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Assisted Living in Alabama
Alabama has a population of slightly over 5 million, with 17.3% of that total seniors aged 65 and older. Alabama is an increasingly popular destination for seniors. Its year-round warm climate is attractive, and the state does not tax income received from Social Security or pensions, so seniors here have more money to pay for assisted living.
In our Senior Living Report 2024, Alabama ranked 38th overall but 8th in senior housing and 9th in community involvement. However, it ranked last in quality of life and 33rd in affordability. Several excellent hospitals operate in the state, including the University of Alabama at Birmingham Hospital, nationally ranked in eight specialties, and the Huntsville Hospital.
Alabama offers three kinds of assisted living communities, organized by the number of people who reside in each facility:
- A facility with two to three residents is known as family assisted living
- A facility with four to 16 residents is known as group assisted living
- A facility with 17 or more residents is known as congregate assisted living
This guide will focus on the cost of congregate assisted living facilities, which is $3,503 per month, and show how it compares to costs in other states and cities within Alabama. It also explains how to get help paying for assisted living through Medicaid, Medicare and other options and highlights free resources available to seniors in the state. At the end of the guide, seniors can review the rules and regulations assisted living facilities must abide by in Alabama.
The Cost of Assisted Living in Alabama
When trying to decide how to pay for assisted living, one of the first questions that comes up is "How much does it cost?" With the impact of inflation, it's more important than ever to have up-to-date information when making a financial plan for senior living. To help shed light on real senior living prices, Caring.com has compiled proprietary cost data from its network of over 75,000 senior living providers to offer insight into the average cost of assisted living in Alabama and its 16 cities.
The Cost of Assisted Living in Alabama's Top Cities
Alabama’s average assisted living rate is $3,798 for 2023, slightly lower than Huntsville at $3,858, one of its top cities. Other top cities in this state where rates are comparable include Decatur at $3,353 and Hoover at $3,283. However, looking at Birmingham, the average charge of $6,040 for assisted living differs drastically from the state average. Because of these fluctuations, comparing alternatives before settling on one is advisable.
Alabama
$3,798
Huntsville
$3,858
Birmingham
$6,040
Decatur
$3,353
Hoover
$3,283
Inflation's Impact on the Cost of Assisted Living in Alabama
Inflation applies everywhere, including Alabama, where costs rose by 14.53% from $3,316 to $3,798. Similarly, the national average increased, but by a lower 9.55%, from $4,070 to $4,459.
In neighboring Tennessee, costs increased by 24.17% to $4,201. However, Georgia only underwent a minor 5.95% change to $3,952, while Mississippi prices grew 8.20% to $3,996. Florida’s inflation hike was more in line with the national average at 9.12%, moving its rates to $4,067. Variations like these show the need to be careful when choosing where to go for assisted living.
| Location | 2022 Cost (Historical) | 2023 Cost (Current) | 2024 Cost (Estimated) |
|---|---|---|---|
| Alabama | $3,316 | $3,798 | $4,045 |
| U.S. Average | $4,070 | $4,459 | $4,802 |
| Tennessee | $3,383 | $4,201 | $4,543 |
| Georgia | $3,730 | $3,952 | $3,895 |
| Mississippi | $3,693 | $3,996 | $3,881 |
| Florida | $3,727 | $4,067 | $4,438 |
The Costs of Other Types of Senior Living
Senior living rates in Alabama vary substantially from $2,754 for independent living to $3,798 for assisted living and $4,769 for memory care. These cost variations are primarily due to specific care levels, facilities, amenities, and other benefits. Independent living is usually the lowest because it offers access to nearby care, whereas assisted living provides additional care. Likewise, memory care includes expert support that the other two don’t require. Due to these care levels, seniors should explore their options and choose the best care that meets their needs.
Assisted Living
$3,798
Memory Care
$4,769
Independent Living
$2,754
Does Medicaid Cover Assisted Living in Alabama?
No. While Alabama’s Medicaid program offers numerous options for people who need skilled nursing care, it doesn’t provide any coverage for assisted living. Alabama offers several Medicaid waivers, but they are all oriented towards delivering coverage for seniors who have been in nursing care but wish to return to their homes or communities. In rare cases, seniors might be able to use Alabama’s Elderly and Disabled Waiver to help pay for some costs in a small assisted living facility. Alabama also offers a state supplement to people receiving Supplemental Security Income (SSI), but this is for in-home care.
| Household Size | Number of Applicants | Income Limits Per Year* | Asset Limits: Applicant(s) | Asset Limits: Non-Applicants |
|---|---|---|---|---|
| One Person | 1 | $32,904 | $2,000 | |
| Two People | 1 | $32,904** | $2,000 | 148,620 |
| Two People | 2 | $65,808*** | $4,000**** |
*Depending on the facility setting, a recipient may not be able to keep income up to this level.
**Income limit is for applicant only.
***Income is limited to $2,742 per month per spouse.
****Assets are limited to $2,000 per spouse.
Does Medicare Cover Assisted Living in Alabama?
The short answer is that no, Medicare does not cover the cost of assisted living in Alabama. Assisted living facilities are considered to be a “residential setting” and not a “clinical setting,” (think nursing homes). While Medicare doesn’t cover the cost of care received in an assisted living community, it does still cover things like approved medications, doctor visits, medical equipment, etc., just like it would if you lived at home.
For more information about when Medicare can be used to pay for senior living in a nursing home, and for Medicare-related resources, see our guide to Nursing Homes in Alabama.
Paying for Assisted Living Facilities in Alabama
The Alabama Department of Senior Services offers the Elderly and Disabled Waiver, which helps elderly and disabled Alabamians retain their independence while also receiving proper care. Participating seniors work with a case manager who designs a plan around each person's individual needs. Services include meal delivery, companionship, help with personal care and more.
To be eligible, applicants must:
- Demonstrate financial need according to Medicaid guidelines
- Be at risk of placement in a long-term care facility
To learn more about eligibility requirements, call (800) 243-5463 or visit the Alabama Department of Senior Services website.
Other Financial Assistance Options for Assisted Living in Alabama
Seniors who are not eligible (due to location, financial situation, or other factors) for other types of financial assistance, do still have some options. See the table below for an overview of some of the most common ways to make Assisted Living affordable.
| Name | How To Apply | How It Works |
|---|---|---|
| Aid and Attendance | Learn more and apply online at va.gov. | Veterans who receive a VA pension may also be eligible for the Aid and Attendance benefit, a monthly cash allowance that veterans receive in addition to their standard pension amount. The benefit is intended for veterans in need of long-term care services and may be used towards paying for Assisted Living. |
| Reverse Mortgages | Learn more about your options and how to apply at ftc.gov | If you own a home, you may be able to use a reverse mortgage to help pay for Assisted Living. Reverse mortgages are loans that one can take out against the value of their home, essentially converting some of the home's equity into cash. Reverse mortgage loans do need to be repaid with interest, typically within 12 months of receiving the loan. |
| Long-Term Care (LTC) Insurance | Learn more about Long-Term Care Insurance and how to apply for a policy at acl.gov. | Seniors who already have long-term care insurance may be able to use it to pay for Assisted Living. Most policies cover at least a portion of the cost, but it depends on the specific policy terms. Note that older adults who are already in need of Assisted Living will not typically be eligible to sign up for a LTC insurance policy. |
Free and Low-Cost Resources for Seniors in Alabama
There are many resources in Alabama that assist seniors in their retirement. caring.com has compiled information on local organizations, programs and agencies and categorized them into care types for easy reference.
Area Agency on Aging
Retirees can find support and advice on various senior-related issues from their local Area Agency on Aging. The agency provides advice on topics such as financial assistance programs, in-home care and long-term care planning. It also connects seniors and caregivers with community-based resources.
| Program Name | Phone Number | Description |
|---|---|---|
| Alabama Area Agency on Aging | Alabama's Area Agencies on Aging (AAA) serve as critical access points to numerous resources designed to meet the needs of older adults. Seniors contacting the AAA may receive access to benefits such as senior nutrition programs, transportation assistance and referrals to local assistance programs. It can also connect seniors to services for home-delivered meals, discounted prescriptions and assistance with household chores. Seniors can also be empowered through legal and insurance counseling services or be provided advocates through long-term care ombudsmen. |
Cash Assistance Programs
Cash assistance programs in Alabama provide financial support to help low-income retirees remain in their own homes for as long as possible. Seniors and caregivers can apply for tax rebates and reductions, discounts on vital services and help covering the cost of heating and cooling their home.
| Program Name | Phone Number | Description |
|---|---|---|
| Alabama Lifeline Program | 800-234-9473 | The LifeLine Program offers a discount on landline or mobile telephone service, ensuring that participants can stay in contact with loved ones. |
Financial Assistance for Senior Care and Senior Living
Whether living in their own home or in a senior living community, Alabama seniors can find financial assistance from numerous local resources. These organizations help residents cover some of the costs associated with in-home or long-term care and connect them with other helpful community-based resources.
| Program Name | Phone Number | Description |
|---|---|---|
| Alabama Elderly and Disabled Waiver | 877-425-2243 | The Elderly and Disabled Waiver helps seniors pay for services at home and in alternative residential care instead of nursing home admission. The waiver provides home- and community-based services, including housekeeping, dressing, grooming, meal prep and transportation. It doesn't cover the cost of room and board. This program isn't an entitlement program, which means only a limited number of individuals receive the waiver each year. |
| Alabama Senior Discounts | 205-333-2990 | Many retailers, restaurants and other companies give elderly Alabama residents discounts on their products and services. Older adults can find information on Alabama senior discounts via the Area Agency on Aging of West Alabama. The agency lists each organization together with the discount or special offer provided and the age requirements that seniors have to meet to qualify for individual discounts and deals. |
Food Assistance Programs
Local organizations help ensure elderly citizens have a balanced diet and receive essential vitamins and minerals to remain healthy. Through nutrition programs, congregate meals, home-delivered meals and food pantries, these programs help Alabama seniors afford the nutritious food they need.
| Program Name | Phone Number | Description |
|---|---|---|
| Alabama Elderly Nutrition Program | 877-425-2243 | The Alabama Elderly Nutrition Program offers nutritious meals to seniors aged 60 and above across the state. With over 335 senior centers providing congregate meals and home-delivered options for those who qualify, ENP aims to fulfill at least a third of seniors' dietary needs. The facility, managed by registered dietitians, also offers nutrition education and wellness programs, promoting overall health and well-being among Alabama's elderly population. |
| Alabama Food Assistance | 866-465-2285 | The Alabama Food Assistance program strives to combat food insecurity by providing essential benefits to eligible low-income seniors and others who may be struggling to get proper nutrition. Through this initiative, Alabama takes a significant step toward addressing food insecurity, underscoring its commitment to the well-being of its residents. |
| Alabama Meals on Wheels | Meals on Wheels operates in multiple communities throughout Alabama to address isolation and hunger in older adults. The program delivers meals five days a week to individuals incapable of preparing their own food, accessing food sites that offer food or those unable to afford meals. |
Free Used Medical Equipment
Due to the high cost of purchasing new medical equipment, several organizations in Alabama collect lightly used medical devices such as wheelchairs, ramps and walkers and distribute them to local seniors and residents in need.
| Program Name | Phone Number | Description |
|---|---|---|
| Alabama CARE Project | 334-387-3261 | The CARE Project helps connect seniors with no-cost medical equipment that it has cleaned, disinfected and refurbished. Equipment types include wheelchairs, wheelchair ramps, seat lift chairs, breathing equipment, canes, crutches and walkers. The organization also distributes communication devices such as computers and computer equipment. |
| Alabama Statewide Technology Access and Response (STAR) | STAR is a program administered by the Alabama Department of Rehabilitation Services. It connects disabled adults with assistive technologies, including specialized computer software, communication devices, adaptive switches, auditory trainers, Braille readers, scooters, wheelchairs, adaptive vehicles and lifts and ramps. | |
| Alabama Waste-Not Program | 256-837-2373 | The Waste-Not Program provides free assistive technologies and free medical equipment, including wheelchairs, scooters, hospital beds, bath and shower aids, canes and walkers to needy individuals. The program serves individuals in Huntsville and Madison Counties and works to improve the overall quality of life of seniors and families throughout the community. |
Home Repair and Modifications
Seniors and those with disabilities can access a variety of local resources to help them pay for home repairs and modifications. Programs in Alabama have different eligibility criteria and often assist retirees by providing grants or loans.
| Program Name | Phone Number | Description |
|---|---|---|
| Alabama Single Family Housing Repair Loans and Grants | This program provides loans to households with very low incomes for repairs and improvements and to help modernize their dwellings. Recipients may use loan and grant proceeds to remove health and safety hazards. | |
| Alabama Weatherization Assistance Program | 334-242-4909 | This program provides weatherization assistance to help households reduce their energy costs. Assistance typically includes installing attic, wall and floor insulation, sealing ductwork, HVAC repairs and replacements, repairing leaky faucets, upgrading windows and doors and replacing incandescent lighting with energy efficient bulbs. |
Social Security Offices
Social Security offices in Alabama help seniors and disabled people access the benefits they're entitled to. Older adults can contact their local office for information about receiving retirement benefits, disability allowance and Supplemental Security Income.
| Program Name | Phone Number | Description |
|---|---|---|
| Alabama Social Security | Social Security is a source of income available to retirees and people who can no longer work because of a disability. The money for Social Security comes from a payroll tax levied on employers, employees and self-employed individuals. When you retire, you'll receive monthly payments based on how much you earned when you were working. |
Utility & Energy Bill Assistance
Low-income seniors who are struggling to meet the costs of maintaining their homes can find support from organizations that offer assistance with utility and energy bills. Alabama retirees could also qualify for emergency funding programs if they're in danger of losing utility services due to unpaid invoices
| Program Name | Phone Number | Description |
|---|---|---|
| Alabama Low Income Home Energy Assistance Program (LIHEAP) | 800-392-8098 | LIHEAP helps families on limited budgets pay their heating and cooling bills, especially those who are under threat of disconnection. The program makes a one-time payment directly to the utility company for one season based on past energy usage. |
Veteran's Services
Alabama retirees who have served in the U.S. military can find support from local veteran services. These offices and organizations help vets access the benefits they're eligible for and provide advice and information on a variety of issues.
| Program Name | Phone Number | Description |
|---|---|---|
| Alabama VA Benefits and Health Care | Alabama VA Benefits and Health Care, a comprehensive resource for senior veterans, provides various medical and financial resources, from primary care to general benefits information. In addition to physical therapy, mental health support, caregiver assistance and prescription drugs, Alabama veterans can access help with disability compensation, pensions and VA home loans. The program also assists with burials and memorials, ensuring respect and support for survivors during difficult times. |
Assisted Living Laws and Regulations in Alabama
The Alabama Bureau of Public Health, Bureau of Health Provider Standards, regulates rules and regulations for assisted living facilities in Alabama. The Bureau ensures that all facilities maintain proper living conditions for residents.
| Topic | Rule |
|---|---|
| Assisted Living Service Plan Requirements | Before they can be admitted, physicians examine potential residents to determine their healthcare needs. That exam helps the physician and the facility develop a comprehensive care plan. Service planning includes not just the physician but also the resident and, if the resident chooses, a third-party representative. |
| Assisted Living Admission Requirements | While most seniors who require assistance with ADLs can reside in an assisted living facility in Alabama, facilities cannot admit seniors who need restraints, can't understand the in-house medication system, require daily skilled nursing care or have been diagnosed with severe mental health issues or cognitive impairment. Facilities can make exceptions for seniors who require care for 90 days or less if they are receiving hospice care for a non-cognitive condition. |
| Assisted Living Scope of Care | Assisted living facilities must provide general health supervision, medication assistance, housekeeping, laundry and transportation to medical appointments. They must also aid with ADLs, including bathing, manicure/pedicure, food service, personal safety, shaving, and hair care. An outside agency or hospice care organization working with the facility can provide some of these services. |
| Assisted Living Medicaid Policy | While Medicaid does not cover assisted living facilities in Alabama, there is an outside chance some seniors may be able to use the Alabama Medicaid Elderly and Disabled Waiver. Normally this waiver assists seniors receiving in-home care, but seniors can occasionally justify its use in a small assisted living facility. Many facilities also do not accept any payments using this waiver, so it's essential to check with the facility to see if they accept it. |
| Assisted Living Facility Requirements | Units in Alabama can be single or double occupancy. Apartment-style living is not required. Units can share bathrooms and showers or tubs, but there must be at least one sink and toilet for every six residents and at least one shower or bathtub for every eight residents. |
| Medication Management Regulations | Residents can administer their medication if they are considered competent. They can also ask for assistance from licensed or unlicensed staff members. Staff can help residents remember to take their medications, and open those medications, but they cannot administer the medication. They may not give injections or prepare medications in any other way, including in food or feeding tubes. Staff must record every medication in the resident's medication administration record. |
| Staffing Requirements | There are no minimum staff-to-resident ratios for assisted living facilities in Alabama. All facilities need an administrator and personal care staff. If the facility plans to administer medication, it must have a registered nurse or licensed practical nurse (LPN). All facilities must have an automated external defibrillator (AED). There must always be one Red Cross- or American Heart Association-certified employee on site. Also, at least one employee must be approved in CPR. |
| Staff Training Requirements | Assisted living staff must be trained upon hire and then regularly on the following subjects: • Federal, state and facility-specific laws and policies • Guidelines for spotting and reporting abuse, neglect or exploitation of seniors • First aid • Basic elderly nutrition • Fire safety • Indications of dementia • Facility administrators must annually complete at least 6 hours of continuing education |
| Background Checks | Everyone considered a worker at an assisted living facility, including contract employees, volunteers and applicants, must undergo a background check and be fingerprinted. No one who appears on the Alabama Department of Public Health Nurse Aide Abuse Registry can be employed in a long-term care facility. |
| Reporting Abuse | Caregivers in Alabama assisted living facilities legally must report suspected senior abuse or exploitation. “Abuse” includes causing pain or injury, intentional deprivation of care, refusing to provide essential services such as food and shelter, reckless infliction of anguish or exploitation of an individual or their resources. Whenever a staff member or employee witnesses or suspects a case of abuse or neglect, they should report it to the Abuse Hotline at (800) 458-7214. |
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