Home Care Agency Insurance in Metro Detroit: Wayne, Oakland and Macomb Counties

Short answer: A home care or home health agency in Wayne, Oakland or Macomb County needs Michigan workers' comp once it has three employees, or one caregiver working full time for 13 weeks, plus general and professional liability at the limits its MI Choice, hospital and referral contracts require. One Michigan program covers all three counties. What changes from county to county is who you contract with.

Key takeaways

• Michigan requires workers' comp at three employees, or one employee working 35+ hours a week for 13 weeks (MCL 418.115).
• Caregivers are classified under Michigan's class 8835, home health care; office-only staff under 8810.
• Detroit and its suburbs can't set their own minimum wage. The state rate is $13.73 in 2026 and $15.00 from January 1, 2027.
• Five MI Choice waiver agents serve the three counties, and each sets its own insurance requirements.
• Michigan doesn't license home health or non-medical home care agencies, so your contracts, not a license, usually set your liability limits.

Why Metro Detroit is its own market

Wayne, Oakland and Macomb counties are home to about 3.9 million people, according to the Census Bureau's July 2025 estimates: 1,769,038 in Wayne, 1,288,337 in Oakland and 886,221 in Macomb. That makes the region Michigan's largest concentration of home health agencies, visiting nurse associations and private-duty providers, from Detroit and Dearborn to Southfield, Troy, Warren and Clinton Township.

Most agencies here serve more than one county. A Southfield agency might send caregivers to Detroit in the morning and Sterling Heights in the afternoon. The good news: Michigan's workers' comp rules, class codes and minimum wage are the same statewide, so one policy covers all of it.

Workers' comp: who must carry it

A private Michigan employer must carry workers' comp if it regularly employs three or more people at one time, part-time staff included, or has employed at least one person 35 or more hours a week for 13 weeks or longer in the past 52 weeks. Going without coverage is a misdemeanor punishable by a fine of up to $1,000 and up to six months in jail, and each day counts as a separate offense (MCL 418.641). Injured workers can also sue the employer directly.

Medicaid Home Help agencies almost always meet the threshold. MDHHS requires them to directly employ their caregivers, with no subcontracting, and to have at least two caregivers besides the owner on payroll.

Class codes for Detroit-area care providers

Michigan doesn't use NCCI. It has its own classifications, and advisory pure premiums come from the Compensation Advisory Organization of Michigan (CAOM). For care providers, the classes that matter most are:

• 8835 Home health care: home help, homemaker and nursing services in clients' homes.
• 9053 Adult foster care, assisted living and homes for the aged: a Michigan-only class.
• 8829 Nursing or convalescent homes and hospice facilities.
• 8810 Clerical office employees: schedulers and billing staff who never provide care.

Carriers add their own expenses to CAOM's advisory numbers or file their own rates, so two quotes for the same agency can be far apart. It pays to shop.

Wages: one rate for the whole region

Michigan bars cities and counties from setting their own minimum wage (MCL 123.1385), so Detroit, Southfield and Warren employers all pay the state rate: $13.73 an hour in 2026 and $15.00 from January 1, 2027. Workers' comp is priced on payroll, so the 2027 increase will raise premiums for agencies paying near the minimum. Update your payroll estimate at renewal so your deposit is right and your audit doesn't bring a surprise bill.

Who you'll contract with in each county

• Wayne County: two Area Agencies on Aging. The Detroit Area Agency on Aging serves Detroit, Hamtramck, Highland Park, Harper Woods and the five Grosse Pointes. The Senior Alliance, based in Dearborn, serves the rest of the county. MI Choice waiver agents are the Detroit Area Agency on Aging, The Senior Alliance and The Information Center.
• Oakland and Macomb counties: AgeWays Nonprofit Senior Services (formerly Area Agency on Aging 1-B), based in Southfield. MI Choice waiver agents are AgeWays and Easterseals/MORC, which is based in Clinton Township.

Each waiver agent, hospital and referral partner can set its own liability limits and certificate wording. Before you sign, ask for the insurance section of the contract so your policy matches it the first time.

Liability coverage referral partners ask for

• General and professional liability at the limits in your contracts.
• Abuse and molestation coverage, which many contracts and general liability policies treat separately.
• Hired and non-owned auto for caregivers driving their own cars to clients.
• Employment practices liability for hiring, firing and wage claims.

One Michigan-specific point: under the no-fault law, if a caregiver is hurt in a crash while working, workers' comp benefits are subtracted from the auto insurer's personal protection benefits (MCL 500.3109(1)). In practice, your comp policy pays first, which is another reason to have it in place before your first hire.

See our county pages for Wayne County, Oakland County and Macomb County, our Michigan workers' comp guide, or call 847-767-4504.

Sources: U.S. Census Bureau QuickFacts, Vintage 2025 estimates; MCL 418.115, 418.641, 123.1385 and 500.3109; Michigan LEO minimum wage notice; MDHHS Area Agencies on Aging list and MI Choice waiver agents by region; MDHHS Home Help agency provider requirements; CAOM classifications 8835, 9053, 8829 and 8810.