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MI Health Link, Explained: What Dual-Eligible Seniors in Wayne and Macomb County Actually Get

If your parent has both Medicare and Medicaid, MI Health Link is one of the few Michigan programs that tries to put those two coverages under a single roof - and it is easy to confuse with the MI Choice waiver. Here is what MI Health Link is for dual eligible seniors in Detroit and Metro Detroit, which counties it actually covers, what an integrated care organization does day to day, and where the program stops short of paying for a parent's living arrangement.

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By Detroit Senior Advisor Care Team · August 7, 2026

What MI Health Link Is for Dual Eligible Seniors in Detroit, and Why It Exists

MI Health Link is Michigan's integrated Medicare-Medicaid demonstration program. It was created for people who are dual eligible - enrolled in Medicare and in Michigan Medicaid at the same time - because that population historically had to manage two completely separate systems, each with its own card, its own network, its own appeals process, and its own idea of who was responsible for what. A dual eligible senior in Detroit could have a Medicare plan paying for a hospital stay and Michigan Medicaid paying for long-term supports, with nobody in the middle making sure the two talked to each other after a discharge.

MI Health Link addresses that by routing both sets of benefits through a single health plan, called an integrated care organization (ICO), that is accountable for the whole picture: primary and specialty medical care, hospital coverage, prescription drugs, behavioral health, and the long-term services and supports side. For a Metro Detroit family, the practical appeal is having one plan, one care coordinator, and one phone number instead of assembling a care plan out of two disconnected programs during a Henry Ford or DMC discharge conversation.

Which Metro Detroit Counties Are Actually in the MI Health Link Region

This is the detail that trips families up most often, because MI Health Link has never been a statewide program. It is a demonstration operating in defined regions of Michigan, and Southeast Michigan is one of them - Wayne County and Macomb County are inside that Southeast Michigan footprint, which means a dual eligible parent in Detroit, Dearborn, Livonia, Grosse Pointe, Warren, Sterling Heights, or Clinton Township is in territory where MI Health Link enrollment is generally available.

Oakland County families should not assume the same. The demonstration's geography was drawn by county and does not automatically follow the way the rest of the senior care system in this metro is organized, so a family in Royal Oak, Troy, Birmingham, or Novi needs to confirm current eligibility for their specific county rather than assuming that anything true in Wayne County is true one municipality north. The cleanest way to verify is a free call to MMAP, the Michigan Medicare/Medicaid Assistance Program, whose counselors handle exactly this question, or to Michigan Medicaid enrollment services directly. Program regions and participating plans have both changed over the life of the demonstration, so verify the current roster before building a care plan around it.

What an Integrated Care Organization Actually Manages Day to Day

When a family enrolls, they choose an ICO - the health plans that have participated in the Southeast Michigan roster include Aetna Better Health of Michigan, AmeriHealth Michigan, HAP/Midwest, Meridian, and Molina Healthcare of Michigan, and the current list should be confirmed at the time of enrollment since participation has shifted over the years. The ICO then becomes the single entity responsible for both the Medicare and Medicaid side of the parent's coverage.

The piece that matters most for senior care planning is care coordination. Each enrollee is assigned a care coordinator who is supposed to build and maintain an individual care plan covering medical needs, medications, behavioral health, and long-term supports and services. Those supports can include personal care assistance, homemaking, respite for a family caregiver, home modifications, adult day programming, and other services intended to help someone stay at home rather than move into a nursing facility. In practice, the value a family gets depends heavily on how engaged that care coordinator is, which is why families should treat the first care-plan meeting as a working session - bring the medication list, the fall history, the hospital discharge paperwork, and a specific description of what a bad day at home looks like.

Where MI Health Link Stops: Room and Board in an AFC or Home for the Aged

Michigan does not license a category called assisted living. Communities in Metro Detroit that market themselves that way operate under one of two LARA license types: Homes for the Aged, licensed under the Public Health Code for 21 or more unrelated residents, or Adult Foster Care homes, licensed under the Adult Foster Care Facility Licensing Act in family, small group, large group, and congregate sizes. Both are licensed and inspected by the Bureau of Community and Health Systems within the Michigan Department of Licensing and Regulatory Affairs.

Neither MI Health Link nor the MI Choice waiver pays for room and board in those settings. This is the single most expensive misunderstanding a family can carry into a tour. Medicaid programs in Michigan can cover the services layer - the personal care, the supports coordination, the help with bathing, dressing, and medication reminders - but the rent-and-meals portion of a Home for the Aged or AFC bill remains the family's responsibility, typically covered by Social Security, a pension, VA benefits, long-term care insurance, or private assets. With Metro Detroit assisted living generally running roughly $3,800 to $5,600 a month in 2026 and dementia-focused care in an HFA or AFC setting running higher, the gap between what an ICO covers and what a community bills is real money, and it should be mapped out before a deposit is signed.

How Metro Detroit Families Decide Between MI Health Link, MI Choice, and PACE

These three programs overlap enough to confuse people and differ enough that the choice matters. MI Choice is Michigan's home and community-based services Medicaid waiver, administered regionally by agencies including the Detroit Area Agency on Aging for Detroit, Hamtramck, Highland Park, Harper Woods, and the five Grosse Pointes; The Senior Alliance for southern and western Wayne County; and Area Agency on Aging 1-B for Oakland, Macomb, Washtenaw, Livingston, Monroe, and St. Clair. MI Choice requires a nursing-facility level-of-care determination and operates against a capped number of regional slots, which is why families encounter an interest list. MI Health Link, by contrast, is a coverage and coordination structure for people who are already dual eligible, not a slot-limited waiver.

PACE - including PACE Southeast Michigan - is a third door: an all-inclusive program that wraps medical care, therapies, day center programming, and long-term supports into one organization for participants inside its specific service footprint. For most families the decision is not philosophical, it is practical. Confirm dual eligibility status first, confirm which county-level programs your parent's address qualifies for, then ask an MMAP counselor to compare what each option would actually deliver for your parent's specific needs. Do this before touring communities, because the answer changes which price points are realistic. And whichever route a family takes, verify any AFC or HFA community's license record through LARA's Bureau of Community and Health Systems licensing search before signing anything - the license file, including inspection and complaint history, is public and is the most reliable single document a family can read.

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Common questions

Is MI Health Link available to every dual eligible senior in Detroit and Metro Detroit?
MI Health Link is a regional demonstration rather than a statewide entitlement, so availability depends on county. Wayne County and Macomb County sit inside the Southeast Michigan region the demonstration serves, which covers Detroit, Dearborn, Livonia, the Grosse Pointes, Warren, Sterling Heights, and Clinton Township among others. Families in Oakland County and elsewhere in the metro should verify their county's current status directly rather than assuming it matches Wayne County, because the demonstration's geography was drawn separately from how other senior programs in this region are organized. A free MMAP counselor can confirm eligibility for a specific address in one phone call, and it is worth doing before building any plan around the program.
Does MI Health Link pay for assisted living or memory care in Michigan?
Not for the room and board portion, which is the part families are usually asking about. Michigan has no standalone assisted living or memory care license - communities operate as Homes for the Aged or Adult Foster Care homes under LARA, and dementia care is delivered inside those same license types with dementia-trained staff. Michigan Medicaid programs, including MI Health Link and the MI Choice waiver, can cover the services layer such as personal care and supports coordination, but the rent-and-meals charge remains private pay in nearly every case. Budget for that gap using Social Security, pension income, VA benefits, long-term care insurance, or assets before touring communities in Metro Detroit.
What is the difference between MI Health Link and the MI Choice waiver?
MI Choice is Michigan's home and community-based services Medicaid waiver. It requires an assessed nursing-facility level of care, is administered by regional agencies such as the Detroit Area Agency on Aging, The Senior Alliance, and Area Agency on Aging 1-B, and runs against a capped number of regional slots, which is why applicants often land on an interest list. MI Health Link is not slot-limited in that same way - it is an integrated coverage structure for people who already have both Medicare and Medicaid, delivered through a single health plan with one care coordinator. Some families pursue both, and MMAP counselors can walk through how they interact for a specific situation.
How does a Metro Detroit family enroll, and who can help for free?
Enrollment runs through Michigan Medicaid enrollment services, where an eligible dual enrollee selects an integrated care organization from the plans currently participating in the Southeast Michigan region. Before choosing, ask each plan which Metro Detroit hospital systems and physician groups are in network - continuity with an existing Henry Ford, DMC, Ascension St. John, or Corewell Health provider is often the deciding factor. Free help is available from MMAP, the Michigan Medicare/Medicaid Assistance Program, which provides unbiased benefits counseling, and from the regional Area Agency on Aging serving your parent's address. Michigan 2-1-1 is another no-cost starting point for families who are not sure which agency covers their community.

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