Medicaid long-term care in Michigan: 2026 limits, forms, and how to apply

Assistance Application(MDHHS-1171)

Michigan's standard assistance application — the same application MI Bridges files online.

The general application; per the forms' own titles, nursing-facility patients use DHS-4574 instead.

Application for Health Care Coverage — Patient of Nursing Facility(DHS-4574)

The Medicaid application used for patients of nursing facilities.

For applicants in (or entering) a nursing facility.

Assets Declaration — Patient and Spouse (initial asset assessment for married applicants)(DHS-4574-B)

Declares the couple's combined assets for the initial asset assessment — the assessment that sets the community spouse's protected share.

For married applicants when a spouse remains in the community.

Medicaid deductible (spend-down) for income over the limit

If your monthly income is above Michigan's limit, the application is not simply denied. Under the 'Medicaid deductible' program (Group 2, medically needy), coverage in a given month begins once that month's medical expenses use up the income above your county's protected income level, which ranges from $341 to $408 per month for one person depending on county. For nursing-home residents, monthly care costs almost always exceed income, so the deductible is usually met. Michigan does not require a Miller Trust.

Divestment penalty: 60-month look-back on gifts and below-value transfers

When you apply for nursing home or waiver Medicaid, MDHHS reviews all asset transfers in the 60 months before your 'baseline date.' Giving away money or property for less than fair market value ('divestment') triggers a penalty period during which Medicaid will not pay for your long-term care. The penalty length equals the amount given away divided by the average monthly private nursing home cost, $12,216.30 for 2026 (BEM 405). There is no maximum penalty period, and even small transfers count.

Protections for the spouse at home (CSRA and MMMNA)

If you are married and enter a nursing home, your at-home spouse may keep a protected share of the couple's assets: half of the countable assets as of the 'snapshot' date, between $32,532 and $162,660 in 2026. Your spouse can also keep part of your income if their own income is below the maintenance allowance, between $2,705 (floor effective July 1, 2026, per BEM 546) and $4,066.50 per month. The home is exempt while the spouse lives in it.

Patient-pay amount: most income goes to the nursing home

Once approved, a nursing-home resident does not keep their income. After deductions for a $60 monthly personal needs allowance ($90 for veterans), health insurance premiums, and any spousal or family allowances, the rest of your monthly income is paid to the facility as your 'patient-pay amount.' Medicaid pays the balance of the nursing home bill.

Home equity cap for long-term care

Your home is normally an exempt asset, but Medicaid will not pay for nursing home or in-home long-term care if your equity in the home exceeds $752,000 (effective January 1, 2026). This cap does not apply if your spouse, a child under 21, or your blind or disabled child lives in the home.