MI Choice Waiver or Home Help? How Michigan's two programs differ

The short answerHome Help and the MI Choice Waiver are two separate Michigan Medicaid programs that help adults stay in their own homes. Home Help is handled by your county MDHHS office, which assesses daily tasks and sets paid time. MI Choice is a waiver program with its own list of services, and MDHHS says to start by contacting the MI Choice waiver agency in your community. Only the State and the waiver agency decide who qualifies.

If your parent needs help at home, you may have seen both names and wondered whether they are the same thing. They are not. This guide sets out what each program is, how they differ, and who to call. We have kept to what Michigan's own pages say, and we say so where we could not confirm something.

What Home Help is

MDHHS describes Home Help as a program designed to support people who want to live independently in their own home, as an alternative to an adult foster care home, a home for the aged or a nursing facility. It is paid for with Medicaid funds.

An Adult Services Worker from your county MDHHS office does a functional assessment. The State looks at seven personal care tasks (bathing, dressing, eating, grooming, mobility, toileting and transferring) and five household tasks (housework, laundry, taking medication, meal preparation and shopping). Each is ranked from 1 to 5, and the State pays only for tasks ranked 3 or higher. The worker sets time for each task, and the total appears on form MDHHS-6064-C as a monthly maximum. The person who needs care chooses the caregiver, and in some cases that can be a family member.

What the MI Choice Waiver is

MDHHS describes MI Choice as one program run by Michigan Medicaid. It began in 1992 and became available in all Michigan counties on October 1, 1998. Through it, eligible adults who meet income and asset criteria can receive Medicaid-covered services like those provided by nursing homes, but can stay in their own home or another residential setting. MDHHS also says the aim is to let people live independently while receiving nursing facility level of care in their home or in a community setting.

MDHHS lists the services a participant can receive: the basic services Michigan Medicaid covers, supports coordination, and one or more waiver services. The waiver services on the State's page include adult day health, chore services, community health worker, community living supports, community transportation, counseling, environmental accessibility adaptations, fiscal intermediary, goods and services, home delivered meals, nursing services, personal emergency response systems, private duty nursing and respiratory care, respite, specialized medical equipment and supplies, and training in independent living skills.

How they differ

• Where you start. For Home Help, you contact your county MDHHS office and ask for Adult Services. For MI Choice, MDHHS says to contact the MI Choice waiver agency in your community.
• How the help is decided. Home Help is task by task, with paid time set for each task ranked 3 or higher. MI Choice is described as a set of services, including supports coordination, drawn from the State's list.
• What it covers. Home Help covers the twelve tasks listed above. MI Choice lists a wider range, such as meals, transportation, respite and equipment.

What we could not confirm

The MDHHS page we read do not let us say how long the wait is for MI Choice, what the exact eligibility tests are, whether a family member can be paid under it, or whether a person can use both programs at once. Please do not rely on us for those. Ask your local MI Choice waiver agency, and ask your county MDHHS office about Home Help. Rules change, so confirm with them.

Where Already Caring fits

Already Caring is preparing to work with Michigan Home Help and is not yet taking clients. We do not provide MI Choice services, and we cannot tell you which program fits your parent. If Home Help is the route you choose, our guide to who qualifies and how to apply lists the steps.

Common questions

What is the MI Choice Waiver?

MDHHS describes the MI Choice Waiver as a program run by Michigan Medicaid. Eligible adults who meet income and asset criteria can receive Medicaid-covered services like those provided by nursing homes, but can stay in their own home or another residential setting.

What is the difference between MI Choice and Home Help?

Home Help is run through your county MDHHS office. A State Adult Services Worker assesses seven personal care tasks and five household tasks and sets paid time for each. MI Choice is a waiver that offers a set of services, such as supports coordination and community living supports, and you contact a MI Choice waiver agency in your community about it.

How do I apply for the MI Choice Waiver?

MDHHS says to contact the MI Choice waiver agency in your community, which can give you more information. Its web page has a region map and a list of waiver agencies. Ask that agency how to apply.

Can I be paid to care for my parent under MI Choice?

We could not confirm this from MDHHS pages, so we do not say. Ask your local MI Choice waiver agency whether a family member can be paid. For Home Help, the person who needs care chooses the caregiver, and in some cases that can be a family member, but only the State decides.

Which program is right for my parent?

We cannot say. Only the State and the waiver agency decide who qualifies. Many families ask both: your county MDHHS office about Home Help, and the MI Choice waiver agency in your community about the waiver.

This is general information, not legal, tax or benefits advice. Whether someone qualifies depends on the State's decision for that person. Rules change, so confirm with MDHHS. Already Caring is a private company and is not part of MDHHS or the State of Michigan.