Page Reviewed / Updated - November 05, 2020
This webpage will help Michigan residents understand assisted living, home care, and adult day care costs throughout the state. It also explores various payment options and financial assistance programs that are available to assist in caring for the elderly, be that in residential care or for aging in place at home.
The programs discussed on this page are comprehensive of what is available from the state of Michigan. But it is not comprehensive of what is available at a national level. It’s important to be aware of all your options in order to choose the program most suitable for your circumstances. To easily search for assistance nationwide, please use our Resource Locator Tool, which is free to use.
Cost of Care Calculator
Assisted living communities typically charge a monthly rate; the average rate statewide in Michigan as of 2020, according to Genworth’s Cost of Care Survey 2019, is $4,000. This is slightly below the national average of $4,051 / month. And there are some areas within Michigan where assisted living is considerably less expensive. These areas include Jackson ($3,000 / mo.), Muskegon ($3,350 / mo.), Bay City ($3,500 / mo.), Battle Creek ($3,500), and Kalamazoo ($3,600 / mo.). It can also be helpful to know the areas of the state that have the most expensive assisted living. These include: Detroit ($4,625 / mo.), Ann Arbor ($5,049 / mo.), and Monroe ($5,300 / mo.). The Grand Rapids area is also a bit more costly than the statewide average at $4,240 / mo., as is Flint at $4,375 / mo. But both are still below the monthly cost of these more expensive areas.
Caring for persons with Alzheimer's disease is more expensive than standard assisted living due to the increased supervision and security required. On average, it costs between 20% and 30% more. Consequently, the cost for dementia related care in assisted living is approximately $750 / mo. - $1,325 / mo. over the normal rates.
Per Genworth’s 2019 Cost of Care Survey, the average hourly cost of home care in Michigan this year (2020) is $23.00, and is slightly over the national average of $22.50. As with the dramatic cost swings associated with assisted living, home care costs also vary considerably throughout the state. The most affordable home care in Michigan can be found in Ann Arbor and Battle Creek, where it costs between $18.50 and $21.75 / hour. Midland, Jackson, Saginaw, and Bay City also have an average cost below the statewide average at $22.00 / hour - $22.50 / hour. The costliest areas of the state are Monroe, Detroit, Muskegon, and Grand Rapids, where the hourly cost is between $24.50 and $26.00.
Home health care is also available for those who need a slightly higher level of care that is medical in nature. Statewide, the average hourly cost is $23.50. However, depending on where you live in Michigan, the hourly rate may range from $18.50 to $27.00.
Families using home care may want to consider adult day care several days per week. It is considerably more affordable, according to Genworth’s Cost of Care Survey 2019, even though the Michigan average ($78 / day) in 2020 is higher than the national average ($75 / day). This is especially true for persons living in Monroe, where the cost can be as low as $68 / day. The most expensive areas of the state are Lansing, Jackson, and Ann Arbor, where daily cost may be between $99 and $128. Kalamazoo, Battle Creek, and Saginaw also have fairly expensive rates with an average cost between $88 and $95 / day.
Medicaid is a health insurance program, though the benefits it offers go well beyond those of typical health insurance. (The state of Michigan and the federal government jointly manage this program.) Michigan has several different Medicaid programs. But for the purposes of this article, we are focused on Long Term Care Medicaid and the associated waivers, as these are most relevant to the elderly.
Originally intended to cover low-income seniors who required nursing home care, or limited personal care, Long Term Care Medicaid has now expanded to offer other programs that provide assistance outside of the nursing home environment.
Home Help, MI Choice, and Health Link
While not a Medicaid waiver, the Michigan Home Help Program, which is part of Michigan’s state Medicaid plan, provides personal care assistance in one’s home. The goal is to prevent or delay nursing home placement of elderly Michigan residents by providing assistance with bathing, dressing, eating, housecleaning, laundry, and shopping for essentials. This program allows for self-direction of services, including the hiring of certain family members.
The state of Michigan currently offers one Medicaid waiver (or program) that is relevant to seniors. (Medicaid waivers are commonly known as Home and Community Based Services Waivers and abbreviated as HCBS). Unlike the state Medicaid program, the waiver is not an entitlement program. This means that there are a limited number of people who can receive services under this program. Therefore, if all of the enrollment slots are filled, there may be a waiting list.
The MI Choice Waiver is intended to allow individuals who are aged or disabled who might otherwise require nursing home care to live at home, a home for the aged, or an adult foster care home. In order to do so, it offers a broad range of services, both medical and non-medical, including home / vehicle modifications, personal emergency response systems, meal delivery, and personal care assistance. There is an option to self-direct one’s own care services, and allows some family members, including adult children, to be hired as caregivers. More information is available here.
Another program that may be of interest to elderly Michigan residents is the Health Link Program. This program, which is a managed care program, is for dually eligible Medicaid and Medicare recipients. All services that are provided via Medicaid and Medicare are available via this program. It includes adult day care, prescription drugs, durable medical equipment, and nursing home services, to name just a few of the benefits. Assistance can be provided in one’s home, adult foster care, or an assisted living facility, which is more commonly called Homes for the Aged in Michigan. Unfortunately, at the time of this writing, this program is not available statewide.
Michigan Medicaid Eligibility
As a general rule of thumb, the income limit for long-term care Medicaid (HCBS waivers and nursing home Medicaid) is 300% of the Federal Benefit Rate (FBR). As of 2020, this equals $2,349 / month for a single applicant. Please note that the income limit for state Medicaid is lower, and as of 2020, is 100% of the Federal Poverty Level (FPL), which equals $1,063 / month. That said, being over the income limit is not automatic cause for Medicaid ineligibility, as Michigan has a medically needy pathway. Simply put, applicants who have high recurring medical and care expenses in relation to their income are able to spend their excess income on these costs. Once they have “spent down” their income to the income limit, they will be income eligible for the remainder of the medically needy period.
A second "test" is made, which considers the applicant's financial resources. Seniors are permitted up to $2,000 in resources, as well as a home (limited to an equity interest value of $595,000 in 2020), household items, a single vehicle, and personal effects. Should an applicant’s resources exceed the allowable limit, they will be asked to spend-down their resources on their care costs until they meet the limit. That said, it is vital that one does not give away cash and valuables in order to meet the asset limit. Doing so may violate Medicaid’s 5-year look-back period and can result in a period of Medicaid ineligibility.
Married applicants (nursing home care or Medicaid waiver) with non-applicant spouses, also called community spouses, are able to transfer a portion of their income (up to $3,216 / month in 2020) to their non-applicant spouses. This is called the monthly maintenance needs allowance and is permitted if non-applicant spouses do not have sufficient income in which to live. There is also a community spouse resource allowance that enables non-applicant spouses to keep up to $128,640 (in 2020) in joint assets.
Persons unsure about their eligibility or have income and / or assets over the eligibility limit, should consult with a Medicaid planning professional before they submit their Medicaid application and associated paperwork.
Unfortunately, the state of Michigan offers little non-Medicaid based financial assistance to help the elderly with paying for home care or assisted living. However, Michigan does offer some programs that can help reduce the overall cost of living for seniors who need care. These programs can help free up other financial resources that can then be allocated towards the cost of care. Most notably among these programs are the MiCAFE Program, also referred to as Michigan’s Coordinated Access to Food for the Elderly. They help seniors get access to food and LIHEAP (assistance with energy costs), as well as provide assistance with applying for Medicare and Medicaid.
In addition to the state specific options that help pay for care, there are many non-profit and federal options. Use our Resource Locator Tool to find other programs that help pay for or reduce the cost of care. There are also programs that help veterans with assisted living and there are eldercare loans available in Michigan. It’s important to find the most appropriate assistance to match your needs.
To effectively find the most affordable care for your loved one, it is helpful to understand exactly what care assistance is required. As untrained caregivers, family members cannot always accurately assess need requirements. Our organization has partnered with professionals who provide free assessments and help to match families with the most affordable, high-quality elder care throughout Michigan. These services are provided at no charge to the individual or their family. Get started now.
For more information about the top rated facilities in Michigan, click on one of the city pages below.