Alabama’s Elderly and Disabled Medicaid Waiver: Qualifications & Services

Page Reviewed / Updated - Jan. 2016

 What is a Medicaid Waiver?
For persons with limited financial resources, Medicaid pays for nursing home care.  For those who wish to live at home or in assisted living, sometimes Medicaid will pay for care in those locations if it can be obtained at a lower cost than in a nursing home.  It does this through "Medicaid Waivers," which are also called Home and Community Based Services (HCBS) Waivers or Waiver Funded Services.

Waiver Description

Alabama’s Elderly and Disabled Medicaid Waiver (E & D) is designed to provide services to allow elderly and/or disabled individuals who would otherwise require care in a nursing facility to remain living at home or in the community. This waiver also assists those currently residing in a nursing home to transition back into the community.

The program administrators do not intend for the E & D waiver to pay for 24 hour home care, but instead, to assist families in caring for their loved ones at home. Should 24 hour home care become a necessity, it may become less expensive for the state to cover nursing home care and the individual may be required to move to a residential care home.

Under this waiver, individuals decide whether to have the state manage their care services or to self-direct their care services. Self-direction may also be referred to as consumer direction, participant direction, or the Cash and Counseling model. As long as a provider is a qualified waiver provider, an individual is able to choose that provider.

The E & D waiver is administered by the Alabama Department of Senior Services and the Alabama Department of Public Health

 Alabama has two other programs with self-direction that may be of interest to the reader: the SAIL Waiver and the Personal Choices Program.

Eligibility Guidelines

In order to qualify for the Elderly and Disabled Medicaid Wavier, one must be a resident of Alabama, be disabled or elderly, and require a level of assistance consistent with nursing home care. Applicants must also qualify financially, with an income amount of 300% of the Federal Benefit Rate (FBR). As of 2016, this means that an applicant cannot have a monthly income in excess of $2,199.

The countable asset limit is $2,000 if the applicant is single. If married with both spouses applying, the limit is $3,000 and if married with one spouse applying, the limit is $119,220. This large increase is intended to prevent the spouse who is not receiving Medicaid services from becoming impoverished.

For some families, while their income and assets exceed the eligibility limits, they still cannot afford the cost of care.  There is the option of working with a professional Medicaid planner to bring assets and income in line with the requirements.  These individuals are knowledgeable about Medicaid law nuances in each state and can help to re-structure an individual's or family's financial resources into income trusts and non-countable assets so that they become compliant.  Find assistance to prepare for Medicaid.


Benefits and Services

The E&D Waiver's objective is to assist persons to live outside of nursing homes and to assist their loved one's in helping to care for them.  Accordingly the benefits are selected to help the individual, their family and caregivers achieve this objective.   Under this waiver, candidates are eligible to receive the following types of care and support.

  • Adult Day Health -Education, health screening, therapeutic activities, etc.
  • Case Management
  • Non-Medical Companion Services 
  • Home Delivered Meals - Frozen meals, shelf-stable meals, and breakfast meals
  • Homemaker Services - Meal preparation, house cleaning, grocery shopping, etc.
  • Personal Care - Aid with dressing oneself, bathing, eating, etc.
  • Skilled and Unskilled Respite Care - Provided in the eligible individual’s home


How to Apply / Learn More

The program is available statewide throughout Alabama.  Although available, it is not an entitlement, like Medicaid's nursing home benefits.  There are a limited number of slots available (9,205 in total), so in some areas there may be waiting lists for services.  To learn more, download the rules and regulations here.  One can apply online or by contacting their local Area Agency on Aging.

Did You Know? There are approximately 100 people living in Alabama over the age of 100.