I. What You Should Expect to Pay for Home Care in Alabama

According to the Genworth 2021 Cost of Care Survey, Alabama residents can expect to pay around $3,813 per month for home care. For this price, you can receive help with activities of daily living, personal care, companionship, transportation to doctor’s appointments and other supportive services. Home health care costs a bit more at $3,851. It focuses on medical services such as physical therapy, maintenance of chronic illness and wound care, allowing you to receive some skilled nursing services in the comfort of your home.

The Cost of Home Care and Home Health Care in Nearby States

At $3,813 per month, Alabama ranks as one of the lowest-cost states for home care in the southern United States. It’s also $1,144 cheaper than the national home care median of $4,957 and almost $1,300 less than the home health care average of $5,148. The state is nearly tied with Mississippi, which has an average cost of $3,813 for both home care and home health care. Both services cost $4,576 to the north in Tennessee, which is approximately $725-$760 more than what Alabama residents pay. To the east in Georgia, home care and home health care cost $4,290 and $4,385, respectively. Florida is among the higher-priced states for care; here, both services cost $4,767.

Home Care Home Health Care
Alabama $3,813 $3,851
National $4,957 $5,148
Mississippi $3,813 $3,813
Tennessee $4,576 $4,576
Georgia $4,290 $4,385
Florida $4,767 $4,767

The Cost of Home Care vs. Other Types of Care

If you’re not sure whether home care will meet your needs, there are several other options to consider. Home health care costs $3,851, on average, and it may be a good choice for seniors who need some medical services in addition to regular home care. Adult day care provides community-based services on weekdays, so it’s the cheapest solution at $758. Assisted living costs an average $3,503 per month, which is about $300 cheaper than home care. Nursing homes are ideal for those who need around-the-clock supervision and skilled care services. In Alabama, a semiprivate room in a nursing home costs an average of $6,676.

II. Can Medicaid Help You Pay for Home Care in Alabama?

In Alabama, Medicaid covers both regular home care and home health care for people of any age who meet the eligibility criteria. Recipients must have a disability, injury or illness that prevents them from leaving their home or going to a medical clinic, doctor’s office or other outpatient setting for treatment. They must also be able to safely receive necessary services in their own or a family member’s home.

Alabama has three Medicaid programs that can be used to cover home care: the Alabama Community Transition (ACT) Waiver, the Elderly and Disabled Waiver and the Personal Choices program.

Home Care Waiver Programs in Alabama

These waivers and programs pay for home care provided you meet eligibility criteria, which is different for each one. In general, you need to demonstrate financial and medical needs to qualify.

Program Services Provided
Elderly and Disabled Waiver The Elderly and Disabled Waiver provides home care for seniors who meet the care level requirements for a nursing facility. The program aims to help people retain their independence while getting care in a familiar and comforting environment. Services may include personal care, companionship, home-delivered meals, caregiver respite and light housekeeping. If accepted, a caseworker will assess your needs to determine the types of services you qualify for.

To apply, print and complete Form 204/205, then mail it to your local Medicaid district office.

Alabama Community Transition (ACT) Waiver The ACT Waiver is for people who currently live in a nursing facility but wish to transition back to their home or another community setting. To qualify, you must have lived in the nursing facility for at least 90 days and plan to move back to the community within 180 days of your referral. The services you’ll receive at home will be determined by a case manager and Medicaid transition coordinator. In addition to personal care and housekeeping services, you may receive assistive technology, skilled nursing, medical supplies and home modifications, such as a wheelchair ramp.

In Alabama, nursing facilities are required to make an ACT referral on your behalf if you wish to return to the community. You can also self-refer through the Gateway to Community Living portal.

Personal Choices Program Seniors who currently receive care through a Home and Community-Based Waiver can opt into the Personal Choices program. The program provides a monthly allowance that can be used to hire the caregivers and services of your choice. Financial advisers can help you determine your needs and develop a budget for how to best spend your allowance.

Complete Form 204/205 and mail it to your nearest Medicaid district office to apply for the program.


How to Know if You're Eligible for Medicaid in Alabama

You must meet certain financial limits to be eligible for Medicaid in Alabama. The state’s income limits are $10,332 for a single person ($861 per month) and $15,372 for a married couple ($1,281 per month). Alabama Medicaid also has caps on the value of assets you can own, such as checking and savings accounts, investments, stocks, bonds and cash. The limit is $2,000 per single person and $3,000 for a two-person household.

2022 Medicaid Income Limits for Seniors in Alabama
Income Limits* Asset Limits
Single Person $10,332 $2,000
Two-Person Household $15,372 $3,000

*Per year

To qualify, you must also be a:

  • Resident of Alabama
  • U.S. resident, legal alien, U.S. national or permanent resident

How to Apply for Medicaid in Alabama

To apply online, visit the Alabama Medicaid Agency Expedite portal for Elderly and Disabled Programs. You’ll be required to upload proof of income and other supporting documents to submit your application. You can also print and complete Form 204/205 and mail it to your nearest Medicaid district office or drop it off in person.

What Information You Will Need

  • Proof of your monthly income (before taxes) and assets
  • A copy of your Medicare card and/or information about other health insurance you have
  • A copy of your Social Security card
  • Information about other members of your household, including their monthly income and relationship to you

How to Get Help Applying for Medicaid

If you need assistance with filling out your application or have questions about the enrollment process, there are several statewide resources available to help.

Contact Area Served Services Provided
Alabama State Health Insurance Assistance Program (SHIP) (800) 243-5463 Entire State Alabama SHIP provides information about various Medicaid programs and can walk seniors through the application process while answering any questions they may have. SHIP counseling is offered at Area Agencies on Aging throughout the state.
Legal Assistance Program (800) 243-5463 Entire State The Legal Assistance Program provides a variety of free legal services to seniors, including help with Medicaid eligibility, denials and appeals. Contact your local Area Agency on Aging to learn more.
Alabama Medicaid Contacts (800) 362-1504 Entire State Seniors can Contact Alabama Medicaid for answers to questions and information about its Home and Community-Based Waiver Programs. Staff can explain more about what each waiver covers and help you determine if you’re eligible to apply.


III. Can You Use Medicare to Pay for Home Care in Alabama?

Medicare doesn’t pay for non-medical home care, but it can cover the cost of the medical version of home care, called “Home Healthcare” in some situations. In order to be eligible, you need to be homebound and have a referral from your doctor for the specific type of medical care that is needed. There are also other restrictions that apply.

Below is an overview of some of the services typically covered by Medicare for those who are eligible:

  • Physical Therapy: Physical therapy is used to help patients recover from injuries (broken bones, knee injuries, etc.), and to treat ongoing conditions such as arthritis. Additionally, physical therapy is often provided in the home to help seniors recover from surgeries and procedures, such as a knee or hip replacement.
  • Nursing Care: Licensed nurses can provide a number of medical services (such as wound care, changing feeding tubes, etc.) for those who need medical care, but don’t need to stay in a hospital full-time.
  • Occupational Therapy: Occupational therapy is designed to help seniors regain or maintain the ability to accomplish normal, daily tasks, such as bathing, dressing, eating, etc., and providers can travel to your home if needed.
  • Speech Therapy: Seniors can lose the ability to adequately communicate for many reasons, and speech therapists are there to help seniors regain the ability to communicate using a variety of means. Additionally, speech therapists help to keep seniors independent by modifying diets and teaching special techniques to swallow safely.

As mentioned above, home care is distinctly different from home healthcare, but there is some overlap – so while Medicare doesn’t cover non-medical home care, there are personal care services that may be covered in special circumstances – such as an occupational therapist helping with eating or dressing.

Read our guide to Medicare and Home Care Coverage for more information.

IV. Other Financial Assistance Options for Home Care in Alabama

While the above programs can be a great way to make home care affordable for many people, they are not the right solution for everyone. Thankfully, there are other ways to make home care more affordable for you and your family. For more information about your other options, read our section on Other Ways to Pay for this guide.

V. Free Resources for Aging in Place in Alabama

If you’d like to live at home for as long as possible, there are many services and supports available to help. These include transportation to doctors’ appointments, home-delivered meals, financial assistance and more.

Contact Area Served Services Provided
Area Agencies on Aging (800) 243-5463 Entire State There are 13 Area Agencies on Aging (AAAs) serving the various regions of Alabama. Services offered may include public benefits counseling, future planning assistance, health promotion and family caregiver respite. AAAs also serve as a point of contact for the local long-term care ombudsman, who handles issues such as elder fraud and abuse.
Meals on Wheels (888) 998-6325 Entire State If you’re unable to grocery shop or prepare your own meals, and no one is available to prepare meals for you, Meals on Wheels may be able to help. Recipients of the program receive low-cost or free meals delivered to their door several days a week. Depending on where you live, other services may include free pet food, toiletries and wellness checks. The program also serves congregate meals at senior centers statewide.
Alabama Weatherization Assistance Program (334) 242-4909 Entire State Provided by Community Action Agencies throughout the state, this program aims to reduce energy costs for low-income residents through a variety of free weatherization services. Eligible seniors may receive a home energy audit, insulation for attics and walls, weatherstripping, window repair, ductwork sealing and upgrades to energy-efficient appliances and light bulbs. Visit the Weatherization Assistance Program website to find the Community Action Agency serving your county.
Low-Income Home Energy Assistance Program (LIHEAP) (800) 392-8098 Entire State LIHEAP provides financial assistance for households that need help paying their utility bills. The program prioritizes very low-income households with people who are elderly and/or disabled. To qualify, your household income must be at or below 150% of the federal poverty level. If you receive SNAP, SSI or TANF benefits, you automatically qualify for the program.
USDA Home Repair Program (334) 279-3400 Entire State This program provides grants to very low-income seniors to make repairs and remove safety hazards in their home. You can receive a lifetime maximum of $10,000 in grants and $40,000 in low-interest loans. To qualify, you must be aged 62 or older, a homeowner and unable to obtain credit for home repairs elsewhere.
Senior Ride Programs 2-1-1 Entire State Many organizations throughout Alabama offer free or low-cost transportation programs for seniors. Residents can get rides to doctors’ appointments, stores, senior centers and other destinations in their service area. These programs typically offer door-to-door transit for seniors who are unable to drive or ride the regular bus system. Depending on the program, wheelchair-accessible paratransit services may be available. Call 2-1-1 or visit its website to find a program near you.
Alabama Department of Revenue Homestead Exemptions (334) 242-1170 Entire State Alabama offers a homestead exemption that lowers the amount of property taxes seniors pay on their primary residence with property of up to 160 acres. The exemption is based on your age and household income. Very low-income people aged 65 or older and residents who are permanently disabled are fully exempt from the state portion of property taxes.

VI. Vaccination Requirements & COVID-19 Rules for Home Care Aides in Alabama

In Alabama, per the Centers for Medicaid & Medicare Services, all home health workers employed by agencies that participate in Medicaid and/or Medicare programs are required to be fully vaccinated against SARS-CoV-2. This is intended to help prevent the spread of COVID-19 and protect the health and safety of elderly residents. Alabama doesn’t have a vaccine mandate for home care agencies that don’t participate in Medicare or Medicaid.

These rules are current as of April 2022, but the guidelines may change, and home care agencies may have their own policies regarding vaccination requirements. Contact your local Area Agency on Aging if you have questions about COVID-19 vaccination requirements for workers entering your home.

VII. Rules and Regulations for Home Care Providers in Alabama

The Alabama Department of Public Health is responsible for regulating home care agencies throughout the state. Alabama only has regulations for agencies that provide home health care; there are no specific regulations for agencies providing regular home care without medical services.

What Types of Care Can Be Provided? Regular home care can provide assistance with activities of daily living, such as bathing, grooming, toileting, getting dressed and eating meals. It also includes companionship, chores, housekeeping and meal preparation. Home health care agencies can provide physical, speech, occupational and respiratory therapy, skilled nursing and medical equipment and supplies.
Are Care Plans Required? Alabama doesn’t have any specific care plan regulations for home care agencies; care plan requirements are only specified for assisted living and nursing facilities. For home health care, services are provided under a plan of treatment certified by the person’s physician.
Can Home Care Providers Assist with Medication Management? Registered nurses and other licensed medical professionals can dispense medications. Other home care workers may assist seniors with the self-administration of medication.
Are There Special Requirements for Screening Home Care Aides? Alabama doesn’t have any special screening requirements for regular home care workers. Registered nurse aides are required to pass a criminal background check.
Are Home Care Aides Required to Undergo Special Training? Alabama doesn’t require regular home care workers to have any special training or education. Registered nurse aides must be licensed and keep their license current.
Does Medicaid Cover Home Care in Alabama? Medicaid covers home care in Alabama through the Elderly and Disabled Waiver, Personal Choices program and the Alabama Community Transition (ACT) Waiver.
How Do I Report Abuse of Myself or a Loved One? To report abuse, call Alabama Adult Protective Services at (800) 458-7214 or contact a long-term care ombudsman via your local Area Agency on Aging.

VIII. How to Find a Home Care Provider in Alabama

Whether you are looking for yourself or a loved one, finding a quality home care provider can be a stressful process. To help you overcome this challenge, we’ve created a helpful checklist below that can help guide you through the process of both determining your needs, and finding a home care agency that will be the best fit for you and your family.

Download PDF Here

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