MI Choice Waiver in Michigan: Eligibility, Services & How It Works

What is the MI Choice Waiver?

MI Choice is a Home and Community-Based Services (HCBS) waiver under Section 1915(c) of the Social Security Act — a different kind of Medicaid program than Home Help. MDHHS administers it at the state level and contracts with regional Waiver Agencies (often Area Agencies on Aging) to run it locally.¹ Unlike Home Help, MI Choice is capped: it serves a fixed number of approved slots, so when a Waiver Agency's capacity is full, new applicants can be placed on a waitlist.

Who qualifies?

MI Choice generally requires three things:

• Age or disability: typically age 65 or older, or age 18–64 with a disability.
• A Nursing Facility Level of Care Determination (LOCD): an assessment confirming your functional need is comparable to what a nursing facility would provide. It's completed in person by your regional Waiver Agency, the same determination required before nursing home admission or PACE enrollment.²
• Financial eligibility: Michigan Medicaid's income and asset limits for long-term care apply, and those limits change periodically — your Waiver Agency or MDHHS caseworker can confirm the current thresholds.

What does MI Choice cover?

MI Choice covers a much wider range of services than Home Help's personal-care focus, which is limited to activities of daily living and a few household tasks.³ MI Choice includes:

• Personal care with activities of daily living
• Respite care
• Adult day health programs
• Home modifications (ramps, grab bars, and similar changes)
• Home-delivered meals
• Private-duty nursing
• A personal emergency response system (PERS)

Room and board is never covered, under either program.¹

How do you apply?

1. Contact the MI Choice Waiver Agency serving your county — often the local Area Agency on Aging.
2. Complete an initial screening to see whether a formal evaluation makes sense.
3. If the screening qualifies you, a team — typically a registered nurse and a social worker — completes the in-person Nursing Facility Level of Care Determination (LOCD) and reviews financial eligibility.²
4. If approved, a support coordinator builds your service plan and connects you with providers for each covered service.

MI Choice vs. Home Help

If a possible wait is a dealbreaker and you only need help with daily personal care, Home Help's no-waitlist entitlement may get a family caregiver paid faster. Read the full Home Help guide →

A proposed addition: Structured Family Caregiving — not yet approved

MDHHS has proposed adding a new service — sometimes called Coordinated Caregiving — to the MI Choice Waiver. It's Michigan's version of what's known nationally as Structured Family Caregiving: a participant would receive personal care and caregiving support from a trusted live-in caregiver.

As of this writing, it isn't available. MDHHS's own posted materials still label the 1915(b) and 1915(c) amendment documents that would create it “Draft”¹ — the amendment needs federal approval from CMS before it can take effect, and that approval hasn't been posted yet, even though MDHHS had originally targeted mid-2026 for the change. Don't plan around this until it's actually approved.

And even once approved, it would be a MI Choice benefit — Kinwell works within Home Help and MI Coordinated Health, not MI Choice, so Kinwell wouldn't administer it directly.

Frequently asked

Is MI Choice the same as the Home Help program? No. Home Help is an uncapped Medicaid entitlement covering personal care only. MI Choice is a capped waiver with a much broader service menu — but it can carry a regional waitlist. Read the full Home Help guide →

Does Kinwell help with MI Choice applications? Not directly — Kinwell works within Michigan's Home Help program and MI Coordinated Health. If Home Help's personal-care coverage fits your situation, Kinwell can get a family caregiver approved and paid without an MI Choice waitlist. Check your Home Help eligibility →

Is there really a waitlist for MI Choice? It depends on your region and how full your local Waiver Agency's approved slots are — MI Choice is capped, unlike Home Help, so a wait is possible where capacity is full.

Related reading

• Michigan Home Help Program: Eligibility & How It Works
• Medicaid Family Caregiver Pay in Michigan: The Complete Guide
• Full FAQ