Memory Care in Michigan

Table of Contents

Memory Care in Michigan

Table of Contents

• The Cost of Memory Care in Michigan
• Michigan Medicaid Programs for Memory Care
• Can You Use Medicare To Pay for Memory Care in Michigan?
• More Ways To Pay for Memory Care in Michigan
• Memory Care Laws and Regulations in Michigan
• Free and Low-Cost Resources for Seniors in Michigan
• Michigan COVID-19 Rules for Memory Care Facilities

Because of the specialized staff training and resources required to provide high-quality memory care, memory care typically costs more than other types of residential care. On average, memory care will cost 20-30% more than assisted living.

To provide an idea of memory care costs in Michigan, we've added 25% to assisted living costs reported in the 2021 Genworth Cost of Care Survey.

Michigan's memory care costs are the lowest in its immediate region. At $5,313 per month, the average cost in the state is over $300 less than the national average. Indiana is just slightly more expensive at $5,354 monthly, while in Illinois, seniors pay $5,610 per month. Ohio and Wisconsin carry the highest average costs in the area at $5,794 and $5,750 per month, respectively.

The cost of memory care in Michigan varies depending on where a senior lives in the state. Seniors in Battle Creek pay $4,250 per month, while in Detroit and Lansing, the cost is closer to the state average at $5,269 and $5,391. In Grand Rapids and Monroe, costs are above both state and national averages at $6,035 and $6,313 per month.

The Michigan Department of Health and Human Services oversees the state's Medicaid program, which provides free health insurance to low-income seniors and other individuals in need. While regular Medicaid doesn't provide coverage for memory care services, there is a waiver program that amends what's covered to include extra services to save on costs. 

• Who Is Eligible: Seniors aged 65 and older who meet the state's Medicaid income limits.
• How To Apply: Applications can be submitted by visiting a DHS county office or calling (800) 803-7174.

MI Choice Waiver Program

The MI Choice waiver helps seniors who aren't residing in a nursing facility to access services that are provided by memory care and assisted living facilities, including personal care and emergency call systems. This waiver doesn't cover the cost of room and board for seniors, though, so those in residential memory care need to use their own funds to cover those expenses. 

• Who Is Eligible: To qualify for the MI Choice waiver, seniors must be at least 65 years of age and meet the medical or functional criteria for nursing care. Additionally, seniors must be financially eligible for Medicaid.
• How To Apply: Seniors can contact their nearest community agency to start the application process.

Medicaid Eligibility for Seniors in Michigan

Seniors who wish to apply for Medicaid in Michigan are subject to maximum income and asset limits. Any person, whether applying alone or with a spouse, is limited to earning no more than $2,523 per month, or $30,276 annually. Assets are limited to $2,000 for the applicant, or $3,000 when both spouses in a two-person household apply together. Those who are married but applying for coverage alone are subject to the $2,000 asset limit, while their spouse can retain as much as $137,400 in countable assets.

2022 Medicaid Income Limits for Seniors in Michigan

In addition to the income limits in place for Michigan's Medicaid program, seniors also must:

• Be a full-time Michigan resident
• Be a U.S. citizen or permanent resident
• Have a valid Social Security number or be willing to apply for one

How To Get Help Applying for Medicaid in Michigan

There are programs available in Michigan to provide assistance with applying for Medicaid. 

Unfortunately, Medicare does not generally cover the cost of Memory Care. Most Memory Care Facilities are considered to be "social settings," so Medicare does not cover the cost incurred in these facilities. The only exception to that is if you are receiving memory care services in a Nursing Home. While this situation is much less common, Medicare would sometimes cover the cost, depending on a number of circumstances.

That being said, Medicare does still cover qualified doctor visits, medications, etc., as it would if you were still at home, but it will not cover the cost of care received at the Memory Care Facility.

In addition to the state programs mentioned above, those looking for resources to finance memory care may consider:

• Long-Term Care Insurance: Depending on the policy details, long-term care insurance may be used to pay for memory care services. It's best to sign up for a policy early, as coverage will likely be denied if one already has long-term care needs. More information about the intricacies of long-term care insurance can be found at longtermcare.acl.gov.
• Reverse Mortgages: Reverse mortgages allow some homeowners to take out a loan as an advance from the eventual sale of their primary residence. This can be a good way to fund memory care in the short-term, but the loans will need to be paid back after the sale of the home. The most commonly used type of reverse mortgages for seniors is the Home Equity Conversion Mortgage, which is the only reverse mortgage insured by the federal government.
• Veterans Benefits: The Department of Veterans Affairs offers several programs that veterans and their spouses may use to cover health care needs such as memory care. More information about these programs can be found on the VA website.

Memory Care Regulation

In Michigan, assisted living facilities are licensed as homes for the aged (HFA) or adult foster care (AFC) homes. Any adult may receive AFC services, whereas HFAs are licensed for those aged 55 and older. Most adult foster care facilities have 20 or fewer residents, and most homes for the aged have 21 or more.

Individuals with Alzheimer’s and other dementias may receive memory care in either an AFC or HFA, and both types of facilities must provide a certain set of services and accommodations as described in the licensing rules and statutes for each category of facility.

Facility Scope of Care

Residents in Michigan’s homes for the aged and adult foster care homes may receive intermediate or temporary nursing care, but these facilities aren’t licensed for full-time nursing. Facilities offering memory care must provide a written description of their overall philosophy, assessments, care plans, staff training and other issues related to Alzheimer’s.

HFA and AFC facilities are required to provide:

• Housing and meals, supervised personal care and protection
• Staffing that’s appropriate and qualified to handle the facility’s needs
• Activities that are appropriate for people with various physical, social and behavioral needs

Admissions Requirements

Homes for the aged and adult foster care facilities in Michigan have different purposes and treatment options, and the policy for admission is based largely on those factors. See below for a general outline, and request the admission policy in writing from individual facilities.

Residents Who May Be Admitted

Adults of any age diagnosed with Alzheimer’s or another dementia disorder and elderly persons aged 55 or older with:

Residents Who May Be Admitted Older adults and people with:

• Alzheimer’s or other dementias
• Physical disabilities
• Mental health needs
• Behavioral issues that can be managed

Residents Who May NOT Be Admitted Those who:

• Require continuous nursing care
• Are determined as a risk to self, other people and/or property
• Have behavioral issues that are unmanageable by the facility

Care Plan Requirements

Licensed facilities in Michigan are required to conduct assessments on potential residents before they’re admitted, which are then used to form a personalized care plan. This plan must incorporate the physical and cognitive needs of the individual, and it must clearly describe the amount of care and services needed, as well as the itemized costs.

Residents and their family members or designated representatives can be involved in the formulation of the plan, which must be updated at least annually, and the facility is required to maintain and produce copies upon request.

Medication Management Requirements

Medication, dietary supplements and special medical procedures must be prescribed by a physician or dentist, and kept in the original container in a secure location. Residents are generally permitted to administer their own medication, often with supervision from staff, unless otherwise stated by a health care professional. According to Michigan’s medication management requirements, the supervisory staff member is responsible for making sure the resident takes the correct medication at the dosage and timing indicated by a licensed physician or dentist.

Facility Requirements

All facilities must have a maximum of four beds per room, one sink and toilet for every eight residents on each floor and one bath or shower for every 15 residents. There are no regulations requiring an HFA or AFC to provide an environment specifically for people with dementia. However, as noted in the facility scope of care section, any facility that offers memory care services is required to fulfill the particular needs of residents with Alzheimer’s and other dementias. As a result, it’s advisable to ask whether a facility does provide memory care.

Staffing Requirements

Michigan’s regulations require that all homes for the aged and adult foster care facilities have an administrator who is responsible for facility operations. Facilities must also have one staff member on duty for each shift to serve as the resident care supervisor, who’s responsible for maintaining the respectful and kind treatment of residents, as well as their safety during an emergency situation.

There is no minimum ratio of staff to residents, although facilities are required to have an adequate number of sufficiently trained staff on duty and awake at all times.

Medicaid Policy

Michigan Medicaid doesn’t directly cover the costs of homes for the aged or adult foster care facilities. However, the Michigan Medicaid State Plan does cover the cost of personal care services received by enrolled members, such as assistance with bathing or mobility issues. Preventive services aimed at delaying placement in a home are also available through the Medicaid MI Choice waiver, but room and board costs aren’t covered.

Reporting Abuse

Complaints related to Michigan’s homes for the aged and adult foster care facilities are processed by the Bureau of Community and Health Systems. Individuals can submit a report using the online complaint form, print and mail a paper form to the Complaint Intake Unit or call (866) 856-0126. Reports must allege that a facility is in violation of state regulations, which are available to view online. In the case of alleged serious criminal activity, rather than a breach of regulations, contact the police and file a report.

Seniors in Michigan who are living with Alzheimer's disease or other forms of dementia can access a variety of resources, including support groups.

Note: The following information was compiled and most recently updated on 2/8/2022. Since COVID-19 is a rapidly evolving crisis, be sure to contact your Memory Care Facility or local Area Agency on Aging for the most up-to-date information.