State of Alabama Independent Living (SAIL) Medicaid Waiver

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

 SAIL will pay for home modifications and personal care to help persons live independently.

This Medicaid waiver is designed to help disabled individuals remain living in their homes or community instead of moving into a skilled nursing facility. Elderly residents of Alabama are eligible should they meet the medical requirements. Neurological conditions, such as Parkinson’s disease, stroke, and Alzheimer’s disease meet the medical diagnosis requirements. To help with the move out of nursing home care, the waiver pays for home modifications, assistive technology and personal care services that increase a disabled individual’s ability to live independently.

A Medicaid-certified home health agency must operate the personal care services unless there is no such service available in the individual’s geographic area. In this situation, the participant may select friends, neighbors and some family members to be compensated for the personal care services they provide. However, children, spouses and parents are barred from being paid as caregivers.

The SAIL waiver may also be called the State of Alabama Independent Living Waiver and is administered by the Alabama Medicaid Agency and is operated by the Department of Rehabilitation Services. Also, to avoid confusion, one should note that there are 3 sub-programs under this waiver: Homebound Program, Medicaid Waiver Program, and Independent Living Support Program.

The SAIL waiver takes part in the Personal Choices Program, which allows individuals to direct their own personal care. Another Alabama Medicaid program that might be of interest is the Elderly and Disabled Waiver.

 Did You Know?  The state of Alabama has the third highest rate in the nation of seniors who live under the poverty level.

Eligibility Guidelines

To be eligible for the SAIL waiver, individuals must be at least 18 years old and have a physical disability that requires nursing home level care. This disability must not be related to aging and must have an onset before the age of 60.

Although they require nursing home level care, the individual must live at home or be willing to move from a skilled nursing facility back to their home or that of a family member to receive services under this waiver. In addition, they must be financially eligible to receive Medicaid HCBS (waivers) and for this, there are both income and asset considerations.

2016 Alabama Medicaid Waiver Income Limits
Individual applicants are limited to a monthly income of no greater than $2,199. However, if they are married and their spouse is not applying for Medicaid, they can allocate some of their joint income to the non-applicant spouse as a living stipend.

2016 Alabama Medicaid Waiver Asset Limits
The asset limit for a single applicant is $2,000. In the situation where there is also a non-applicant spouse, that spouse is permitted up to $119,220 in countable assets. These limits are somewhat misleading in that many resources are, or can be, considered exempt. For example, the full value of one’s home is exempt, provided the applicant lives there, or plans to return to the home, and it is valued under $552,000.  A car, burial plots, final expense insurance, and even some personal effects are can be exempt.

 It is strongly advised that persons unsure if they are financially eligible consult with a Medicaid planning expert in advance of submitting their application paperwork. Learn more.

Benefits and Services

As implied by the words "Independent Living" in the Waiver name, the services provided under this waiver are selected to help participants achieve that objective.

  • Assistive Technology Needs Evaluations
  • Assistive Technology and Devices - Hearing aids, vehicle modifications, etc.
  • Transitional Assistive Technology - May include wheelchairs, hospital beds, and Hoyer lifts
  • Assistive Technology Repairs - Replacing parts/batteries of assistive technology bought for the individual previously
  • Case Management Services
  • Environmental Accessibility Adaptations / Home Modifications - Ramp installation, adding grab bars, and widening doorways
  • Medical Supplies
  • Personal Care Services - Assistance with activities of daily living, such as bathing, eating, and dressing, aid in preparing meals, basic housecleaning, etc.
  • Personal Emergency Response System - Installation and monthly charge
  • Personal Assistance Service - Transportation, monitoring of medication, shopping, etc.


How to Apply / Learn More

One should contact the Alabama Medicaid office at 1-800-362-1504 to learn more about this waiver program and begin the application process. While open to residents statewide, participation may be limited due to enrollment caps on the program.