What MI Choice is
A Home and Community-Based Services waiver. The reasoning behind it is straightforward: nursing facility care is expensive, and many people who technically qualify for it would rather stay in their own homes. The waiver redirects that funding toward community-based services instead.
Because it is displacing a nursing facility placement rather than supplementing ordinary living, MI Choice generally authorizes a broader service package than Michigan’s standard Home Help Program.
Services it commonly authorizes
- In-home personal care and assistance with activities of daily living
- Family caregiver compensation where a relative is the primary provider
- Respite care so primary caregivers can rest
- Homemaking and chore services
- Personal emergency response systems
- Home modifications supporting safety and accessibility
- Adult day programming
- Residential placement in licensed settings
- Care coordination and case management
Not every participant is authorized for every service. The care plan is built from the assessment, and the assessment determines what gets approved.
MI Choice eligibility, in plain terms
- 1Medicaid financial eligibility. Income and asset limits apply. This is assessed separately from care need and it is where a large share of applications stop.
- 2Nursing facility level of care. An assessment has to show the person would qualify for nursing home placement. The entire purpose of the waiver is to fund community living as an alternative to that.
- 3Age or disability criteria. Generally adults 65 and older, or adults 18 and over with a qualifying disability.
How the assessment works
An assessor evaluates ability to perform activities of daily living: bathing, dressing, transferring, toileting, eating, medication management, and mobility. That produces a level-of-care determination which drives everything downstream.
Two things are worth knowing before it happens. First, the assessment is a snapshot, so it should reflect a typical day rather than the best day of the month. Families routinely understate need because they have normalized how much they are doing and no longer notice it. Second, it can be redone when circumstances change. An authorisation set two years ago does not bind you if the situation has deteriorated since.
Using MI Choice with us
We provide MI Choice authorized services across Southeast Michigan, including in-home care, family caregiver arrangements, and residential placement. If you are already enrolled, bring your care plan to the intake call and we will map your existing authorization to what we deliver.
If you are not enrolled but appear to qualify, we can point you to the application path in your region, which runs through the local waiver agent rather than through MDHHS directly.
MI Choice compared to Home Help
Both are Michigan Medicaid programs that fund in-home care, and people conflate them constantly.
Home Help covers assistance with daily activities for Medicaid beneficiaries and is generally the lighter touch program with a simpler application. MI Choice targets people who would otherwise be in a nursing facility, authorizes a wider range of services at higher intensity, and carries a more involved assessment along with the possibility of a waitlist.
Some people qualify for both, and which one is used depends on the level of care required. If you are unsure which applies to your situation, describe the care need on the first call and we will tell you where it lands.
Redetermination and staying enrolled
MI Choice enrollment is reviewed periodically. Both the financial eligibility and the level-of-care determination get revisited, and participants occasionally lose services not because their needs changed but because paperwork lapsed or a review appointment was missed.
Two things prevent that. Keep the local waiver agent informed of any change of address or phone number, because review notices go out by post and a missed notice is the single most common cause of a lapse. And treat the review assessment with the same care as the original: if the situation has deteriorated, say so, because the review is an opportunity to increase authorized services rather than merely a hurdle to clear.
What to bring to the first conversation
- The current care plan if one exists, even an out-of-date one
- Any correspondence from the waiver agent or MDHHS
- The Medicaid ID for the person receiving care
- A rough list of what help is needed on an ordinary day
- Names of any physicians or case managers already involved
None of it is mandatory and we will work with whatever you have. Families frequently arrive with a carrier bag of unsorted paperwork and no idea what any of it means, which is a perfectly normal starting point.
MI Choice questions
In-home personal care, family caregiver compensation, respite, homemaking, emergency response systems, home modifications, adult day services, residential placement, and care coordination. Individual authorization depends on the assessment.
Applications run through the regional waiver agent for your area, and there may be a waitlist depending on region and enrollment capacity. We can point you to the right agent and explain what the assessment will look at.
In many cases yes. Family caregiver compensation is one of the authorized service categories. The specifics depend on the relationship, the assessed need, and the care plan.
Sometimes, and it varies by region and by year because enrollment is capped. This is the main reason to start the conversation earlier than feels urgent.
Home Help covers assistance with daily activities for Medicaid beneficiaries and is the lighter program. MI Choice targets people who would otherwise need nursing facility care and authorizes broader services at higher intensity.
Yes. Request a reassessment when circumstances change. Authorizations reflect need at a point in time and are meant to be revisited rather than treated as permanent.