MI Choice Medicaid Waiver Referral Form
The MI Choice Medicaid Waiver Program is a home-and community-based program that provides in-home services to eligible older adults aging and adults living with disabilities with in-home services. Long-term support and services are designed to allow recipients to stay in a home or residential setting (including an individual’s or family member’s home, assisted living communities, licensed homes for the aged or licensed adult foster care homes).
Use the HIPAA-compliant form below to make a MI Choice Medicaid Waiver Referral only. Information submitted via this form is secure (encrypted when traveling between systems or at rest).
For all other program referrals, please call (800) 815-1112.