Alabama is becoming a popular destination for seniors. Residents 65 and over comprise slightly over 17% of Alabama’s population of approximately 5 million. Alabama doesn’t tax income seniors receive from Social Security or pensions. Its cost of living, which is approximately 18 points below the national average, makes it another attractive option for seniors.

Three levels of assisted living communities operate in the state:

• Family assisted living facilities house 2-3 residents
• Group assisted living facilities house 4-16 residents
• Congregate assisted living facilities house 17 or more residents

Unfortunately, Alabama is one of two states which does not provide Medicaid or a Medicaid waiver to help cover the cost of assisted living, which is $3,503 a month.

This guide offers seniors information on the costs of assisted living in Alabama. There are free or low-cost resources included they can use to obtain prescription drugs, free legal aid, information on Medicaid or Medicare — in addition to various other resources for seniors throughout the state.

How Much Does Assisted Living Cost in in Alabama?

According to the Genworth Cost of Care Survey 2021, Alabama has one of the lowest costs for assisted living in the United States. The average cost of assisted living in Alabama is $3,503. That’s approximately $1,000 cheaper than the national average of $4,500 a month. Mississippi’s cost of assisted living is $3 less expensive at $3,500 a month. Georgia’s cost averages $3,535 a month or slightly over $30 more per month. Florida averages $4,000 per month. Tennessee has the highest average cost for assisted living in the region, costing $4,105 monthly.

Cost of Living in Alabama’s Top Cities 

The cost of living in Alabama’s cities and towns remains relatively inexpensive and within $2,000 of each other. Dothan has the lowest assisted living cost, averaging $2,150 per month. Birmingham has the highest cost, averaging $4,028 a month. Huntsville — also known as Rocket City because of its connection to space-related industries and organizations — averages $3,345 a month. Montgomery, the state capital, duplicates the state average of $3,500 a month. Mobile, located on the Gulf Coast, is approximately $25 more expensive at $3,523 per month. Tuscaloosa, home to the Crimson Tide and the University of Alabama, averages $3,150 per month. Decatur averages $3,439 a month.

The Cost of Assisted Living Vs. Other Types Of Care

Seniors have the choice of several care options in Alabama. The least expensive option is adult day care, which averages $758 a month. A semiprivate room in a nursing facility costs $6,676 monthly, making it the most expensive option. Seniors who want to age in place have two options: in home services and home health care. In-home services include assistance with ADLs such as personal care, housecleaning and laundry. Home health care assists with ADLs and some medical care. In-home care costs $3,813 a month, while home health care is approximately $40 a month more expensive at $3,851.

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

No. While Medicaid covers seniors who need the sort of skilled nursing care only found in a nursing facility, it does not assist seniors in assisted living facilities. While several Medicaid waivers are available to older residents of the state, they provide financial assistance for seniors aging in place or who have been in nursing care but wish to return to their homes.

The Elderly and Disabled Waiver cannot be used in institutionalized settings, such as assisted living, but only in residential settings. The waiver can only be used in assisted living under a special agreement. It will never pay the cost of room and board in any assisted living situation. Alabama also offers a financial supplement for people receiving federal Supplemental Security Income (SSI), but it only applies to costs associated with in-home care.

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

Unfortunately, Medicare does not cover the cost of assisted living in Alabama. Unlike nursing homes, assisted living facilities are not considered to be “clinical settings’ and so are not eligible for Medicare coverage. That being said, you can still use Medicare to cover the cost of approved medications, doctor visits, medical equipment, etc.

For more information about what Medicare visit medicare.gov.

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

	How to Apply	How It Works
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 and Low-Cost Resources for Seniors in Alabama

The following section presents free and low-cost resources that will help seniors with legal issues, prescription drug costs, how to deal with allegations of abuse or neglect and researching assisted living facilities in Alabama.

Resource	Contact	Service
Area Agencies on Aging	(800) 243-5463	Working closely with Aging and Disability Resource Centers (ADRCs), Alabama’s 13 Area Agencies on Aging (AAA) provide essential resources and information for seniors in the state. The AAA offices coordinate with senior organizations in every community to ensure seniors have the resources that they need. If they find gaps in coverage, the AAA will work with the ADRCs to fill them. The AAA offices can provide information on assisted living facilities in the state, nonmedical transportation, access to government benefits, legal advice, meal delivery programs for at-home seniors and tax preparation information.
Long-Term Care Ombudsman	(800) 243-5463	Alabama’s ombudsmen advocate for seniors when they or their caregivers have alleged abuse or neglect against an LTC facility. The ombudsman investigates the alleged complaint and then works to resolve the issue between the parties. Ombudsmen serve as non-partial third parties to advise seniors on Medicare or Medicaid, billing issues and consumer fraud. If a senior has received a negative Medicaid or Medicare decision that results in a denial of service, ombudsmen can help seniors prepare an appeal. Ombudsmen also educate their communities about seniors’ rights in long-term care facilities.
Alabama Department of Veterans Affairs	334-242-5077	Senior veterans, their spouses or survivors who wish to reside in an assisted living facility may be able to stay in one of four veterans’ homes through the Alabama Veterans Homes program. Operated by the Department of Veterans Affairs, the veterans’ homes provide affordable living in a community setting. They assist with ADLs and provide skilled nursing care if needed. Applications may be downloaded from the Alabama State Veterans Home Program website or obtained from your local veterans’ service office.
Assisted Living Association of Alabama (ALAA)	(334) 262-5523	The ALAA is a non-profit 501 (c) 4 corporation dedicated to promoting excellence in assisted living in Alabama. It provides information to seniors or caregivers about assisted living facilities, including a complete listing of all available facilities. Seniors will also find a compilation of facts and figures that will help them search for an assisted living community.
Legal Assistance Program	(334) 242-5743 or (877) 425-2243	The Legal Assistance Program provides civil legal services free of charge to all seniors aged at least 60 in Alabama. On a non-fee generating basis, legal professionals work with seniors on issues where they need advice and counseling. These issues include legal representation, advanced planning directives, preparation of legal documents, landlord/tenant disputes, end-of-life planning, contract negotiations, estate planning, Medicaid eligibility, contract disputes and debt collection.
SeniorRX	(800) 243-5463	SeniorRX is a program of the Alabama Department Of Senior Services (ADSS). Seniors aged at least 55 and who’ve been diagnosed with chronic medical conditions requiring regular medication are eligible for the program. The ADSS designed the program for seniors who need medications but may have difficulties paying for them. Seniors who qualify for the program receive a three-month supply of prescription drugs for free or low-cost from pharmaceutical manufacturers. Prescriptions will be renewed for seniors who remain eligible for the program. You can apply for SeniorRX by calling (800) 243-5463 and working through your local Area Agency On Aging.

Assisted Living Laws and Regulations in Alabama

The Alabama Bureau of Public Health, Bureau of Health Provider Standards regulates rules for, and laws about, all three levels of assisted living facilities in the state. The Bureau ensures facilities maintain safe and proper living conditions for all residents.