Alabama is a warm Southern state that’s rich with history and very welcoming to seniors. Nearly 17% of Alabama’s 4.9 million people are seniors aged 65 and over. Most of the state enjoys warm, balmy summers and some of the mildest winters in the United States. First joining the nation in 1819, Alabama’s landscape is rich with history and numerous cultural sites where seniors can volunteer. Several Civil War sites can be found between Birmingham and Mobile, with local monuments to the Civil Rights era a century later.

Alabama’s seniors can expect to pay less than the national average for all care types. For instance, the cost for room and board in one of the state’s 196 assisted living facilities averages $3,250 a month, according to Genworth Financial’s 2019 Cost of Care Survey. This is significantly less than the $4,051 seniors pay nationwide for similar senior living services, and it’s well below the price paid in many other nearby Southern states. This guide is written to help seniors and their loved ones find safe and comfortable senior living in the state of Alabama. It also lists several local resources that seniors in Alabama can use to help pay for many of the costs of senior living.

The Cost of Senior Living in Alabama

Note: There currently isn’t authoritative data on the average cost of Independent Living Facilities nationwide, so instead, we use the cost of Assisted Living to estimate it. Since the cost of Independent Living is typically 30-40% lower than the cost of Assisted Living, the numbers below were calculated by subtracting 35% from the cost of Assisted Living.

Note: Memory care is typically provided in communities licensed as assisted living facilities, and in general, costs 20-30% more than standard assisted living services. No authoritative cost data is available for this type of care, so we estimated memory care rates by adding 25% to assisted living fees in the Genworth 2021 Cost of Care Survey.

Seniors residing in Alabama have a variety of long-term care options to consider. These choices can depend on financial status, living preferences and specific care needs. Alabama is generally an affordable state for those seeking long-term residential care according to the Genworth 2021 Cost of Care Survey. Active seniors who don’t require medical or personal care may choose an independent living community. Others may opt for adult day care where social engagement and medical services are offered. Seniors living at home who need help with personal care tasks or have health care needs can consider in-home aides. Others requiring help with day-to-day personal tasks and some medical oversight, including memory care services, may find that moving to an assisted living facility meets their needs.  Seniors with chronic conditions who need skilled nursing services and higher levels of medical care may be most suited to residing in a nursing home.

Independent living communities are the least expensive options in Alabama at an average cost of $2,277 a month. When seniors require help with some daily living tasks, assisted living is often a good fit, and this option offers memory care services to seniors with dementia. Nursing home care is appropriate for seniors who need constant monitoring and assistance due to their medical needs.

The Cost of Assisted Living in Alabama

Seniors pay approximately $3,503 for assisted living in Alabama, which is $997 cheaper than the national average of $4,500. When comparing costs in neighboring states, Georgia and Mississippi are similar at $3,535 and $3,500, respectively. Tennessee’s, South Carolina’s and Florida’s costs for assisted living average between $100-$600 more per month than Alabama.

The Cost of Nursing Home Care in Alabama

Alabama seniors have access to the least costly nursing home rates when compared to nearby states and the national average of $7,908. Florida exceeds Alabama’s costs by $1,978 per month. Assisted living in Georgia ($7,011), Mississippi ($7,118) and Tennessee ($7,148) costs between $300 to $500 more monthly, while prices in South Carolina top Alabama’s rates by $609.

Can You Use Medicaid to Pay for Senior Living in Alabama?

Although paying for long-term care in Alabama is not as expensive as in nearby states, costs can mount up for seniors. Alabama’s Medicaid program doesn’t cover the costs of residing in an assisted living facility. The state does, however, have an Elderly and Disabled (E&D) Waiver program that will pay for a certain amount of in-home care for ill, disabled or injured seniors who need the care of another person or special medical equipment and are nursing home eligible.  Another waiver that may help seniors living at home is the State of Alabama Independent Living (SAIL) waiver. It’s available to elderly persons with specific, disabling medical diagnoses, such as Alzheimer’s disease and other forms of dementia. The goal of the program is to help them remain living at home or in their community by covering the cost of personal care assistance, adult day care services and respite care.

For seniors living in nursing home facilities, Medicaid for Institutional Care is available to eligible applicants who require a nursing home level of care and qualify for a Home and Community Based Waiver (HCBS).

	Medicaid Coverage Level	Type of Medicaid Coverage	Entitlement?*
Assisted Living	None	N/A	No
Independent Living	Partial	Medicaid Waivers	No
Memory Care	Partial	Medicaid Waivers	No
Nursing Home Care	Full	Medicaid	Yes

*Note: Entitlement programs mean that everyone who qualifies will receive coverage and be accepted into the programs. If the program is not “entitlement,” then participant caps could be in place, and there may be a waiting list. 

Medicaid’s Coverage of Assisted Living & Memory Care in Alabama

Alabama’s Medicaid system does not cover any of the costs for seniors in assisted living settings. Instead, the state offers persons aged 65 and up the Elderly & Disabled Medicaid Waiver to help seniors receive services at home from family members or outside caregivers and by offering programs that provide home-delivered meals and other services. By including help with home care needs, the E&D Waiver assists with delaying or avoiding placement in a nursing home. Some specific services available include:

• Adult day health care
• Case management
• Companions who provide limited assistance with personal care and household help
• Home-delivered meals and groceries
• Homemaker services
• Personal care aides to help with the activities of daily living
• Respite care for family members

To be eligible for this waiver, applicants must be disabled or 65 years old and up, be an Alabama resident and need a nursing home level of care. Qualified seniors must demonstrate the need for help with some or all of the activities of daily living, such as requiring assistance with ambulation, feeding, dressing or bathing. Seniors with Alzheimer’s disease and other forms of dementia may also be eligible for memory care under this waiver if they exhibit behavioral issues, such as frequent wandering.

To apply for the E&D Waiver, seniors or a responsible family member can apply online for Alabama Medicaid. They can also contact their local Area Agency on Aging.

Medicaid’s Coverage of Nursing Home Care in Alabama

Nursing home care in Alabama can cover the costs of care for seniors who are eligible for and enrolled in the state’s Institutional Medicaid program. Medicaid for Institutional Care is available to seniors who require a nursing home level of care. This means that they have been diagnosed with a medical condition that requires skilled nursing services, and they cannot care for themselves without medical oversight or personal care assistance. Other qualifications require applicants to:

• Be a U.S. citizen and reside in Alabama
• Be medically approved for skilled nursing care
• Reside in an approved medical setting for at least 30 days (an exception is made for Supplemental Security Income recipients)
• Have a monthly income and resources that are below a yearly set limit

Eligibility for Medicaid in Alabama

Qualifying for the E&D, SAIL or various other Medicaid waivers in Alabama each comes with its own eligibility requirements. Seniors should first apply for Alabama Regular Medicaid coverage, which has certain income and asset limits that must be met to qualify. After this, the necessary waivers can be sought.

The Medicaid income limits for Alabamians are $861 per month for a single applicant or $1,281 for a married couple. Limits may increase up to $2,523 per month, per applicant for institutional care. Qualified applicants cannot have assets that amount to more than $2,000 or $3,000 for couples. Resources or assets include cash, checking or savings accounts, investment funds and real estate, for example. There are exclusions if only one spouse requires long-term care. Individuals can also apply for Medicaid through the Social Security Administration’s Supplemental Security Income (SSI) program.

2022 Alabama Medicaid Income Limits

	Income Limits*	Asset Limits
Single Applicant	$10,332	$2,000
Two-Person Household (Only one applicant)	$15,372	$2,000 for applicant $137,400 for nonapplicant
Two-Person Household (Two applicants)	$15,372	$3,000

*per year

Seniors aged 65 and older also must meet eligibility requirements when applying for Medicaid that include:

• Requiring a nursing home level of care in order to function
• Citizenship requirements, including being a U.S. citizen or legal alien
• Being a permanent resident of Alabama

Applying for Medicaid in Alabama

Residents of Alabama can apply for Medicaid in different ways. Individuals can contact a local Medicaid district office for help with their application in person or by telephone. Seniors can also contact their Social Security office for assistance with benefits. Residents can apply for Medicaid online as well. For help with applications or to receive one in the mail, seniors should call the general information number at (800) 362-1504.

Before You Apply

Before applying for Medicaid in Alabama, it’s important to have the information and documents that you’ll need to complete your application. This gives you a better chance for a quick approval without needing to submit more paperwork later on. Some eligibility documents you’ll need to gather include:

• Proof of U.S. citizenship, age and identity (These are not needed if an applicant has already been approved for Medicare or Social Security.) Some documents needed may include a passport, birth certificate and driver’s license
• Social Security card
• Proof of Alabama residency

How to Get Help

It can often be an intimidating or overwhelming task to apply for Medicaid coverage, which is why Alabama offers applicants some resources to help them navigate the system, understand the benefits they may be eligible for and how to appeal a decision that isn’t in their favor. These resources can also be helpful to seniors whose financial holdings and yearly income exceed eligibility limits.

Resource	Contact	What You Should Know
Alabama Department of Senior Services (ADSS)	(334) 242-5743	The ADSS is a state agency administering programs for senior citizens, individuals with disabilities and caregivers. Also serving as the operating agency for the Elderly & Disabled Medicaid Waiver, the ADSS provides case managers to work with seniors on a plan of care that meets their medical and other needs at home.
Alabama Area Agencies on Aging	(800) 243-5463	Alabama has 14 Area Agencies on Aging and Aging and Disability Resource Centers that cover each region within the state. Each public agency provides regional services to seniors either through local organizations or direct service programs, including senior centers, meal sites, nutritional outreach, prescription drug assistance and other resources.
Alzheimer’s Association, Alabama Chapter	(800) 272-3900	This chapter of the Alzheimer’s Association has offices in Birmingham and Huntsville and a free telephone helpline that’s available 24/7 to provide information and support to individuals living with dementia. Assistance is also available to families and caregivers. The organization offers a variety of programs, services and educational materials as well as help in advocating for the rights of those dealing with this type of memory loss.

Can You Use Medicare to Pay for Senior Living in Alabama?

Unfortunately, Medicare does not cover the cost of assisted living, independent living, or memory care. Unlike nursing homes, these care types are not considered to be “clinical settings” and so are not eligible for Medicare coverage. That being said, those who live in these communities can still use Medicare to cover the cost of approved medications, doctor visits, medical equipment, etc.

When it comes to nursing home care, it gets much more complicated. Medicare does provide limited coverage for a qualified stay in a nursing home,but there are strict rules and requirements of which you should be aware. This benefit is available to seniors who have been hospitalized for at least three days, excluding the date of discharge.

Once you’ve met the hospitalization requirement, Medicare will pay for up to 100 days in a skilled nursing facility (per benefit period). While the first 20 days are covered in full, there is a daily coinsurance rate that must be paid starting on day 21. After day 100, seniors are responsible for the entire cost.

	Medicare Coverage	Medicare Coverage Duration	Coinsurance Requirement?
Assisted Living	None	N/A	N/A
Independent Living	None	N/A	N/A
Memory Care	None	N/A	N/A
Nursing Home Care	Limited	100 Days Per Benefit Period	Yes – After 20 Days

What Nursing Home Care Services Does Medicare Cover?

Medicare covers a number of specific services, including:

• Meals
• A semiprivate room
• Medications
• Skilled nursing services
• Physical therapy
• Occupational therapy
• Speech therapy
• Audiologist care
• Medical supplies
• Medical social services
• Nutritional counseling
• Ambulance transportation

What Nursing Home Care Services Aren’t Covered by Medicare?

Medicare does not cover long-term custodial care that addresses seniors’ day-to-day needs. This includes help with daily activities, such as bathing, dressing and using medical equipment.

Medicare Support & Resources in Alabama

Alabamians who are eligible for Medicare can access a number of free services to help them better understand this insurance coverage, what their private Medicare options are and how they may be able to save on premiums and copays. Some of the resources available to Alabama residents are listed in the table below.

Resource	Contact	What You Should Know
State Health Insurance Assistance Program	(800) 243-5463	This is a free program sponsored by the Alabama Department of Senior Services to help provide individuals with personalized, unbiased counseling, information and help concerning Medicare insurance. Volunteers answer questions about the various Medicare options and benefits, help beneficiaries obtain home health benefits and prepare Medicare claims and appeals. Counselors also refer seniors to other agencies or programs when needed.
Medicare.gov	(800) 633-4227	The federal Medicare website provides state-specific resources for contacting coordinators in Alabama about claims, billing, complaints and a variety of services in your area, including health care facilities. Seniors can find information on the latest Medicare costs, eligibility requirements, private insurance plans and how to apply for various financial assistance programs.
Medicare Advisors of Alabama	(205) 704-9020	Medicare Advisors of Alabama is an insurance agency offering free consultations and advice concerning Medicare coverage options and benefits. The agency holds free seminars in libraries and community centers, helps seniors apply for Medicare Part B and assists with applications for financial assistance with copays, premiums and prescription drugs.
BenefitsCheckup	(800) 794-6559	This free service is administered through the National Council on Aging to improve the health and financial security of older adults. By inputting a zip code on the website, seniors can access benefits in their local areas, including Medicare Savings Program, help with premiums or drug coverage costs, Medicaid benefit information and Veterans benefits.

Are There Other Financial Assistance Options for Senior Living in Alabama?

Depending on your unique situation, there may be other financial assistance options to partially or fully cover the cost of senior living in Alabama. Below, we cover some of the common ways that seniors can make senior living options such as assisted living or memory care more affordable.

	How to Get Started	What You Should Know
Aid and Attendance	Apply online at va.gov.	If you are a veteran and you receive a VA pension, you may also be eligible for the Aid and Attendance benefit. This benefit takes the form of a monthly cash allowance that you receive in addition to your standard pension. This benefit is used by veterans who need long-term care services, including care received at an assisted living facility.
Reverse Mortgages	Research and learn about the different types at ftc.gov.	If you own a home, you may be able to use a reverse mortgage to access some of the equity in your home. Like traditional loans, reverse mortgages do need to be repaid with interest, typically within 12 months, so seniors should carefully weigh this option alongside other financing methods.
Long-Term Care (LTC) Insurance	Learn about how to receive LTC insurance benefits at acl.gov.	While those who currently need assisted living will typically not be eligible, if you purchased an LTC insurance policy in the past, you may be able to use it to help pay for assisted living. While most policies cover at least a portion of the cost, you still need to check the specific terms of your policy.

Free Senior Living Resources for Seniors in Alabama

A variety of no-cost resources are available to seniors living in Alabama regardless of their income or health and personal care needs. Some of the statewide resources that can help elderly Alabamians maintain their independence and quality of life as they age are listed below.

	Contact	What You Should Know
Legal Services and Assistance Programs	(800) 243-5463	Legal assistance is available to older Alabama citizens through a statewide system of attorneys and legal professionals. Staff members can advise seniors of their rights and benefits that help ensure their well-being and protect their dignity, including estate planning, Medicaid eligibility and benefit access.
Elderly Nutrition Program	(800) 243-5463	Provided through the Alabama Department of Senior Services, the Elderly Nutrition Program provides free information and education from a registered dietitian nutritionist to help seniors set and achieve their health goals. Sessions are available for groups and individuals. The program services meals at over 350 senior centers and delivers meals to many Medicaid waiver recipients.
AARP Alabama	(866) 542-8167	Available to Alabamians aged 50 and up and their families, AARP Alabama provides important news and information concerning the rights and resources available to older Americans in the state and throughout the country, including federal and state bills that may impact health benefits. The organization offers advocacy, helpful webinars, local resources and a variety of senior discounts for travel and shopping.
Alabama Department of Veterans Affairs	(334) 242-5077	The Alabama Department of Veterans Affairs administers state and federal benefits to eligible senior veterans throughout the state. Through 61 local offices in Alabama, veterans can access representation for filing claims, obtain a veteran driver’s license, find out about long-term care in the state’s veterans homes and apply for the various federal veterans benefits that range from pensions to home loans, compensation and more. Assistance with applying for benefits and services that are provided in nursing homes, memory care units and assisted living settings is also available through this department.
AlabamaDementia.gov	(800) 243-5463	Administered through the Alabama Department of Senior Services, AlabamaDementia.gov is a web-based resource for seniors living with memory loss as well as their families and caregivers. Links to services provides seniors with access to information about Medicaid waiver programs, Medicare coverage, veterans homes, education and resources about dementia for caregivers, friends and family.

Senior Living Laws and Regulations in Alabama

Note: All these rules typically apply to non-clinical senior living facilities, such as independent living, assisted living, and memory care facilities. Nursing homes and other senior living facilities with a clinical setting may have additional or slightly different requirements and regulations.

Senior living and personal care homes in Alabama are licensed by the Department of Public Health, Bureau of Health Provider Standards. This bureau sets statewide standards, conducts inspections of licensed facilities and develops best practices for Alabama residential care facilities, including assisted living communities. Licensed facilities in the state are required to comply with Bureau standards for admissions, Alzheimer’s and dementia care, medication handling and staff training.

Admission Requirements

Prior to admission to an Alabama senior living community, prospective residents must undergo a preadmission health screening by a licensed physician. A doctor must certify that the resident doesn’t require a higher level of care than the facility can provide, such as continuous wound care or behavior management beyond the scope of the admitting facility. Senior living residents must not require skilled nursing for more than 90 days unless they have been diagnosed with a terminal illness and can be admitted to a hospice program in the facility. Medical evaluations must be repeated annually or after any observable change in the resident’s condition. Residents must be able to evacuate unsafe conditions, such as fire, alone or with minimal assistance.

Memory Care Regulation

Facilities may not admit residents with Alzheimer’s disease or other forms of dementia unless they are licensed as specialty care facilities. Unlicensed facilities are not permitted to advertise or to represent themselves as providing Alzheimer’s care or dementia/behavior management without a specialty care license. Specialty care may be licensed for an entire facility or for a designated wing inside of an otherwise unlicensed facility. Specialty care units are subject to memory care inspections and requirements. New residents must pass a medical and psychological screening prior to admission that includes a clinical history, examination of mental status, aphasia screening, geriatric depression screening and a physical function evaluation. Current memory care residents must be reevaluated annually or after a noticeable change in behavior or ability.

Medication Management

Residents of senior living facilities may keep, manage and self-administer medications with the written permission of a physician. Approval is also required for facility nursing staff to assist with medication for residents who need it. No approval is necessary for over-the-counter medications that the resident can self-administer without assistance. Medications must be stored in unit dose containers and kept in accordance with state medication management protocols. Residents who have trouble managing their medication, or who cannot remember their own names or respond to instructions, may have their medication administered by staff. Authorized staff includes registered nurses, licensed practical nurses or physicians only.

Staffing Requirements

Licensed senior living communities must have a designated administrator who is responsible for the day-to-day operation of the facility and sufficient staff on duty to adequately care for every resident. Senior living facilities that aren’t licensed to provide specialty care don’t have a set staffing ratio, though at least one member of the staff who has current CPR certifications must be on duty at all times. Facilities licensed to provide specialty care must employ an administrator, a medical director, a minimum of one registered nurse and a certified care coordinator. At least two staff members must be present and on duty 24 hours a day, seven days a week. CPR-certified staff must be available at all times and close enough to the specialty care unit to respond rapidly to emergencies. Staff ratios are specified by the facility’s license, though more staff may be required to adequately manage evacuations in the event of a fire.

Facility administrators must be licensed by the Alabama Board of Examiners of Assisted Living Administrators. Administrators must be high school graduates aged 19 and over. They must also have either two years of experience working in administrative or care positions in a senior living, hospital, skilled nursing or other residential care facility or two years of college and at least one month of experience in a residential care setting. Administrators must report 12 hours of continuing education each year for licensing in a senior living facility or 18 hours a year for special care facilities.

Staff members in licensed facilities must be high school graduates who have completed an initial training program with state-specified coursework. Limited continuing education requirements apply to all resident-care positions, as does the requirement to pass a preemployment background check.

Frequently Asked Questions

How much does assisted living cost in Alabama?

Assisted living in Alabama costs an average of $3,250 per month. This is less than the $4,051 national average and also less than many of the surrounding states, including Georgia, Mississippi and Tennessee.

Does Alabama Medicaid pay for assisted living?

Medicaid doesn’t directly support the cost of board and care in a residential assisted living community. Alabama’s low-income health insurance plan does, however, cover many of the costs associated with assisted living, such as prescription drugs and medical supplies.

Does Medicare pay for assisted living?

Medicare doesn’t provide a long-term residential care benefit as part of its regular health services for qualifying seniors. Some Medicare Advantage or supplemental Medigap plans may offer a long-term care option. Plan details vary, and so it’s best to consult with a plan representative before making financial decisions about senior care.

What are “activities of daily living”?

The term “activities of daily living” describes the regular daily chores many seniors need personal caregivers to help out with. Common activities of daily living include personal hygiene, dressing, meal preparation and light housekeeping. The term is sometimes expanded to include shopping and other tasks outside of the home.

What is the difference between assisted living and nursing homes?

Assisted living is a largely nonmedical choice of senior living, while nursing home care is designed to meet residents’ medical needs in a residential care setting. Residents in a nursing care home can expect skilled nursing care, physical and occupational therapy services and lift assistance while moving. Seniors in assisted living generally lead more independent lifestyles with daily help performing normal activities of daily living.

Learn More About Senior Living in Alabama

For more information about specific types of senior living in Alabama read our Guide to Assisted Living and Independent Living.

The Top Cities for Senior Living in Alabama

Learn more about the cost of senior living in the top Alabama cities. Additionally, find reviews and information about assisted living facilities and other senior living communities across the state.