,950 for a single applicant effective January 1, 2026, up from $9,660 in 2025. Exempt assets include the primary home, one vehicle, household goods, personal effects, and a prepaid burial plan within limits.2
• Home equity limit: the home is not an excluded asset when the applicant's homestead equity exceeds $752,000 (effective January 1, 2026); the cap does not apply when a spouse, a child under 21, or a blind or disabled child lives in the home.2

Spousal impoverishment protections. When one spouse enters long-term care, federal spousal impoverishment rules protect the community spouse.2

• Community Spouse Resource Allowance (CSRA): the non-applicant spouse keeps one-half of the couple's countable assets, up to $162,660, with a minimum resource standard of $32,532 (both effective January 1, 2026).2
• Monthly Maintenance Needs Allowance (MMNA): the community spouse's basic income allowance is $2,705.00/month, up to a maximum of $4,066.50/month.2

Medically needy spend-down (the Michigan distinction). An adult whose income exceeds the limit can incur or pay qualifying medical expenses to spend down to the applicable Protected Income Level (PIL), which for a fiscal group of one runs $341 to $408 per month depending on county shelter area; for a person in long-term care the entire month, the special institutional PIL is $37/month.2

Personal Needs Allowance. A nursing facility resident keeps a $60/month personal needs allowance ($90/month for a veteran receiving a VA Improved Pension).3

Penalty divisor (transfer of assets). A 60-month (five-year) look-back applies to asset transfers made for less than fair market value. An uncompensated transfer creates a penalty period computed by dividing the transferred value by Michigan's average monthly private-pay long-term care cost, which is $12,216 for a 2026 baseline date. A $100,000 uncompensated transfer produces roughly 8.2 months of long-term care ineligibility.3

For the full eligibility tables, see Long-Term Care: Nursing Home Medicaid.

Medicaid Health Plans (MHPs)

Most Michigan Medicaid members must enroll in a Medicaid Health Plan, the state's name for its mandatory managed-care organizations. There are nine under the contract cycle that took effect October 1, 2024, and availability is local, so your choices depend on your county.5

Two major carve-outs sit outside the MHPs:

1. Behavioral health and substance use disorder services, administered through Michigan's regional Prepaid Inpatient Health Plans (PIHPs) rather than the physical-health MHPs.5
2. MI Choice Waiver services, which are carved out of MHP coverage and delivered through the participant's regional waiver agency, while acute care continues through the MHP.5

To choose or switch a plan, or to ask which plans serve your county, call MI ENROLLS at 1-888-367-6557.5

For the full MHP comparison and switching mechanics, see Managed Care Plans.

MI Choice Waiver

The MI Choice Waiver is Michigan's §1915(c) home and community-based services waiver. It pays for personal care, home modifications, respite, adult day health, private-duty nursing, and more, so Medicaid-eligible adults can get nursing-facility-level care at home, in adult foster care, or in a Home for the Aged.

Key structural facts:

• Enrollment is capped, not an entitlement. Each waiver agency gets a set number of slots per fiscal year; once capacity is reached, a screened applicant goes on the MI Choice waiting list, ordered by priority category and then by the date services were requested.6
• Eligibility requires a nursing facility level of care (an LOCD assessment) plus the financial tests above (the $2,982/month income limit and $9,950 asset limit).2
• MI Choice does not pay room and board. Community Living Supports excludes room-and-board costs, and respite excludes them as well, except when the respite is furnished in an MDHHS-approved facility that is not a private residence.7
• A spouse generally cannot be paid. MDHHS's Self-Determination in Long Term Care guidelines bar a participant from hiring their own legal spouse, guardian, or designated representative as a paid worker, and MDHHS's May 2025 Structured Family Caregiving material lists spousal pay as "TBD" for that service and available only "in limited situations" for Community Living Supports. Confirm with your waiver agency before anyone leaves a job.8

While waiting for a slot, families often use Home Help for immediate paid care, then move to MI Choice when one opens. MDHHS's statewide MI Options line (see Where to Get Help) is not an application line: MI Choice applications go through the regional waiver agency serving your county, and MDHHS publishes a Waiver Agency Region Map to help you find yours.6

For the waiver agency directory and service catalog, see MI Choice Waiver.

MI Coordinated Health (Dual Eligibles)

MI Health Link has ended. Michigan's Medicare-Medicaid Plan demonstration closed December 31, 2025 and was replaced on January 1, 2026 by MI Coordinated Health (MICH), a Highly-Integrated Dual Eligible Special Needs Plan (HIDE SNP). If you are searching for MI Health Link, MICH is where that coverage went; enrollees could move over with no break in coverage.1

MICH covers all Medicare benefits and most Medicaid benefits, including long-term services and supports, but excludes certain behavioral health and community transition services. It is for residents 21 or older enrolled in both Medicare and Medicaid. Nine health plans hold contracts; for 2026 MICH runs in ten named counties plus most of the Upper Peninsula, expanding statewide in 2027.1

For dual eligibles outside the 2026 MICH counties, the alternatives are:

• A Dual-Eligible Special Needs Plan (D-SNP), a Medicare Advantage plan designed for dual eligibles
• Original Medicare plus Medicaid, with Medicare as primary and Medicaid as secondary
• PACE (Program of All-Inclusive Care for the Elderly), a fully integrated program for participants 55 and older in select Michigan areas

For eligibility and the county list, see MI Coordinated Health.

HCBS Waivers

In addition to MI Choice, Michigan operates several other HCBS pathways.

• Habilitation Supports Waiver (HSW), for people with intellectual or developmental disabilities at an ICF/IID level of care, administered through the regional PIHP/CMHSP system.
• Children's Waiver Program (CWP), for children with developmental disabilities.
• SED Waiver, for children with serious emotional disturbance.
• Home Help Program, a Medicaid state-plan personal care benefit, not a §1915(c) waiver. Because it is a state-plan benefit rather than a capped waiver, it is an entitlement with no cap and no waitlist: any Medicaid-eligible adult needing hands-on help with at least one activity of daily living must be offered services.9 See the Caregiver Pillar.

For the full waiver catalog, see HCBS Waivers.

Long-Term Care: Nursing Home Medicaid

For residence in a Medicaid-certified nursing facility, Michigan requires income at or below $2,982/month (or a medically needy spend-down using medical expenses), countable assets at or below $9,950 for a single applicant, a nursing facility level of care determination (LOCD), and residence in a Medicaid-certified facility.2

Once eligible, the resident contributes most monthly income toward the facility cost. The patient-pay amount is monthly income minus the $60 personal needs allowance, health-insurance premiums, any community-spouse and family income allowances, and certain medical expenses; Medicaid pays the rest.3

For context, the CareScout 2025 Cost of Care Survey puts Michigan's statewide nursing-home median at about $11,254 per month for a semi-private room and $11,969 per month for a private room, both above the national medians of $9,581 and $10,798. These are industry-survey medians rather than government figures, and rates vary across the state.10

Estate recovery is probate-only. Michigan's Estate Recovery Program reaches only assets subject to probate court administration. Non-probate assets (jointly-titled property with right of survivorship, payable-on-death accounts, life insurance with named beneficiaries, and assets in certain trusts) are generally outside recovery. Recovery applies to recipients who were 55 or older and received Medicaid long-term-care services on or after September 30, 2007. Note what happens once an estate is subject to it: the claim then pursues all services after the member's 55th birthday, long-term care and not, fee-for-service claims and capitation payments both. It is not limited to the nursing-home bills.3

MDHHS will not seek recovery at all while a surviving spouse, a child under 21, or a blind or permanently and totally disabled child of any age is living. It defers recovery, a weaker and more temporary protection, while certain people live in the home: a survivor who lived there and provided care for at least 2 years immediately before institutionalization (where that care delayed it), or a sibling with an equity interest who lived there for at least 1 year immediately before institutionalization. MDHHS also defers on undue hardship, for example where the estate is the survivors' primary income-producing asset such as a family farm, or a home of modest value. That deferral carries a means test: household income below 200% of the federal poverty level and household resources below $10,000.3

For LOCD criteria and PASRR, see Long-Term Care: Nursing Home Medicaid.

Medicare Savings Programs (MSPs)

Michigan Medicaid administers Medicare Savings Programs (MSPs) that help low-income Medicare beneficiaries pay Medicare costs.11

Federal law bars providers from billing a QMB enrollee for any Medicare cost-sharing. Check QI against your Medicaid status first: a person with full Medicaid cannot also hold QI. Enrolling in QMB, SLMB, or QI automatically qualifies you for Extra Help (the Part D Low-Income Subsidy), which eliminates most prescription drug cost-sharing. A fourth MSP, QDWI, pays the Part A premium for certain working people with disabilities who lost premium-free Part A, and it does not confer Extra Help.11

Covered Services

Michigan Medicaid covers the federally mandated state-plan benefits every state must provide, which include inpatient and outpatient hospital, physician, lab and X-ray, nursing facility, home health, federally qualified health center, rural health clinic, family planning, and transportation to medical care, which belongs on that mandatory list rather than the optional one. On top of it, Michigan has elected optional benefits, and MDHHS tells beneficiaries the program covers medically necessary care including hospice, personal care, private duty nursing, prescribed medicine, dental, vision, hearing and speech, podiatry, therapies, chiropractic, medical supplies, and mental health and substance use disorder treatment. MDHHS cautions that some of these are limited, may not be covered for beneficiaries age 21 and older, and may require prior approval.12

Key carve-outs:

• Behavioral health and substance use disorder services are carved out to regional PIHPs.5
• MI Choice Waiver services are carved out to the participant's regional waiver agency.5

For the full covered-services list, see Covered Services.

Dental Coverage (April 2023 Expansion)

Michigan made two separate changes, on two separate dates. A rate policy implemented January 1, 2023 pays dental providers at 100% of the Average Commercial Rate. Then, effective April 1, 2023, MDHHS expanded the adult dental benefit itself for beneficiaries 21 and older, adding deep teeth cleanings, sealants, root canals, crowns, and gum care.12

For the dental coverage detail, see Dental Coverage.

What Makes Michigan Medicaid Different

1. Michigan's $9,950 asset limit is more generous than most states, which cap long-term care applicants at $2,000, so Michigan families do not have to spend down as aggressively before applying.2

2. Michigan is a medically needy state with an adult spend-down. Income-cap states such as Texas and Florida do not let adults spend income down to qualify; Michigan does.2

3. Michigan uses a monthly penalty divisor, $12,216/month for 2026, rather than the daily divisor other states use. The 60-month look-back is the same; the arithmetic differs.3

4. The architecture is segmented. Acute care runs through Medicaid Health Plans, behavioral health through regional PIHPs, and MI Choice through regional waiver agencies.5

5. Estate recovery is limited to probate, so with joint titling, beneficiary designations, and the caretaker-child deferral, many families keep more of the estate.3

6. Michigan does not license assisted living as a separate category. The state licenses no assisted-living or independent-living facilities; the LARA Bureau of Community and Health Systems instead licenses Adult Foster Care homes and Homes for the Aged, and a community marketed as assisted living is generally licensed as one of those two.13

How to Apply for Michigan Medicaid

Applying for long-term care Medicaid follows a defined sequence.4

If you disagree with a decision, you have 90 calendar days from the date on the written notice of case action to request a hearing before the Michigan Office of Administrative Hearings and Rules (MOAHR). Michigan allows the full federal window: 42 CFR 431.221(d) caps a state's hearing-request period at 90 days, and Michigan uses all of it.14 Plan around the trigger rather than the number. The clock starts on the notice date, and your request must be received in the local office inside those 90 days, so one mailed on day 89 can still arrive too late.4 This 90 is not the disability processing standard in step 5 or the renewal reconsideration below.

If a plan denied your care rather than MDHHS, appeal to the plan first. A member enrolled in a Medicaid Health Plan, a behavioral-health PIHP, or a MI Choice Waiver agency must exhaust that organization's internal appeal before becoming eligible to request a state fair hearing from MOAHR.15 That track runs on the plan's own clocks, not the 90-day eligibility deadline above.

Keeping benefits while you appeal runs on a much shorter clock than those 90 days. For Medicaid, MDHHS must maintain your benefits if you request the hearing before the effective date of the action, so work backward from the date the change takes effect, not from the appeal deadline. Separately, a request is "timely" when MDHHS receives it within 10 days of the date the notice was issued (if day 10 falls on a weekend or holiday, the next workday counts), and a timely request reinstates benefits to the former level. One limit bites hardest: benefits do not continue at all when what you are contesting is a denial at application.4

For a form-by-form checklist, see How to Apply for Michigan Medicaid.

Keeping Michigan Medicaid Once You Have It

Missing a renewal is one of the most common ways people lose coverage they still qualify for, and federal rules put most of the work on the agency rather than on you. Before it asks you for anything, Michigan Medicaid must first try to renew your coverage automatically from information it already holds, and may only request documents if it cannot.16 If it does need paperwork, it must send a renewal form and give you at least 30 days from the date on that form to return it.16 That duty, and the 90-day reconsideration window below, cover eligibility based on modified adjusted gross income (MAGI). If you qualify through age, disability, long-term care, a Medicare Savings Program, or the medically needy pathway, Michigan may offer the same windows but is not required to, so ask MDHHS what applies to you.16

If coverage does close because a form went unreturned, that is not the end of it. Federal rules require the agency to reconsider your eligibility without a new application if you return the renewal form within 90 days of the termination (required for MAGI-based coverage; a state option otherwise).16 So a MAGI-based renewal missed by a few weeks is usually recoverable, provided you act.

Return a renewal form the week it arrives. See Michigan Medicaid Recertification and Renewal for the full cycle and how to recover coverage that has already closed.

Where to Get Help

Michigan Medicaid FAQ

Learn More

Find personalized help with Michigan Medicaid programs 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. 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.