Overview of MI Coordinated Health HCBS Waiver
MI Coordinated Health (MICH) is a managed care program available in 22 Michigan counties for residents who are aged or disabled and “dually eligible” for Medicaid and Medicare. MICH combines the benefits of both programs into one delivery system, making it easier to coordinate services and supports.
Benefits include medical care, prescription drugs, behavioral health services, nursing home care, as well as Home and Community Based Services (HCBS) to prevent and / or delay the need for institutionalization. HCBS, available via the MI Coordinated Health HCBS Waiver, are for persons who require the level of care provided in a nursing home. Potential services and supports include adult day care, home delivered meals, personal care assistance, home and vehicle modifications, and personal emergency response systems.
Program participants can live in their own home, the home of a family member, an adult foster care home, or a home for the aged (commonly referred to as assisted living).
Beneficiaries of MI Coordinated Health / MI Coordinated Health HCBS Waiver receive their benefits via a single managed care plan called a Highly Integrated Dual Eligible Special Needs Plan (HIDE SNP). HIDE SNPs are managed care organizations (MCOs) that coordinate Medicaid and Medicare benefits and run by private healthcare companies. HIDE SNPs have a network of care providers and program participants receive services via these providers. Based on the region of Michigan, persons may be limited to a single HIDE SNP plan, while others have several plans from which to choose. Currently, MI Coordinated Health / MI Coordinated Health HCBS Waiver is only available in 22 counties. However, it is anticipated to be available statewide in 2027.
There is some flexibility of providers for Home and Community Based Services, as some benefits, such as expanded community living supports (assistance with daily living activities), can be participant-directed. Called “self-determination” in MI, program participants can hire their own caregiver, rather than receive these services by the HIDE SNPs network of licensed care providers. While one can hire their adult child, niece / nephew, grandchild, or sibling, the “caregiver” must meet all required provider qualifications for the service for which they are being hired. A fiscal intermediary handles the financial aspects of employment responsibilities, such as withholding tax and issuing payments. Note: While spouses and legal guardians cannot be hired via the self-determination option. However, in some cases, these persons may be hired by a home care agency and be paid to provide care.
Home and Community Based Services via the MI Coordinated Health Waiver are not an entitlement; there are a limited number of participant enrollment slots, and when they are full, a waitlist for program participation forms.
MI Coordinated Health is a 1915(b) Managed Care Delivery System Waiver. It operates jointly with the MI Coordinated Health HCBS Waiver, also known as the MI Coordinated Health Waiver, which is a 1915(c) Home and Community Based Services (HCBS) Medicaid Waiver. MI Coordinated Health / MI Coordinated Health HCBS Waiver replaced MI Health Link / MI Health HCBS Waiver on 1/1/26.
Medicaid pays doctors, hospitals, and other providers in one of two ways, either “Fee-For-Service” or “Managed Care”. Under Fee-For-Service, Medicaid pays providers directly for each service they provide. Beneficiaries can receive services from any Medicaid-certified provider. Under Managed Care, Medicaid contracts with a Managed Care Organization (MCO). Medicaid pays the MCO a set amount for each beneficiary, rather than for each service provided. The MCO has a network of doctors, hospitals, and other providers and the MCO pays them. Beneficiaries must use providers within the network.
Benefits of MI Coordinated Health HCBS Waiver
Program participants receive all of their Medicaid and Medicare benefits via MI Coordinated Health. In addition to medical benefits (i.e., physician appointments, laboratory work, x-rays, hospitalization), dental services, hearing aid coverage, vision services, behavioral health services, prescription drugs, and nursing home care, a variety of Home and Community Based Services are also available via the MI Coordinated Health HCBS Waiver. The list that follows are potential HCBS, although an individualized care plan determines which benefits a program participant receives.
– Adaptive Medical Equipment / Supplies (i.e., lift chairs, shower seats, bath lifts, medical alert bracelets)
– Adult Day Health Care – supervised care in a community group setting a minimum of 4 hours / day. Transportation between home and the facility may be provided.
– Assistive Technology
– Care Coordination
– Chore Services – mowing the lawn, plowing snow, window washing, etc.
– Expanded Community Living Supports – assistance for persons who require prompting and supervision to do Activities of Daily Living (i.e., bathing, dressing personal hygiene, eating). May also include hands-on assistance for Instrumental Activities of Daily Living (i.e., meal preparation, laundry, medication management, shopping)
– Financial Management Services – for persons self-directing their care
– Home Meal Delivery – one to two meals / day
– Home Modifications – also called environmental modifications. May include widening doorways, installing ramps / grab bars, and modifying a bathroom to be wheelchair accessible
– Individual Goods & Services – services, supplies and equipment otherwise not provided that increases one’s safety and decreases the need for other Medicaid-funded services. Only available to persons who are self-directing their own care.
– Personal Emergency Response System (PERS)
– Preventive Nursing Services – on an intermittent basis
– Private Duty Nursing – up to 16 hours daily
– Respite Care – in-home / out-of-home short-term care to alleviate a primary caregiver from caregiving responsibilities
– Transportation – non-medical
– Vehicle Modifications
While services can be received in an adult foster care home or a home for the aged, MI Coordinated Health Waiver does not cover the cost of room and board.
Eligibility Requirements for MI Coordinated Health HCBS Waiver
To be eligible for MICH, an applicant must be a MI resident aged 21+ who is enrolled in Medicaid and Medicare (Parts A, B and D), not on hospice, and live in one of the 22 counties in which the program is available: Alger, Baraga, Barry, Berrien, Branch, Calhoun, Cass, Delta, Dickinson, Houghton, Iron, Kalamazoo, Keweenaw, Luce, Mackinac, Macomb, Marquette, Ontonagon, Schoolcraft, St. Joseph, Van Buren, and Wayne. While additional eligibility criteria follows, the criteria below is specific to those who require long-term Home and Community Based Services. MI Coordinated Health without HCBS has different criteria.
Financial Criteria: Income, Assets & Home Ownership
Income
The applicant income limit is equivalent to 300% of the Federal Benefit Rate (FBR), which increases annually in January. In 2026, an applicant, regardless of marital status, can have a monthly income up to $2,982. When both spouses are applicants, each spouse is considered individually, with each spouse allowed income up to $2,982 / month. When only one spouse is an applicant, the income of the non-applicant spouse is not counted towards the income eligibility of their spouse. Furthermore, monthly income from the applicant spouse can be transferred to the non-applicant spouse as a spousal income allowance, also called a Monthly Maintenance Needs Allowance (MMNA).
Michigan has set a minimum MMNA of $2,705 / month (eff. 7/1/26 – 6/30/27). This allows an applicant spouse to supplement their non-applicant spouse’s monthly income, bringing their income up to this amount. In 2026, the state also sets a maximum income allowance of $4,066.50 / month. While this potentially allows a non-applicant spouse a higher income allowance, any additional amount above the minimum income allowance is dependent on one’s shelter and utility costs. A spousal income allowance, however, can never push a non-applicant’s total monthly income over $4,066.50.
Assets
In 2026, the asset limit is $9,950 for a single applicant. For married couples, with both spouses as applicants, the asset limit is $9,950 per spouse. When only one spouse is an applicant, the assets of both spouses are still limited. This is because Medicaid considers the assets of a married couple to be jointly owned. In this case, the applicant spouse can retain up to $9,950 in assets and the non-applicant spouse is allocated a larger portion of the couple’s assets as a Community Spouse Resource Allowance (CSRA).
The CSRA allows the non-applicant spouse to keep 50% of the couple’s assets, up to $162,660. If the non-applicant’s share of assets falls under $32,532, they can keep 100% of the assets, up to $32,532.
Some assets are not counted towards Medicaid’s asset limit. This generally includes an applicant’s primary home, household furnishings and appliances, personal effects, and a vehicle.
Assets should not be given away or sold for under fair market value within 60-months of long-term care Medicaid application. Medicaid has a Look-Back Rule and violating it results in a penalty period of Medicaid ineligibility.
Home Ownership
The home is often the highest valued asset a Medicaid applicant owns, and many persons worry that Medicaid will take it. For eligibility purposes, Michigan Medicaid considers the home exempt (non-countable) in the following circumstances.
– The applicant lives in the home or has Intent to Return, and in 2026, their home equity interest is no greater than $752,000. Home equity interest is the current value of the home minus any outstanding mortgage. Equity interest is the portion of the home’s equity value that is owned by the applicant.
– The applicant has a spouse who lives in the home.
– The applicant has a disabled or blind child (of any age) who lives in the home.
– The applicant has a minor child (under 21 years old) who lives in the home.
While the home is likely exempt while one is receiving Medicaid benefits, it may not be safe from Medicaid’s Estate Recovery Program. Learn more about the potential of Medicaid taking the home.
Medical Criteria: Functional Need
For Home and Community Based Services, an applicant must require a Nursing Facility Level of Care (NFLOC). For the MI Coordinated Health HCBS Waiver, the tool used to make this determination is the Michigan Medicaid Nursing Facility Level of Care Determination (LOCD). There are several functional areas of consideration, including one’s ability to complete their Activities of Daily Living (i.e., transferring from the bed to a chair, mobility, eating, toileting), their cognitive abilities (i.e., daily decision making, short term memory, ability to communicate), and potential behavioral difficulties (i.e., wandering, refusing care, inappropriate behavior). While many persons with Alzheimer’s disease or a related dementia likely will meet the functional criteria, a diagnosis of dementia in and of itself does not mean one will automatically meet a NFLOC.
Qualifying When Over the Limits
Having income and / or assets over Medicaid’s limit(s) does not mean an applicant cannot still qualify for Michigan Medicaid. There are a variety of planning strategies that can be used to help persons who would otherwise be ineligible to become eligible. Some of these strategies are fairly easy to implement, and others, exceedingly complex. Below are the most common.
While Michigan has a Spend-down Program that permits Medicaid applicants to spend “excess” income on medical expenses in order to meet Medicaid’s income limit, the MI Coordinated Health HCBS Waiver prohibits persons from qualifying via this avenue.
When persons have assets over the limits, there are a variety of options. While the majority of states allow Irrevocable Funeral Trusts (IFTs), which are pre-paid funeral and burial expense trusts that Medicaid does not count as assets, Michigan does not allow IFTs. Instead, they permit Irrevocable Prepaid Funeral Contracts. With this type of contract, funeral and burial goods / services are selected and pre-paid. Another option, but for persons with a significant amount of “excess” assets, are Medicaid Asset Protection Trusts (MAPTs). The assets that are put into this type of trust are no longer considered to be owned by the applicant. However, a shortcoming of MAPTs is that they must be created well in advance of the need for long-term care. There are many other options when the applicant has assets exceeding the limit.
Inadequate planning or improperly implementing a Medicaid planning strategy can result in a denial or delay of Medicaid benefits. Professional Medicaid Planners are educated in the planning strategies available in the state of Michigan to meet Medicaid’s financial eligibility criteria without jeopardizing Medicaid eligibility. Furthermore, some Medicaid planning strategies, such as MAPTs, not only help one meet Medicaid’s financial criteria, but also protect assets from Medicaid’s Estate Recovery Program. These strategies often violate Medicaid’s 60-month Look-Back Rule, and therefore, should be implemented years prior to the need for long-term care. However, there are some workarounds, and MI Medicaid Planners are aware of them. For these reasons, it is highly suggested one consult a Certified Medicaid Planner for assistance in qualifying for Medicaid when over the income and / or asset limit(s).
How to Apply for MI Coordinated Health HCBS Waiver
Before You Apply
Prior to submitting an application for MI Coordinated Health / MI Coordinated Health HCBS Waiver, applicants need to ensure they meet the eligibility criteria. Applying when over the income and / or asset limit(s) will be cause for denial of benefits. The American Council on Aging offers a free Medicaid Eligibility Test to determine if one might meet Medicaid’s eligibility criteria.
As part of the application process, applicants need to gather documentation for submission. Examples include copies of Social Security and Medicare cards, life insurance policies, property deeds, pre-need burial contracts, bank statements up to 60-months prior to application, and proof of income. A common reason applications are held up is required documentation is missing or not submitted in a timely manner.
Since the MI Coordinated Health HCBS Waiver is not an entitlement program, there may be a waitlist for program participation. It is approved for a maximum of approximately 3,531 total beneficiaries per year, with each region allotted a specific number of participant slots. This means waitlists are region specific. However, based on need, the available slots in each region are adjusted accordingly.
In the case of a waitlist, priority is given to select groups of persons, such as those residing in a nursing home who wish to return to community living and those who will require nursing home admission in the very near future. If an applicant does not fall into a priority group, one’s placement on the waitlist is based on the date of application.
Application Process
To enroll in the MI Coordinated Health HCBS Waiver, one must be eligible and enrolled in both Medicaid and Medicare. One can apply for Michigan Medicaid online via MI Bridges, over-the-phone by calling the Michigan Health Care Helpline at 1-855-789-5610, or in-person at one’s local MDHHS office.
Persons not already enrolled in Medicare can apply online on the Social Security Administration (SSA) website, by calling SSA at 1-800-772-1213, or in-person at one’s local SSA office.
Once determined eligible for MI Coordinated Health / MI Coordinated Health HCBS, one must enroll in a managed care plan. As part of the application process for HCBS, a functional needs assessment is completed. See available plans in program counties. See contact information.
Learn more about MI Coordinated Health / MI Coordinated Health HCBS Waiver. The Michigan Department of Health and Human Services (MDHHS) administers the MI Coordinated Health Program / MI Coordinated Health HCBS Waiver. HIDE SNPs (Highly Integrated Dual Eligible Special Needs Plans contract with MDHHS to provide program benefits.
Approval Process & Timing
The Medicaid application process can take up to 3 months, or even longer, from the beginning of the application process through the receipt of the determination letter indicating approval or denial. Generally, it takes one several weeks to complete the application and gather all of the supportive documentation. If the application is not properly completed, or required documentation is missing, the application process will be delayed. Based on federal law, Medicaid offices have up to 45 days to review and approve or deny one’s application (up to 90 days for disability applications). Despite the law, applications are sometimes delayed even further. Furthermore, if wait-lists exist, approved applicants may spend many months, or longer, waiting to receive benefits.