Every year, Medicaid helps Alabama seniors and their caregivers pay for a good many healthcare services:
- Hospital stays
- Lab work
- Trips to the doctor
- Nursing home care
- Eye care
- Certain prescriptions
Medicaid also covers some in-home needs for seniors living in Alabama. What Medicaid does not cover in Alabama is non-medical residential care.
Assisted Living in Alabama
Unfortunately, Alabama is one of only two states that does not cover the costs of assisted living in a residential care setting. Through the elderly and disabled waiver system, however, Medicaid will help pay for a limited amount of in-home care for recipients who have illnesses, disabilities, or injuries that keep them from leaving home without special equipment or the help of another person.
Although the Alabama Medicaid program offers many options for people who need skilled care, assisted living is not covered because to live in such a community one must be relatively independent. While residents may need medication reminders, or help preparing meals, they are relatively independent. Medicaid will not pay for this level of care in a community, but will, instead, pay for part-time care providers in the home of the individual.
How the Elderly and Disabled Waiver System Works
While you won’t be able to get the kind of 24 hour support offered by an assisted living community, Medicaid’s elderly and disabled waivers do allow people who would otherwise have to go into a nursing home to get the care they need at home or at an out-patient center.
To qualify for federal funds, seniors must:
- Be living in Alabama.
- Be a U.S. citizen or be in this country legally.
- Meet income and age requirements.
- Meet certain medical criteria.
Seniors who qualify can receive services such as a day rehabilitative program, respite care, help with housekeeping duties in their home, case management services, personal care and meals delivered to their home. While the waiver is not going to cover 24 hours of care in the home, it will cover enough care to give a primary caregiver a considerable break from providing for the needs of a loved one.
Other Alabama Medicaid Waivers
Medicaid also oversees a number of other waivers for individuals who need help living at home. The SAIL waiver (State of Alabama Independent Living), provides services similar to the elderly and disabled waiver to individuals with specific medical diagnoses who are at risk of being placed in a nursing home. This includes people who have suffered a traumatic brain injury, had a stroke, suffer from ALS, or any number of lifelong, disabling illnesses. An HIV/AIDS waiver offers those diagnosed with HIV or AIDS the same services provided to those with an elderly and disabled waiver.
How to Pay for Assisted Care in a Residential Setting
In 2015, the costs associated with living in an assisted living facility in Alabama average about $2,948 per month—that’s a hefty sum for a senior who isn’t getting any financial assistance.
As Medicaid doesn’t pay for non-medical residential care and many Alabamans aren’t able to afford the 24-hour support they need, some seniors end up going to nursing home level care before it is actually necessary. But while Alabama Medicaid does not cover the costs of residential assisted living, you do have other options:
- Life Insurance Benefits and Conversions
- VA Benefits
- Tax Credits
- Assisted Living Loans
- Long Term Care Insurance
As the caregiver of a loved one in the state of Alabama, it is important to know what types of care and support your loved one is entitled to. Whether Mom needs skilled nursing care or assisted living services, there is financial assistance available to help make sure she gets the care she needs.