Every funding option explained — Medicare, the MI Choice Waiver, VA Aid & Attendance, long-term care insurance, and private pay — with verified 2026 figures for families across Metro Detroit.
📞 Not sure how you'll pay for care? Superior Home Health of Michigan helps families across Metro Detroit understand their options and verify coverage before care begins. Free, no-obligation guidance.
Call NowMedically ReviewedRob Devore, FNP-BC · Family Nurse Practitioner · Superior Home Health of Michigan
Quick Answer
How do most families pay for home care in Michigan?
There are five main ways to pay for home care in Michigan: Medicare (which fully covers medically necessary skilled home health for eligible homebound patients), Medicaid through the MI Choice Waiver (which covers long-term in-home personal care at no cost for those who qualify), VA Aid & Attendance (a tax-free monthly pension for eligible wartime veterans and surviving spouses), long-term care insurance, and private pay. Most families use a combination. The right mix depends on the type of care needed, the patient's income and assets, and veteran status.
For most Michigan families, the hardest part of arranging home care isn't deciding that it's needed — it's figuring out how to pay for it. The good news is that there are far more options than most people realize, and several of them cost the family little or nothing when the patient qualifies. At Superior Home Health of Michigan, we help families across Livonia, Novi, Farmington Hills, and all of Metro Detroit navigate these options every day. This guide walks through all five funding paths with current 2026 figures.
One important distinction up front, because it determines which funding applies: "skilled" care versus "custodial" care. Skilled care is clinical work that legally requires a licensed professional — wound care, injections, physical therapy, medication management. Custodial care (also called personal care) is help with daily activities like bathing, dressing, meals, and supervision. Medicare pays for skilled care. Medicaid and VA benefits more often pay for custodial care. Knowing which kind of care you need is the first step to knowing who pays.
Medicare is the most common starting point, and for eligible patients it covers skilled home health care at 100%, with no copay and no deductible. This is the funding source Superior Home Health works with most often.
Medicare Part A and Part B cover medically necessary home health when all of these are true: a physician orders the care, the patient is considered homebound, the care requires a skilled professional, and the services are delivered by a Medicare-certified agency (which Superior Home Health is). Covered services include skilled nursing, physical and occupational therapy, speech therapy, medical social services, and a home health aide when the patient is also receiving skilled care.
What Medicare does not cover is just as important to understand: it does not pay for 24-hour care at home, meal delivery, or custodial (personal care only) services when that is the only care needed. For a full breakdown of eligibility and what's covered, see our detailed guide on whether Medicare covers home care in Michigan.
Key point: If your loved one needs skilled care — wound care, recovery after a hospital stay, injections, therapy — Medicare very often covers it in full. Many families assume they'll pay out of pocket and are relieved to learn otherwise. The fastest way to find out is a free eligibility check. Call (734) 221-0236.
For Michigan families who need ongoing personal care — not just short-term skilled care — the MI Choice Waiver is the most important program to know about. It is Michigan's Medicaid Home and Community-Based Services waiver, and it pays for long-term in-home care so that seniors and disabled adults can avoid moving into a nursing home.
MI Choice covers more than 20 services, including personal care, respite care, adult day programs, home modifications, meal services, personal emergency response systems, private-duty nursing, and supports coordination. For qualifying participants, there is no cost. One thing it never covers is room and board.
To qualify, an applicant must meet three tests — age or disability, level of care, and finances:
Two features families especially value: through the Self-Determination Option, participants can hire and pay family members — including, in many cases, a spouse — as caregivers. And because the program is designed to keep people out of nursing homes, applicants transitioning home from a hospital or facility are often prioritized.
The honest catch: MI Choice is capped at roughly 20,500 statewide slots, so most regions keep a waiting list — standard applicants may wait months, and the full application process typically runs 3 to 6 months. Apply early. The statewide entry point is 1-800-803-7174, or you can start through your local Area Agency on Aging (The Senior Alliance serves Wayne County; AgeWays serves Oakland, Macomb, Monroe, Livingston, St. Clair, and Washtenaw).
If your loved one is a wartime veteran or the surviving spouse of one, VA Aid & Attendance is one of the most overlooked and valuable benefits available. It's a tax-free monthly pension paid on top of the basic VA pension to help cover the cost of in-home care, and the money can be used to pay a professional agency or, in many cases, a family caregiver.
Crucially, this is not a service-connected disability benefit — the veteran does not need a disability rating. It's a needs-based pension for those who require help with daily activities like bathing, dressing, eating, or who need supervision due to a cognitive condition such as dementia.
These maximums are effective December 1, 2025 through November 30, 2026. Your actual benefit depends on income, but unreimbursed medical expenses — including home care costs — can substantially reduce countable income and raise your payment:
To qualify, the veteran generally must have served at least 90 days of active duty with at least one day during a recognized wartime period and have a discharge other than dishonorable. For 2026, the VA net worth limit is $163,699, which excludes the primary residence and one vehicle. Because the paperwork is complex and many claims are delayed by missing documentation, families often work with an accredited Veterans Service Officer (VSO), who can help at no cost.
If your loved one purchased a long-term care insurance policy in past years, it may cover in-home care — and many families forget they have it or assume it only applies to nursing homes. Most modern policies cover home care, but the details vary widely. Check three things on the policy: the daily or monthly benefit amount, the elimination period (the number of days you must pay out of pocket before coverage begins, often 30–90 days), and whether in-home care is explicitly covered.
Superior Home Health works with families using long-term care insurance and can provide the documentation and care records most policies require for reimbursement.
Some families pay privately — either because care is needed immediately while other coverage is being arranged, or because the patient doesn't qualify for the programs above. Private pay offers the most flexibility and the fastest start, with no eligibility process. Understanding the real numbers helps you plan; see our transparent breakdown of home care costs in Michigan.
A few ways families reduce out-of-pocket cost:
Most families don't rely on a single source — they stack them. A common Metro Detroit example: a patient comes home after a hospital stay on Medicare-covered skilled home health for wound care and therapy, the family applies for MI Choice for the long-term personal care that will be needed after the Medicare episode ends, and because the patient is a Korean War veteran, they also file for VA Aid & Attendance to fund additional hours. Each program covers a different piece.
The key is knowing which program fits which need, and applying for the slower ones (MI Choice, VA) early while faster coverage (Medicare, private pay) carries the immediate need. That's exactly the kind of planning our team helps families think through.
Superior Home Health of Michigan is a Medicare- and Medicaid-certified, nurse practitioner-led home health agency serving Metro Detroit. We provide skilled nursing, advanced wound care, physical therapy, and post-hospital recovery in the home — and we help families understand and verify their coverage before care begins, so there are no financial surprises.
We can verify Medicare eligibility quickly, point you to the right Area Agency on Aging for MI Choice, provide the records long-term care insurers require, and connect you with veteran resources for Aid & Attendance. Whether your loved one needs skilled nursing at home, advanced wound care, or post-hospital recovery, the first step is the same: a free, no-obligation evaluation.
Yes. Medicare covers medically necessary skilled home health care at 100% with no copay when the patient is homebound, the care is physician-ordered, and it's provided by a Medicare-certified agency like Superior Home Health of Michigan. Medicare does not cover 24-hour care or custodial-only personal care when that is the only care needed.
In 2026, a single applicant can have monthly income up to $2,982 and countable assets up to $9,950. The primary home (up to $752,000 in equity) and one vehicle are excluded. Applicants must also meet nursing facility level of care, determined by an in-home LOCD assessment.
Call Michigan's statewide entry point at 1-800-803-7174, or contact your local Area Agency on Aging (The Senior Alliance for Wayne County, or AgeWays for Oakland, Macomb, and surrounding counties). A phone screening is followed by an in-home assessment by a nurse and social worker. Because of waiting lists, the full process often takes 3 to 6 months, so apply early.
Effective December 1, 2025 through November 30, 2026, the maximum tax-free monthly Aid & Attendance benefit is up to about $2,424 for a single veteran, $2,874 for a married veteran, and $1,558 for a surviving spouse. Actual amounts depend on income, but unreimbursed medical expenses including home care can reduce countable income and increase the benefit.
In many cases, yes. The MI Choice Waiver's Self-Determination Option allows participants to hire family members, and in many situations a spouse, as paid caregivers. VA programs may also pay family caregivers in certain circumstances. Eligibility rules apply, and your MI Choice supports coordinator will walk you through the options.
No. Aid & Attendance is a needs-based pension, not a disability benefit. A veteran does not need a VA disability rating. The requirements are qualifying wartime service, a documented need for help with daily activities or supervision, and finances within the VA's limits (a $163,699 net worth limit in 2026, excluding the home and one vehicle).
Yes, and most families do. A common approach is Medicare for short-term skilled care, MI Choice for ongoing personal care, and VA Aid & Attendance for additional funded hours when there's a qualifying veteran. Each program covers a different part of the overall need. Superior Home Health can help you map out which applies to your situation.
If skilled care is needed, Medicare can often begin within days for eligible patients. For longer-term personal care while a MI Choice application is pending, many families use private pay or Michigan's Home Help Program as a bridge, then transition to the waiver once a slot opens. Call (734) 221-0236 and we'll help you find the fastest path for your situation.
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