State of Alabama Independent Living (SAIL) Medicaid Waiver

Page Reviewed / Updated - Feb. 2015

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. However, elderly residents are eligible should they meet the medical 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. 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.

There are other Alabama Medicaid programs that may be of interest including the Elderly and Disabled Waiver and the Personal Choices Program which allows individuals to direct their own care.

 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 disability that requires nursing home level care. However, 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.

2015 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.

2015 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 and it is valued under $543,000.  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
  • Assistive Technology Repairs
  • Case Management Services
  • Environmental Accessibility Adaptations / Home Modifications
  • Housekeeping Chores
  • Medical Supplies
  • Personal Care Services
  • Personal Emergency Response System
  • Personal Assistance Service



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.