THERAPY DRIVEN. NURSE LED. INDEPENDENT.
Michigan No-Fault
& Home Care FAQs
Questions about care after a Motor Vehicle Crash? Start here for Michigan Auto No-Fault, insurance reforms, home rehabilitation and support for families.
Michigan Auto No-Fault, explained
Know what changed.
Know what to ask.
Care needs, insurance eligibility and payment rules are connected. They are also different questions. This guide helps you prepare for conversations with your care team, insurer, case manager or attorney.
- 2019Reform legislation signed. June 11 becomes an important dividing date for older-injury payment rules.
- July 2, 2020New PIP medical choices begin, including limited amounts and eligible exclusions or opt-outs.
- 2021Provider fee rules and the applicable family attendant care restriction begin affecting payments.
- 2023–2026Andary, Fremont and later decisions clarify older-injury and other claim questions.
Search questions and answers on this page. Please leave out personal or medical information.
No matching questions. Try fewer words or another topic.
Michigan Auto No-Fault · 5 questions
Understand the benefits. Understand the reforms.
Start with the difference between the care you need, the coverage you selected and the rules that apply to your claim.
What is Michigan Auto No-Fault insurance?
It is an auto insurance system that includes Personal Injury Protection (PIP) benefits for eligible crash-related injuries. PIP medical can help pay for reasonable, necessary care up to the applicable coverage limit. The policy also includes other protections; eligibility and exclusions still matter.
Sources: DIFS: Brief Explanation of Michigan No-Fault Insurance
Do I have to prove another driver was at fault before seeking PIP benefits?
Generally, eligible people can seek PIP benefits without proving another driver caused the crash. Not every claim is covered. Report the injury to the appropriate insurer and confirm which policy is responsible before assuming payment.
Sources: DIFS: Brief Explanation of Michigan No-Fault Insurance
What did the 2019 Michigan No-Fault reforms change?
The reforms introduced PIP medical coverage choices, provider reimbursement limits and changes to certain attendant care payments. They also changed insurance rating and consumer protections. These changes have different effective dates, and later court decisions affect how some provisions apply.
Why do people mention both 2019 and 2020?
The reform legislation was signed in 2019. The new PIP coverage choices became available July 2, 2020. The timing of your crash and the policy in effect matter; do not use the date of a policy renewal as a shortcut for deciding an older claim.
Can PIP medical benefits include rehabilitation and care at home?
They may include eligible medical care, rehabilitation and attendant care. A service must meet the applicable coverage and reasonable-necessity requirements. A home care referral starts a review of the needs and arrangements; it does not establish insurance approval.
Sources: DIFS: PIP Medical Coverage Selection Form (2025 edition)
PIP coverage choices · 10 questions
What does your policy actually cover?
Your declarations page and signed PIP selection form matter. A premium saving can also change how much protection is available after a serious injury.
What are the six PIP medical coverage options?
- Unlimited.
- $500,000 per person, per crash.
- $250,000 per person, per crash.
- $250,000 with eligible people excluded from PIP medical.
- $50,000 for eligible Medicaid households.
- No PIP medical for eligible Medicare households.
The last three require specific eligibility and documentation. Review the state selection form with your insurance agent.
Sources: DIFS: PIP Medical Coverage Selection Form (2025 edition)
Does unlimited PIP mean every service or bill must be paid?
No. Unlimited PIP medical has no aggregate dollar ceiling for covered allowable expenses. Services and charges must still satisfy the policy and applicable law, including reasonable necessity. Not every bill must be paid.
Sources: DIFS: PIP Medical Coverage Selection Form (2025 edition)
What does the $250,000 option with exclusions mean?
An eligible excluded person has no PIP medical under that policy. A named insured excluding themselves needs non-Medicare QHC; an excluded spouse or resident relative needs QHC. Proof is required. A person not excluded retains the $250,000 limit.
Sources: DIFS: PIP Medical Coverage Selection Form (2025 edition)
Is PIP medical the same as bodily injury liability coverage?
No. PIP medical addresses eligible injury expenses under the No-Fault policy. Bodily injury liability concerns legal responsibility for harm to someone else. Discuss both coverage selections with your agent; one limit does not replace the other.
What is Qualified Health Coverage (QHC)?
QHC means Medicare Parts A and B, or qualifying health coverage that does not exclude or limit motor vehicle injury coverage and meets the current individual deductible ceiling. For July 1, 2026–June 30, 2027, that ceiling is $6,579. Ask your health insurer for written confirmation.
Sources: DIFS Bulletin 2026-08-INS: Qualified Health Coverage
Who can choose the $50,000 PIP option?
The applicant or named insured must be enrolled in Medicaid. A spouse and all resident relatives must have QHC, Medicaid or another Michigan auto policy with PIP medical. Eligibility and proof requirements must be checked with the insurer.
Sources: DIFS: Brief Explanation of Michigan No-Fault Insurance
Does having Medicare automatically remove my PIP medical coverage?
No. Medicare does not require you to opt out. An eligible named insured with Medicare Parts A and B may choose the opt-out if the household also meets the requirements. Medicare and PIP do not provide identical benefits; discuss the tradeoffs before selecting coverage.
Sources: DIFS: Consumer Auto Insurance FAQs
What if I lose QHC after excluding or opting out of PIP medical?
Act promptly. Notify your auto insurer and obtain replacement QHC or PIP medical within 30 days of the loss. Coverage during that period has specific conditions. Do not wait until a crash to resolve the gap; ask the insurer to confirm the change in writing.
Sources: DIFS: Consumer Auto Insurance FAQs
What happens when a limited PIP medical amount is used up?
Other health coverage may become important, but it may not cover the same services. You could owe costs that remain unpaid. Before benefits run low, discuss the remaining amount, other coverage and a care plan with the insurer, providers and your claim adviser.
Sources: DIFS: Brief Explanation of Michigan No-Fault Insurance
Family care & benefits · 5 questions
The 56-hour rule needs a careful explanation.
The limit on certain family-provided care is different from a clinical assessment of the hours of care someone needs.
What is attendant care, and how is it different from housekeeping?
Attendant care addresses a person’s injury-related needs, such as help with bathing, dressing or supervision when appropriate. Ordinary household tasks can fall under a different benefit called replacement services. Record the actual task and who benefited from it; the label alone does not decide coverage.
Sources: Michigan Legislature: MCL 500.3107
Does Michigan limit all attendant care to 56 hours per week?
No. When applicable, the restriction concerns the insurer’s obligation to pay for care provided at home by relatives, household members or people with a pre-injury business or social relationship. It does not cap all agency care or determine the person’s clinical care needs.
What if a person needs more than 56 hours of attendant care?
Where the restriction applies, additional necessary care may be arranged through an outside provider, or the insurer may agree to pay the related caregiver for additional hours. Any arrangement remains subject to coverage and care requirements. Obtain written confirmation rather than assuming the extra hours are approved.
Does hiring a family caregiver through an agency avoid the restriction?
Not automatically. The provision can apply when care is furnished directly or indirectly by someone in a covered relationship. The agency arrangement alone does not settle the question. Confirm the caregiver relationship, crash date and insurer agreement before relying on payment.
Can I buy additional attendant care coverage above a limited PIP amount?
Michigan insurers must offer excess attendant care coverage with the eligible limited PIP selections described in the state form. This is an optional policy purchase. It is different from an insurer’s agreement to pay family care beyond 56 hours. Ask your agent what your existing policy includes.
Fees, claims & court decisions · 10 questions
Older injuries and newer rulings matter.
Crash dates, service dates, payment rules and the type of claim can lead to different answers. Keep your documentation and get advice about your own claim.
What did the Andary decision mean for people injured before June 11, 2019?
In 2023, the Michigan Supreme Court held that the non-Medicare reimbursement provision and family attendant care restriction in MCL 500.3157(7) and (10) do not apply to treatment costs for people injured before June 11, 2019. Reasonable charges and necessary care still matter.
Sources: DIFS Bulletin 2025-11-INS: Payment and Billing Guidance
Did a later decision change the fee schedule guidance for older injuries?
Yes. In April 2025, Fremont v. Lighthouse extended the reasoning to the amended fee schedule as a whole for pre-June 11, 2019 injuries under pre-reform policies. DIFS updated its guidance. Summaries saying only two subsections are excluded can therefore be incomplete.
Sources: Michigan Court of Appeals: Fremont v. Lighthouse (April 11, 2025)
Does receiving care today make an old injury subject to every new payment rule?
No. A recent service date does not, by itself, erase the protection described in Andary and Fremont. The accident, policy and service must be reviewed together. Pre-reform claims still require reasonable charges for reasonably necessary care; exemption from a fee schedule is not unlimited billing.
Sources: Michigan Court of Appeals: Fremont v. Lighthouse (April 11, 2025)
How are provider fees different from my PIP coverage limit?
A PIP limit controls the available medical benefit pool. A provider fee rule addresses reimbursement for a service. Where the amended fee schedule applies, the service, provider category and service year affect the calculation. One universal percentage does not accurately describe every service.
Has there been newer guidance about home health aide and skilled nursing fees?
Yes. DIFS Bulletin 2026-15-INS addresses the Medicare-based reimbursement rule for home health aide and skilled nursing care after a 2025 court decision. Calculations require case-specific information. Apply it together with the older-injury guidance; it does not mean M & M participates in Medicare.
Sources: DIFS Bulletin 2026-15-INS: Home Health Aide and Skilled Nursing Fees
When are unpaid PIP benefits considered overdue?
DIFS explains that payment is generally overdue 30 days after the insurer receives reasonable proof of the loss and amount. Medical bills submitted more than 90 days after service can have a longer payment period. Overdue benefits bear 12% simple annual interest. Ask an adviser how the rule applies.
Sources: DIFS Bulletin 2025-11-INS: Payment and Billing Guidance
Is there one deadline that applies to every No-Fault claim?
No. Notice, suit, recovery and tolling rules require individual review. The 2019 tolling change also has limits on its retroactive application. Submit documentation promptly and obtain legal advice about the actual dates; do not assume that an ongoing discussion with an adjuster preserves every right.
Sources: DIFS Bulletin 2025-11-INS: Payment and Billing Guidance
What should I do if an insurer denies or reduces payment for care?
Request the written reason and identify whether the issue is coverage, medical appropriateness, documentation or the charge. Discuss it with the provider and claim adviser. Some provider disputes can use DIFS utilization review; other coverage or legal disputes require a different route.
What is utilization review, and who can appeal through DIFS?
Utilization review examines the appropriateness of care and related payment issues under the applicable rules. DIFS has a provider appeal process. It is not a single appeal route for every patient coverage denial. The provider should identify the determination, required materials and applicable deadline.
Is a claim against an at-fault driver the same as a PIP claim?
No. A liability lawsuit is a different claim. In Canty v. Mason (July 2026), the Supreme Court held that MCL 500.3157 reimbursement limits did not apply to the tort claim at issue, while reasonable expenses and mitigation still mattered. Ask an attorney about your circumstances; recovery is not guaranteed.
Sources: Michigan Supreme Court: Canty v. Mason (July 27, 2026)
Getting started · 7 questions
From a question to a referral.
Practical answers for patients, families, physicians, case managers and attorneys considering M & M Home Care.
Who does M & M Home Care help?
Our focus is care and rehabilitation after Motor Vehicle Crashes (MVCs). Tell us about the person’s needs, location and care team so we can review the referral and discuss appropriate services. Availability and payment arrangements are confirmed individually.
What services does M & M Home Care offer?
Our service lines are Occupational Therapy, Physical Therapy, Massage Therapy, Speech Therapy, Counseling, Home Modification Evaluations, Wheelchair Seating Evaluations, Nursing and Attendant Care. The combination depends on the assessment and care plan.
Who can start a referral?
Patients and families can contact us, as can physicians, case managers and attorneys. A conversation helps identify the requested services and next steps. Clinical orders, documentation or claim information may be needed before care begins.
What should I have ready when I call?
Start with the person’s location, the services requested, the crash date and the best contact person. If available, have the insurer, claim number, adjuster and referring clinician or case manager details ready. The office will explain how to share supporting records appropriately.
How quickly can services begin?
A start date depends on the referral review, clinician or caregiver availability, location, orders and payment arrangements. Call 248.599.2410 to discuss timing. We do not promise a start date before those details are confirmed.
Do you serve my part of Michigan?
Contact the office with the city or ZIP code and the service needed. Availability can differ by discipline and location. The service area page provides context, and the office confirms whether the requested care can currently be arranged.
How do I confirm payment arrangements with M & M?
Tell the office about the auto claim and any proposed payment arrangement before scheduling. We review the referral and available information, then discuss the next steps. Confirm responsibilities in writing; a referral, policy document or clinical recommendation alone does not guarantee insurer payment.
Therapy & evaluations · 5 questions
Care that connects with everyday life.
Explore services and evaluations that can help identify needs at home. Recommendations follow an individual assessment.
What is the difference between Occupational Therapy and Physical Therapy?
Occupational Therapy focuses on participation in daily activities and routines. Physical Therapy focuses on movement and physical function. Their work may overlap within a coordinated care plan, but an assessment helps determine each discipline’s role for the individual.
Why might someone need Speech Therapy after a crash?
A referral can address concerns involving communication, cognition or swallowing. The clinician evaluates the specific concerns and recommends an appropriate plan. Ask the office about the requested service and whether an in-person or virtual visit is currently available and suitable.
Does a home modification evaluation include the construction work?
The evaluation identifies functional and accessibility concerns and provides recommendations. It is not the construction project itself. Discuss the scope of the report, who will perform any work and how approvals and payment will be handled before proceeding.
What does a wheelchair seating evaluation review?
It reviews the person’s needs in relation to seating, positioning, mobility and everyday activities. The evaluation supports equipment recommendations; it does not guarantee that a particular device will be ordered or funded. Ask what records, equipment and supplier involvement are needed.
How can I learn about the people leading my care?
Our Team page identifies the leadership, operations and clinical staff, with full names and direct email links. Leadership biographies describe the background information available for Michael Malecki, Stephanie Hawk and Christine Sylvia. Ask the office who is assigned to the referral and what their role will be.
Patients & caregivers · 4 questions
Support for the people supporting recovery.
Clear communication helps families understand the plan, raise concerns and prepare for care at home.
Can a family member ask about becoming an attendant caregiver?
Yes. Ask the office about the care needs, proposed caregiver role and current arrangements. The relationship, training, care plan and claim details require review. Family involvement does not automatically establish employment, an approved number of hours or insurance payment.
What should caregivers document?
Follow the documentation instructions for the actual care arrangement. Keep accurate dates, times, tasks and relevant observations, and avoid estimating or recording care that was not provided. Ask the office or claim adviser which records are needed and how they should be submitted.
Can caregivers ask for support or raise a concern?
Yes. Contact the office when the plan, scheduling or a care concern needs attention. Describe what changed and what help is needed. For an immediate medical emergency, call 911.
Should I email medical records or insurance documents?
Call the office first to confirm the appropriate way to send sensitive information. The email link on this website opens your mail application; it is not a secure intake form. Please do not place medical details in the FAQ search box.
Sources & transparency
Information you can trace.
The legal and insurance explanations link to the Michigan Department of Insurance and Financial Services (DIFS), Michigan Legislature and Michigan courts. Later court decisions can change older guidance. Use the linked current materials and obtain advice for your own claim.
- DIFS: Brief Explanation of Michigan No-Fault Insurance
- DIFS: Michigan Auto Insurance Law Changes
- DIFS: New Coverage Choices, July 2, 2020
- DIFS: PIP Medical Coverage Selection Form (2025 edition)
- DIFS: Consumer Auto Insurance FAQs
- DIFS Bulletin 2026-08-INS: Qualified Health Coverage
- DIFS: Explanation of the Attendant Care Provision
- Michigan Court of Appeals: Fremont v. Lighthouse (April 11, 2025)
- DIFS Bulletin 2025-11-INS: Payment and Billing Guidance
- DIFS Bulletin 2026-15-INS: Home Health Aide and Skilled Nursing Fees
- DIFS: Auto Insurance Utilization Review
- Michigan Supreme Court: Canty v. Mason (July 27, 2026)
- Michigan Legislature: MCL 500.3107
- DIFS: Auto Insurance Fee Schedule Resources
- DIFS: Excess Attendant Care Coverage Guidance
- DIFS: Choosing Bodily Injury Coverage
- Michigan Legislature: MCL 500.3157(10)–(11)
Published by: M & M Home Care
Sources checked:
Meet our leadership & clinical team
Ask a question or report a correction
DIFS auto insurance assistance: 833-275-3437. Questions about eligibility, rights, disputes or deadlines should be reviewed with the insurer or an appropriate adviser.
Your next step
Let’s talk about the care you need.
Tell us the location, requested services and who is coordinating the referral. We’ll explain the next steps and the information needed for review.
Admin@MMHomeCare.com
32003 Plymouth Road, Livonia, MI 48150