The Medicaid program provides assistance with medical costs for people with limited resources or income. It also helps with the cost of certain services that Medicare does not cover. The cost of long-term care can quickly strain many people’s financial resources. Medicaid can help people in this situation if they meet the program’s eligibility criteria. According to rules established by Congress, this would primarily apply to long-term inpatient nursing care. Since many people would prefer to remain in their homes if possible, federal law allows waivers in certain circumstances. One type of waiver is known as a Home and Community-Based Services (HCBS) waiver. It allows state Medicaid programs to assist with the cost of long-term care services based in the home or the community, instead of in an inpatient facility. Michigan offers this through the MI Choice Waiver Program, or “MI Choice.”

The Medicaid System

Medicaid is a joint federal and state program. The federal Centers for Medicare and Medicaid Services (CMS) administer the program nationwide in conjunction with state agencies like the Michigan Department of Health and Human Services (MDHHS). Each state funds its own Medicaid program, with additional funding from the federal government.

Federal law sets the overall Medicaid program rules, while each state has broad discretion to set its own rules on eligibility. Qualifying for Medicaid in Michigan therefore might be different than qualifying in another state. Federal law states that a person must be a U.S. citizen or a “qualified immigrant” in order to receive Medicaid assistance, but it leaves almost all other eligibility criteria up to the states.

Every state uses means testing to determine eligibility for Medicaid benefits. Having low income is not enough, by itself, to qualify a person for Medicaid. To qualify for Medicaid coverage for long-term care in Michigan, a person’s income and total assets must be below certain levels.

Medicaid Waivers in Michigan

MI Choice provides HCBS waivers to eligible applicants in Michigan. The waiver is intended for seniors and individuals with disabilities. It allows Medicaid coverage for a wide range of in-home and community-based services for long-term care. These may include:

• In-home or community nursing care;
• Home meal delivery;
• Assistance with household chores, grocery shopping, and other routine activities;
• Community-based transportation assistance or health services;
• Environmental accessibility adaptations (EAA), such as modifications to one’s home or vehicle to improve or allow accessibility; and
• Personal emergency response systems (PERS), which allow a person to press a button to alert local emergency services.

Eligibility for Medicaid Waivers in Michigan

To be eligible for MI Choice, an applicant must meet the following criteria:

• They must be a Michigan resident;
• They must be at least 65 years of age, or at least 18 years of age with a qualifying disability;
• They must need a level of care provided in a long-term facility; and
• They must be financially eligible for Medicaid coverage under MDHHS rules.

The 2019 income limit for a single person seeking long-term care coverage in Michigan is $2,313 per month, and the countable asset limit is $2,000. If a married person is applying, and their spouse is not, the income and assets levels are the same for the applicant. The non-applicant spouse is limited to $126,420 in assets. If both spouses are applying, they each have a monthly income limit of $2,313, and an asset limit of $3,000.

Elder law attorney Rebecca J. Braun practices with Mobile Legal Services, PLLC in Southeast Michigan. She is available to answer your questions about Medicaid eligibility, estate planning, and related matters. She will travel, free of charge, to clients in Oakland, Washtenaw, Wayne, Livingston, and Southern Macomb Counties. Please contact us today through our website or at (734) 407-7657 to schedule a free and confidential initial assessment.