Homecare Agencies in Michigan: What to Check Before You Choose
Choosing home care for a parent or spouse is a big step. You want to get it right the first time. Before you call any agency, ask yourself four things. What kind of care does my family member need? Is that care medical, or is it non-medical? Can Medicaid help pay for it? And what should I check before I sign anything?
Michigan adds one twist. The state does not require a license for non-medical home care agencies. So the usual first question, "Are you licensed?", won't tell you much here. This guide shows you what to check instead.
What to Check First
Quick answer: Before you call an agency, run through six checks. What kind of care is needed. Whether Medicaid is active. Whether the agency handles Home Help and CHAMPS billing. How caregivers are screened. What backup coverage looks like. And how billing works. These six catch most problems early.
- What kind of care is needed. Personal care, like bathing and meals? Or skilled care, like nursing? This one choice shapes your whole search.
- Is Medicaid active? This decides if Home Help or MI Choice can help pay.
- Does the agency handle Home Help and CHAMPS billing? Ask this straight out. Not every agency does.
- How are caregivers screened? Ask about background checks. Ask if caregivers are hired directly or work as contractors.
- What happens if my caregiver is sick? Ask how backup care works before you need it.
- How does billing work? Ask about the hourly rate, minimum shift length, and any extra fees.
The rest of this guide walks through each of these in plain terms.
The Four Ways Home Care Works in Michigan
Quick answer: Home care in Michigan comes in four types. Non-medical private-pay care. The Medicaid Home Help Program. The MI Choice Waiver. And skilled home health care. Each one has its own rules for who pays, who qualifies, and who makes the final call.
Non-medical private pay. You pay the agency directly. It covers help with bathing, dressing, meals, and light housework. No state approval is needed to start.
Medicaid Home Help Program. This is for people already on Medicaid who need help with daily tasks. MDHHS visits the home and decides who qualifies. The state pays the caregiver, not the family.
MI Choice Waiver. This is for people who need the kind of care a nursing home gives, but want to stay in their own home. MDHHS looks at how much care the person needs and decides.
Skilled home health care. This means nursing, wound care, or therapy, ordered by a doctor. Agencies that offer it must follow federal rules and hold Medicare or Medicaid approval. It is billed on its own, separate from non-medical home care.
| Type of care |
Who it's for |
What it covers |
Who decides |
What to ask |
| Non-medical private pay |
Anyone; Medicaid not required |
Bathing, dressing, meals, housework |
You and the agency |
Hourly rate, minimum hours, billing terms |
| Medicaid Home Help |
People on Medicaid who need help with daily tasks |
Personal care help at home |
MDHHS, after a home visit |
Do you handle Home Help and CHAMPS billing? |
| MI Choice Waiver |
People who need nursing-home-level care but want to stay home |
Broader home-based services |
MDHHS, based on care needs |
What services are included? |
| Skilled home health |
Anyone with a doctor's order for nursing or therapy |
Nursing, wound care, physical therapy |
Doctor's order, plus Medicare/Medicaid approval |
Are you Medicare-approved? |
Some people on Medicaid pay a small monthly amount before their coverage starts. This is called a spend-down. It depends on your family's income and savings, not on which agency you pick.
One rule catches many families off guard. Under Michigan's Home Help Program, a spouse cannot be a paid caregiver. Adult children, siblings, other relatives, and friends can be paid. A spouse who gives the care will not get paid through this program.
Licensing and Outside Checks in Michigan
Quick answer: Michigan does not require a state license for non-medical home care. But an agency that serves Medicaid Home Help clients must still be approved by MDHHS, and it must sign up for CHAMPS, before it can bill. Skilled home health agencies must follow federal Medicare rules, and Michigan's LARA office runs those checks. Since Michigan has no license rule, an outside review, such as ACHC or CHAP, is one of the few extra checks left for you to ask about.
Don't stop at "are you licensed?" In Michigan, that question won't sort good agencies from bad ones. No state license exists for non-medical care here. Ask these instead:
- Are you approved by MDHHS as a Home Help provider?
- Are you signed up for CHAMPS?
- Do you hold an outside review, such as ACHC or CHAP?
- Do you hire caregivers directly, or do they work as contractors?
- Are you bonded and insured?
A skilled home health agency should be able to show you its Medicare approval. LARA runs the checks behind that approval in Michigan.
What Good Looks Like, and What Should Worry You
| A good agency |
A warning sign |
| Answers CHAMPS and Medicaid questions clearly |
Gives vague or shifting answers about Medicaid |
| Explains backup care before you ask |
Has no real plan for a sick or absent caregiver |
| Shows proof of bonding and insurance |
Hesitates or won't show proof |
| Builds a written care plan with your family |
Skips a written plan, or won't put it in writing |
| Gives you references you can call |
Won't provide any references |
| Matches caregivers to your family's language and needs |
Assigns a caregiver with no real matching |
| Lets you ask for a different caregiver if it's not a fit |
Pressures you to keep a caregiver you don't like |
| Explains billing and fees up front |
Pushes you to sign before you've asked questions |
Common Mistakes and Red Flags
Quick answer: The most common mistakes are trusting the word "licensed" too much, skipping backup-care questions, assuming Medicaid pays a spouse, and signing before MDHHS finishes its review. Each one has a clear warning sign.
- Mistake: trusting "licensed" too much. Warning sign: an agency leans on that word but says nothing about CHAMPS, outside review, or bonding.
- Mistake: skipping the backup-care question. Warning sign: no clear answer about what happens when your caregiver is sick.
- Mistake: assuming a spouse can be paid. Warning sign: an agency hints a spouse will get paid through Home Help, without checking Michigan's actual rule.
- Mistake: comparing agencies on price alone. Warning sign: the lowest hourly rate, with no answer on caregiver turnover or training.
- Mistake: signing before MDHHS finishes its review. Warning sign: a promise of a set number of paid hours before the state has approved anything.
If you ever notice signs of neglect, missed medicine, or an unexplained injury, that goes beyond agency vetting. Call Michigan Adult Protective Services, or call 911 in an emergency.
Frequently Asked Questions
Is home care licensed in Michigan?
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No. Michigan does not require a state license for non-medical home care. Agencies that serve Medicaid Home Help clients must still be approved by MDHHS and signed up for CHAMPS. Skilled home health agencies need federal Medicare approval instead.
Does Medicaid cover home care in Michigan?
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Yes, through the Home Help Program and the MI Choice Waiver. Both need an MDHHS visit first. Medicaid may cover this at no cost to you, if you qualify, though some people pay a small monthly spend-down.
How much does home care cost per hour in Michigan?
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Private-pay non-medical care ran about $33 to $35 an hour statewide in the 2025 CareScout/Genworth Cost of Care Survey. Rates ranged from about $15 to $71 an hour by region.
Who qualifies for the Home Help Program?
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MDHHS decides after a home visit. In general, you must already be on Medicaid, need help with at least one daily task, and live in your own home rather than a facility.
Can a family member get paid to be a caregiver in Michigan?
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Often, yes. Adult children, siblings, other relatives, and friends can be paid caregivers under Home Help. Spouses cannot.
What's the difference between home care and home health care?
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Home care means non-medical help, like bathing, dressing, and meals. Home health care means medical care, like nursing and therapy, ordered by a doctor.
What should I ask before hiring an agency?
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Ask if they handle CHAMPS billing, how they screen caregivers, what happens if your caregiver is out sick, whether they're bonded and insured, and how billing works.
Is 24/7 or live-in care available in Michigan?
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Many agencies offer part-time, full-time, and live-in schedules. Cost and options depend on whether the care is private pay or Medicaid-funded. Medicaid hours are set by MDHHS, not by the agency.
You now know what really matters in Michigan. Not the word "licensed," but CHAMPS billing, MDHHS approval, background checks, backup care, and clear billing.
Cottage Home Care MI LLC serves families across all 83 Michigan counties from our Detroit office. If you'd like help figuring out whether Home Help or MI Choice fits your situation, call us or visit our Michigan care page.
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Sabine DurgaramDPS/RN
