Q. Is there really any way that someone can “age in place?” You see that promoted in some ads, but is it even possible to stay out of a nursing home unless you are a billionaire?
A. While most of us may never be in such a fortunate position as to have millions of dollars available to pay for all our care needs, there are housing and care options and community resources available when older or disabled adults need more assistance due to physical, cognitive, and medical conditions.
One option available through Region IV Area Agency on Aging is the MI Choice Medicaid Waiver program, a comprehensive, community-based program that can aid persons who need nursing-home level care but want to remain in their home, or a community-based living setting, such as assisted living or adult foster care. This Medicaid program, with expanded income eligibility higher than traditional Medicaid, can provide help in the home, meals, transportation, durable medical equipment, adult day care and respite care in the home, and assistance with personal care, chores and errands. Additionally, MI Choice Waiver clients have a care manager through our Agency who follows the client and helps implement and revise the care plan as needed.
To qualify for in-home services paid for through the MI Choice Waiver program an individual must be age 18 or older. Those under age 65 need to be deemed disabled by the Social Security Administration (SSA.) Individuals age 65+ do not need to be deemed disabled by SSA. An individual’s gross monthly income must be less than $2,901 a month (2025 limit) whether or not that individual is married. Only the income of the person to receive MI Choice Waiver services is counted. Household income is not considered. Allowable assets for a single individual are limited to $2000, excluding their home and one vehicle. Assets can include other properties, vehicles, savings, investments, annuities, 401k funds, and life insurance policies with a cash value. Married couples are often able to have more assets as they are covered by the Federal Spousal Impoverishment Guidelines.
There is also a level of care criteria for the program, which is determined through an initial phone screening. This is the first step in a multi-phase process which can take several weeks before services can be approved and in place. Region IV Area Agency on Aging staff help with the application process including assistance submitting the Medicaid application. Anyone interested in learning more about MI Choice Waiver can contact our Info Line for Aging and Disability at 800-654-2810.
For individuals remaining in their home, most services are provided by home care agency staff. Some services may allow family or friends to be the individual’s paid caregiver. This is referred to as self-determination, where the client becomes the employer of record and hires, supervises, trains, and oversees a worker of their choosing. All applicants are provided information on service delivery options during the home assessment.
For individuals living in a community-based setting, such as an assisted living facility, adult foster-care home, or home-for-the-aged, the MI Choice Waiver can provide some financial assistance in paying for care, but it does not cover the room and board for these settings. The basic room and board costs in community-based settings are always the responsibility of the individual or their family. Any “above and beyond” care costs to cover additional staff and/or staff time could be covered through the MI Choice Waiver program. Additionally, the community setting must accept the MI Choice Waiver and have a provider contract with our Agency.
For more information on getting assistance through the MI Choice Waiver program in a community setting, please contact the Info Line at 800-654-2810.
Sara Duris is community information liaison of Region IV Area Agency on Aging in Southwest Michigan. Questions on age or independence services? Call the Info-Line for Aging & Disability at 800-654-2810 or visit areaagency onaging.org. The Generations column appears each weekend in The Herald-Palladium.