No — under Michigan's Home Help Program specifically, spouses generally cannot be paid to care for their husband or wife. This trips up a lot of families who assume all Medicaid caregiver programs work the same way.
Why the rule exists
Home Help's self-direction option was designed around the idea of compensating a caregiver outside the immediate household unit — spouses are treated as part of a shared household and finances, which is why the exclusion exists at the federal and state program-design level.
The real alternative: MI Choice
Michigan's MI Choice Waiver is a different Medicaid long-term-care program, and its self-direction option does allow spouses to be paid caregivers. The trade-off: MI Choice is a capped 1915(c) waiver program, which means it can carry a regional waitlist, unlike Home Help's uncapped entitlement structure.
What this means practically
If a spouse is the one primarily providing care, it's worth having a conversation with your local MDHHS office specifically about MI Choice eligibility, rather than assuming Home Help is the only option on the table. See our full Home Help vs. MI Choice comparison for the complete picture.