Paying for Home Care in Michigan: Who to Call and What to Ask

Most families come to this question in a hurry, usually because something already happened. A fall, a hospital stay, a diagnosis. So this page is built to be useful fast.

Below are the four ways Michigan families actually pay for in-home care, who to call for each one, and the question to lead with when you get someone on the phone. If you want the fuller explanation behind any of it, I have written those separately and linked them at the bottom.

One thing to know before you start. Original Medicare does not pay for in-home care. It pays for home health, which is the visiting nurse or therapist after a hospital stay, and that is a different service. Almost every family I talk to is surprised by this, and finding it out early saves a lot of trouble later.

1. Private pay

The most common path, and the simplest. Out of pocket, usually from some mix of retirement savings, Social Security, a pension, or proceeds from downsizing.

Who to call: nobody. You are already eligible.

What to ask yourself instead: how many hours a week can we sustain, and for how long? That number is the one that shapes every other decision, and it is easier to look at in calm conditions than during a crisis.

2. Long-term care insurance

If your parent bought a policy years ago, it will often pay a daily benefit toward in-home care. A lot of adult children have no idea a policy exists until they go through the filing cabinet.

Who to call: the insurance company on the policy, or your parent’s insurance agent.

What to ask: what is the elimination period, what is the daily benefit cap, and is there an inflation rider? Those three answers tell you almost everything about what the policy is actually worth today.

Worth knowing: most agencies, including ours, can bill the insurance company directly, so you are not fronting the money and filing paperwork yourself.

3. VA Aid and Attendance

This is the benefit I most often see families miss. If your parent is a veteran who served at least one day during a wartime period, or is the surviving spouse of one, they may qualify for a monthly, tax-free payment that can be used for in-home care.

Michigan has a large Vietnam-era veteran population now in their late seventies and eighties, and a lot of those families have never heard of it.

Who to call: the Michigan Veterans Affairs Agency, 1-800-MICH-VET (1-800-642-4838). There are also VA-accredited attorneys and benefit consultants in Michigan who do nothing but this.

What to ask: would my parent meet the service, medical, and financial requirements, and what documents do you need from us to start?

Do this before you pay out of pocket for months in a row. The application is paperwork-heavy and the benefit is worth the trouble.

4. MI Choice Waiver (Michigan Medicaid)

Michigan’s MI Choice Waiver can cover in-home care as an alternative to a nursing home, for families who qualify medically and financially.

Who to call in Washtenaw County:

• AgeWays Non-Profit Senior Services (formerly Area Agency on Aging 1-B): 248-357-2255
• Easterseals MORC: 586-263-8700

What to ask: can you screen us for MI Choice eligibility, and what is the current wait?

The single most important thing on this page: there is a waitlist, and it commonly runs six to twelve months. If you think your parent might qualify, start the application now, even if you do not need care yet. Families who wait until they need it wait another six months on top of that. Getting into the queue early is most of the game.

A few other numbers worth having

• Michigan 2-1-1 — dial 211. General help finding local services, and a reasonable first call when you do not know who to call.
• Washtenaw County Veterans Affairs — for help gathering the discharge and service records the VA application needs.
• Your parent’s hospital discharge planner — if you are in the middle of a discharge right now, this person can start several of these conversations for you today.

What I would actually do first

If I were sitting at your kitchen table, I would do these in this order.

1. Find out whether there is a long-term care insurance policy. It takes one afternoon and it changes the math more than anything else on this list.
2. Find out whether your parent is a wartime veteran or the surviving spouse of one. Same reason.
3. If money is tight, call AgeWays and get in the MI Choice queue, today, regardless of whether you are ready for care.
4. Then work out what private pay can cover in the meantime.

Most families end up using two of these four. A few use all four.

If you want help sorting through it

I do a free in-home assessment for families in Ann Arbor, Saline, Dexter, Chelsea, Pinckney, and Whitmore Lake. I come to the house, we look at the situation together, and you leave with a clear read on what kind of support would fit and what it would cost. There is no cost and no pressure to decide that day. If a different kind of care is what your family needs, I will tell you that and point you toward it.

Schedule a free in-home assessment, or call (734) 821-4069.

The longer versions

• How much in-home care costs in Ann Arbor, and how families pay for it
• Home care vs. home health vs. hospice