Alabama has a generally mild climate and an affordable cost of living, which may be why more than 18% of the population are seniors over the age of 65. To help meet the unique needs of this large and diverse population, the Alabama Department of Senior Services and numerous other organizations offer a variety of assistance programs and other services aimed at making it easier for residents to age in place. In-home care from private providers also tends to be fairly affordable, with the average monthly cost of only $3,432.

Keep reading to learn more about the cost of home senior care throughout Alabama, as well as programs designed to help seniors afford the care they need to age comfortably in place.

The Cost of In-Home Care in Alabama

In-Home Care Costs in Nearby States

The average senior pays about $3,432 a month for a home health aide in Alabama, according to the 2019 Genworth Cost of Care Study. That’s almost $1,000 less than the U.S. average of $4,385, making Alabama a generally affordable area to age in place. Most other states in the area are similarly affordable, with neighboring Mississippi averaging around $3,527 a month and Tennessee costing around $3,892. Florida is the most expensive neighboring state, with in-home care costing an average of $4,195.




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The Cost of In-Home Care in Alabama’s Top Cities

Comparing Costs Across Alabama

The cost of in-home care varies somewhat between Alabama’s largest cities, although most are within a few hundred dollars of the statewide average of $3,432. Huntsville is the most expensive city and biggest outlier, costing about $400 more each month than the state average. Birmingham and Mobile are closer to the average, though still $100 to $200 more expensive. Tuscaloosa and Montgomery residents can generally expect to pay around $200 less than average each month, making them the most affordable major cities in the state.











Financial Assistance for In-Home Care in Alabama

Personal Choices

The Personal Choices program is available to seniors on Medicaid who are eligible for the Home and Community-Based Waiver Services program. Designed to help low-income seniors stay in their homes for as long as possible, the Personal Choices program provides seniors with a monthly financial allowance. Recipients can use this money on any home care services needed, as well as other health essentials such as medical equipment. Financial advisors are also provided to help seniors decide how to spend the funds, but they do not make the final decision. People who receive Personal Choice funds can also save towards a major purchase, such as an assistive device that is not covered by Medicaid.

Who Is Eligible?
To qualify for the Personal Choices program, residents must be receiving Medicaid and be part of the Home and Community-Based Waiver Services program, which includes the Elderly and Disabled Waiver.

How to Apply
Seniors interested in the Personal Choices program can begin the application process by calling their local Area Agency on Aging at 1-877-425-2243.

Alabama Medicaid Elderly and Disabled Waiver Program

The Elderly and Disabled Waiver Program helps low-income seniors pay for homemaker services, personal care assistance, companion services, adult day care and other in-home care that they need to stay out of a nursing or long-term care facility. Recipients are assigned a caseworker to evaluate their unique needs and create a care plan, and the program can cover respite care for family caregivers. Eligible seniors may also receive meals through this program.

Who Is Eligible?
Seniors must be low-income and fall within Alabama’s Medicaid eligibility guidelines. They must also have health conditions that would require them to move into a long-term care facility without in-home care.

How to Apply
Seniors can apply for this waiver by contacting the Alabama Department of Senior Services at 1-800-243-5463.

Alabama CARES

Alabama CARES is the state’s caregiver assistance program. It is designed to help ease the burden that friends and family caregivers face when helping their elderly or disabled loved ones. Services vary depending on availability and eligibility, but financial assistance can include providing respite care so family members can take a break, as well as limited supplementary services. Caregivers can also use this program to learn about other resources available, as well as to take advantage of educational and training materials, such as the Caregiver College online program.

Who Is Eligible?
Any adult who acts as a primary caregiver for a senior over age 60 is eligible for support from Alabama CARES. People who care for younger adults are also eligible if the person has Alzheimer’s, dementia or other qualifying disabilities.

More Ways to Pay for In-Home Care

While the above programs help many people finance in-home care, they will not cover all costs for everyone. There are other ways to pay for in-home care, including out-of-pocket arrangements with siblings, annuities, reverse mortgages, private insurance, and more. Read’s Guide to In-Home Care Costs to learn more about these alternative payment options.

Free and Low-Cost In-Home Care Resources in Alabama

ContactArea ServedServices Provided
Goodwill Easterseals Gulf Coast251-300-6093Entire StateGEGC has a medical assistance and equipment loan program designed to help seniors with disabilities get the assistive devices they need to stay safe, healthy and comfortable at home. Other programs available to seniors include job training and placement, as well as a temporary emergency assistance program that can help with finances and household goods in a crisis.
Alabama Lifespan Respite Resource Network256-859-8300Entire StateAlabama Respite provides support services for family caregivers, including vouchers for respite care. It also provides emotional support and education, and it can help caregivers connect with other local resources.
Senior Ride205-322-5426Greater BirminghamSenior Ride provides qualifying low-income seniors with free transportation to medical appointments. These rides are provided by professional drivers in the community, but Senior Ride pays the fare. Wheelchair-accessible vehicles are available. Senior Ride is administered by Travelers Aid.
SenioRx1-800-243-5463Entire StateSenioRx is available to people aged 55 and over, as well as people with disabilities. It gives eligible low-income seniors a three-month supply of free or low-cost prescription medications. This program is managed by the Alabama Department of Senior Services.
Alabama State Bar Volunteer Lawyers ProgramEntire stateThe Volunteer Lawyer Program provides free or low-cost legal assistance to low-income Alabama residents. Specific services vary depending on availability, but may include consultations at walk-in clinics or by appointment.

In-Home Care Laws and Regulations in Alabama

Home health agencies (HHAs) are not required to be licensed in the state of Alabama, so regulations can be somewhat flexible. However, many agencies choose to become certified to provide Medicare and Medicaid services. These HHAs are overseen by the Alabama Department of Public Health.

Scope of CareHome care agencies provide assistance with daily tasks and companionship services. Licensed staff may provide occupational therapy, physical therapy and speech therapy. Registered nurses may perform skilled nursing tasks, including wound care, post-surgical care and intravenous therapy.
Care Plan RequirementsThere are no specific care plan requirements for home health agencies in Alabama.
Medication Management RequirementsRegistered nurses may dispense medications, and other aides may assist clients with self-administration.
Staff Screening RequirementsThere are no specific staff screening requirements for home health agencies in Alabama.
Staff Training RequirementsAides have no training requirements. Certified nursing aides and registered nurses must keep their licenses current and follow all licensing requirements.
Medicaid CoverageThe Elderly and Disabled Waiver program may cover some or all home care expenses if the services are provided by a state-certified agency.
Reporting AbuseAbuse should be reported to the state ElderCare hotline at 1-800-356-9596. It can also be reported to a long-term care ombudsman, which can be done in-person, by phone or by mail at any Area Agency on Aging.

Frequently Asked Questions

How Much Does In-Home Care Cost in Alabama?

The cost of home care varies depending on the amount of care needed, but homemaker services in Alabama cost about $3,394 a month on average, according to Genworth’s 2019 Cost of Care Survey. Home health care costs a little more, averaging $3,432 monthly.

Does Alabama Medicaid pay for in-home care?

Alabama Medicaid recipients who want to have home care covered need to receive a home and community-based waiver, such as the Elderly and Disabled Waiver. Seniors who qualify for the Personal Choices program can also use their monthly allowance to pay for in-home care. For Medicaid coverage to apply, the home health agency must be Medicare/Medicaid certified.

Are there transportation assistance programs in Alabama?

There are no government-sponsored or statewide transportation programs in Alabama. However, local charities do provide these services in some areas, such as Senior Ride in the greater Birmingham area. Some cities with public transportation also offer discounted bus fares and paratransit services.

What does it mean to age in place?

Aging in place means that a senior citizen is able to remain in their own home for as long as possible, even as their needs begin to change. This is typically accomplished by changing the home to suit the senior’s needs, such as by installing ramps for seniors with mobility issues. Many seniors also rely on home care providers during this time.

What are “Activities of Daily Living”?

“Activities of daily living” is a general term used to describe basic self-care routines that allow people to live independently. These include bathing and grooming, getting dressed, preparing and eating food, and using the toilet. Transferring between sitting, standing and reclining is also included, as is being able to move around freely and safely.

Home Care Services in Alabama (162)