There are two AgeWays programs that can provide direct care.

1. The MI Choice program (also known as the Medicaid Home and Community Based Waiver) provides direct care to eligible individuals via Medicaid. The program is designed to be an alternative to nursing home care that provides services at home instead. The program is available to both people over 65 and people under 65 with a disability. To qualify for the program, you must meet both financial and level-of-care eligibility requirements. for more details, visit our MI Choice Waiver page. You can also visit the FAQ section dedicated to the MI Choice Waiver.
2. The Community Living suite of programs can also offer some direct care support for qualifying individuals 60 and older who live in our 6-county service region (Livingston, Macomb, Monroe, Oakland, St. Clair and Washtenaw). This program is supported using funds allocated via the Older Americans Act and Older Michiganians Act. The program can also offer respite care for family caregivers and access to personal emergency response systems for the home.

Please note that there are typically waits for both programs.

• Support groups: AgeWays can connect you to in-person and virtual groups where caregivers share experiences and strategies.
• Counseling services: Behavioral health counseling is available for caregivers dealing with stress, grief, or burnout.
• Classes and workshops: These focus on self-care, stress management, and coping skills.

Call 800-852-7795 or visit ageways.org for current offerings.

Caregiver burnout can affect both emotional and physical well-being.

Common signs include:

• Extreme fatigue or trouble sleeping
• Feeling overwhelmed, anxious, or depressed
• Withdrawal from friends, family, or activities you once enjoyed
• Increased irritability or frustration
• Changes in appetite or weight
• Declining health due to stress or neglecting your own needs

If you notice these signs, it’s important to seek support before reaching a breaking point.

• Support groups to connect with others facing similar challenges
• Respite care options, including vouchers to hire temporary care
• Training programs to help caregivers provide safe, effective care
• Resource navigation to find local, state, and national programs

A family caregiver is anyone who provides unpaid care for a loved one, such as:

• An aging parent or relative
• A partner or spouse
• A friend or neighbor
• Caregiving may include personal care, household tasks, transportation, or managing healthcare needs.

Look for these indicators that extra help may be needed:

• Difficulty with daily tasks like cooking, cleaning, or bathing
• Frequent falls or mobility challenges
• Forgetfulness or confusion affecting safety
• Declining physical or emotional health
• Missed medications or medical appointments
• Unexplained weight loss or poor nutrition

AgeWays: Call 800-852-7795 for a list of caregiver support groups in your area.

Community centers and hospitals: Many host free or low-cost groups.

Online directories: Websites like the Michigan Caregiver Resource Network or AARP Caregiver Support can help you find groups near you.

To be eligible for MI Choice, you must:

• • Be 65 years or older or an adult with a disability
  • Need a nursing home level of care
  • Meet financial eligibility. You cannot have more than $9,660 in assets, and there is a monthly income limit as well. In 2025, that limit is $2,901. It’s important to note that not all your assets are considered. Your home and car won’t be counted. If you are married, your assets will be looked at differently.

The program covers a wide range of in-home and community-based services, including:

• Adult day services
• Assistive technology
• Chore services
• Community health worker
• Community living supports (personal care and homemaking tasks)
• Community transportation
• Counseling
• Fiscal intermediary
• Goods and services
• Home modifications (environmental accessibility adaptations)
• Home-delivered meals
• Nursing services
• Private-duty nursing/respiratory care
• Personal emergency response systems
• Residential services
• Respite care
• Specialized medical equipment and supplies
• Supports brokerage
• Supports coordination
• Training (to support independent living)
• Vehicle modification

Once you or your loved one is enrolled in the program, your supports coordinator will work with you to develop a plan of care that includes the services appropriate to you or your loved one’s needs.

Qualifying for and becoming fully enrolled in the program is a multi-step process that often can take several months. AgeWays staff will work with you throughout the process to help answer questions and assist. Seeing if you or your loved qualifies for the program will start with a conversation with one of our clinical screeners who will ask questions about the financial situation and type of care needed by the person applying. This initial conversation can take 30 -45 minutes. You will need to have detailed information regarding the finances of the person needing care. This includes information on both income and assets. If you are the power of attorney for the person needing care, we will need verification of your power of attorney status before gathering information. If our clinical screeners confirm that you or your loved one pass the Michigan Intake Guidelines and may qualify for the program based on the answers given regarding care needed and finances, you will be added to the wait list for the program. For most people, your placement on the waitlist is based on when you contacted the program. The program is a Medicaid program, and the Michigan Department of Health and Human Services (MDHHS) makes decisions regarding financial eligibility. Our staff will work with you to assist with the Medicaid application, but you may receive communication and questions from MDHHS regarding your application. When your name comes up on the waitlist, an assessment team from AgeWays will come to your home to determine if the level of care you need meets the “nursing home level” needed to qualify for the program. This team will include a nurse and a social worker. This assessment usually takes 2-3 hours and includes a standardized set of questions. Once it’s determined that you qualify for the program, you will be assigned a “supports coordinator” who will create a plan of care based on the needs of you or your loved one. AgeWays will then work to set up needed care.

AgeWays works with a pool of well-vetted direct service providers who provide care for individuals enrolled in the MI Choice program. These include home care agencies, transportation providers, and more. Your supports coordinator will work with you or your loved one to develop a plan of care and then work with the appropriate providers to put care services in place.

All services provided by the MI Choice program are paid for via Medicaid funding.

It is possible to be paid to care for a loved one using an element of the program called self-determination or be hired through a provider agency to deliver care. Please note that there are specific requirements related to when a spouse or legally responsible person can be paid to care for a program participant. Your supports coordinator will walk you through both options and help determine what best meets your needs and circumstances.

MI Choice is a statewide program. Easterseals MORC is also a MI Choice Waiver Agent that provides care in the 6-county region also served by AgeWays. Individuals can work through either organization to access the program.

Medicare Savings Programs help eligible individuals pay for some or all of their Medicare costs, such as premiums, deductibles, coinsurance, and copays.
There are four Medicare Savings Programs:

1. Qualified Medicare Beneficiary (QMB) Program
2. Specified Low-Income Medicare Beneficiary (SLMB) Program
3. Qualifying Individual (QI) Program
4. Qualified Disabled and Working Individuals (QDWI) Program

If you qualify for any of the first three programs (QMB, SLMB, or QI), you automatically qualify for Extra Help, which reduces prescription drug costs.

Eligibility is based on income and assets, and requirements are updated annually.

You can still qualify even if you are working and receiving income.

2025 Income & Asset Limits

QMB – Helps with premiums, deductibles, copays, and coinsurance

SLMB – Helps pay Part B premiums

QI – Helps pay Part B premiums (apply yearly, first come-first served)

QDWI – Helps pay Part A premiums for working, disabled individuals under 65

*Assets include bank accounts, stocks, bonds, and similar resources.
Important:

• If you qualify for QMB, providers cannot bill you for Medicare deductibles, copays, or coinsurance.
• With QMB, you won’t pay more than $12.15 for a prescription covered by your Medicare Part D plan.

• Call AgeWays at 800-852-7795.
  • Our trained SHIP counselors will review your eligibility and guide you through the application process.
• Gather required documents.
  • This typically includes proof of income, assets, and identification.
• Submit your application to the Michigan Department of Health and Human Services (MDHHS).

• Medicare: A federal program that provides health coverage if you are 65 or older, or under 65 with a qualifying disability, regardless of income.
• Medicaid: A state and federal program that provides health coverage to people with very low income and limited resources.

You can have both Medicare and Medicaid, and AgeWays can help you understand how the two work together to cover your care.

Not necessarily.

• Some programs require a separate application.
• Call 800-852-7795 to have a SHIP counselor check your eligibility and walk you through the process.

Savings vary by program, but benefits can include:

• No-cost Part B premiums (over $174.70/month in 2025)
• Elimination of copays, deductibles, and coinsurance (QMB program)
• Reduced prescription costs through Extra Help
• Protection from being billed directly by providers

Yes. An ombudsman will visit the resident. If he gives the ombudsman permission to advocate on his behalf, the ombudsman could coordinate a meeting with management staff at the the home to try to resolve these problems. The ombudsman could continue to monitor the resident’s care to ensure the complaints have been resolved for as long as the resident requests the ombudsman to do so.

There are 5 reasons a nursing home can discharge a resident:

1. The home can no longer meet the needs of the resident.
2. The resident no longer needs a nursing home-level of care.
3. The resident is a risk to oneself.
4. The resident is a risk to others.
5. Nonpayment

A 30-day written discharge notice must be provided to the resident prior to discharge. If you are concerned that you or your loved one is being discharged unfairly or without meeting the above criteria, you can contact the Long Term Care Ombudsman Program at 1-866-458-9393.

The home can petition for guardianship and is required to list the family and other recommendations for guardian. The judge will determine in one hearing if the family is the best choice. Usually this is done in one hearing and the home does not re-apply if the family is not appointed.

Residents maintain their constitutional rights and may have additional rights when living in a licensed long-term facility.  To learn more about resident rights, contact your local ombudsman or visit https://mltcop.org/know-your-rights.

Contact the Michigan Long Term Care Ombudsman Program (MLTCOP) at 866-485-9393 or visit www.MLTCOP.org.