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 2022, 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

Alabama has some of the lowest costs for assisted living in the country. According to the Genworth Cost of Care Survey 2021, the average monthly cost of assisted living in Alabama is $3,503. That’s approximately $1,000 a month less than the national average of $4,500 per month. It’s $3 a month more expensive than Mississippi’s monthly average of $3,500. Georgia is slightly more expensive than Alabama, with a monthly assisted living average of $3,535. Florida is about $500 a month more costly at $4,000. Tennessee has the highest cost of assisted living in the states surrounding Alabama at $4,105 a month.

$3503

Alabama

$4500

The United States

$3535

Georgia

$4000

Florida

$3500

Mississippi

$4105

Tennessee

Assisted living prices in Alabama cities vary, but for the most part remain within several hundred dollars of each other. Dothan is the least expensive, with an assisted living cost of $2,150 per month. Tuscaloosa, home to the University of Alabama, is $3,150 a month. Huntsville, now the largest city in Alabama and known as the Rocket City because of its historic ties to the space industry, averages $3,345 per month. Decatur costs $3,345 a month. Montgomery, the state capital, mirrors the state average of $3,500 a month. Mobile on the Gulf Coast is slightly more expensive at $3,523 per month. Just across the harbor from Mobile, assisted living in Daphne runs an average of $3,988 a month. Birmingham has the highest cost of assisted living at $4,028 a month.

$3988

Daphne

$2150

Dothan

$3523

Mobile

$3500

Montgomery

$3150

Tuscaloosa

$4028

Birmingham

$3345

Huntsville

$3439

Decatur

Residents of Alabama have several other options for senior care. Home care, which includes assistance with many ADLs such as personal care, laundry, groceries and house cleaning costs $3,813 a month. Home health care, which includes some medical aid, is slightly more expensive at $3,851 a month. Adult daycare is the least costly option in Alabama at $758 a month. A semiprivate room in a nursing facility averages $6,676 a month.

$3813

Home care

$3851

Home healthcare

$758

Adult daycare

$3503

Assisted living

$6676

Nursing Home Care (semiprivate)

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.

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.

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.

 

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

While not all seniors may live on a fixed income, it is vital to keep their budgets under control. The following section presents some resources that can help seniors with that budget and provide them with resources to assist them with legal issues, prescription drug costs, and how to deal with allegations of abuse or neglect.

Resource

Contact

Service

(800) 243-5463 

The 13 Areas Agencies on Aging Alabama cover the 67 counties in Alabama. They work closely with Aging and Disability Resource Centers (ADRCs) to provide important information and access to resources for seniors. When these resources aren't available, agencies work with local organizations to put them in place. The ADRCs help seniors make informed choices about their services and supports.

(800) 243-5463

The ombudsmen of the Alabama Long-term Care Ombudsman (LTCO) program advocate for seniors who have made allegations of neglect or abuse against an LTC facility. The ombudsman investigates alleged complaints and works to resolve issues between seniors and facilities. Ombudsmen also help advise seniors on Medicare or Medicaid billing issues and how they can appeal decisions that have resulted in a denial of service. Ombudsmen also educate the broader community about the rights of seniors in long-term care facilities.

334-242-5077

The Alabama Department of Veterans Affairs operates four veterans' homes through the Alabama Veterans Homes program. These veterans' homes are a very affordable assisted living solution for senior veterans, their spouses or survivors. Applications may be obtained from local veterans' service offices or downloaded from the Alabama State Veterans Home Program website.

(334) 262-5523

A nonprofit 501(c)4 corporation dedicated to promoting excellence in all aspects of assisted living in Alabama, the ALAA provides information to consumers about assisted living facilities in the state, including a complete listing of all available facilities. Seniors considering an assisted living facility can access a compilation of facts and figures about assisted living to help them in their search for the right community.

(800) 243-5463

Seniors across Alabama can access the Legal Assistance Program. The Legal Assistance Program provides services free of charge, protecting and securing the rights, benefits and dignity of adults aged at least 60 in Alabama. Seniors can work with legal professionals on several personal legal issues. These issues include advice and counseling, legal representation, preparation of legal documents, negotiation estate planning, Medicaid eligibility, landlord/tenant issues, contract disputes and debt collection. All of the Legal Assistance Program's services are provided free of charge.

(800) 243-5463

SeniorRX helps seniors aged at least 55 who've been diagnosed with chronic medical conditions requiring regular medication. The program helps seniors who need medications but may have difficulties paying for them to prevent more serious medical complications in the future. People who qualify for the program receive a free or low-cost three-month supply of medications from various pharmaceutical companies. If the senior remains eligible for the program, their prescriptions can be renewed.

COVID-19 Rules for Assisted Living in Alabama

The following information is based on research done on several government websites. These rules apply to nursing homes and other types of senior living facilities. We’ve most recently updated this data on 4/22/2022, but since COVID-19 is a rapidly evolving pandemic, contact your local senior living facility or Area Agency on Aging for more specific and up-to-date information.

Visitation Policies

Rules for Alabama Communities

Are loved ones allowed to visit to provide emotional support?

Not Available*

Are relatives allowed to visit for end-of-life care?

Not Available*

Are residents required to quarantine after visiting with a loved one?

Not Available*

Are visitors required to wear PPE (including masks) in order to visit residents?

Not Available*

Are non-medical contractors (such as hairdressers and entertainers) allowed in senior living facilities?

Not Available*

Are visitors checked for elevated temperatures?

Not Available*

Are visitors required to answer questions about health, travel, and potential virus contact?

Not Available*

*Note: This information was not available for this state, contact your local area agency on aging or senior living facility for more information.

Outings & Social Activities

Rules for Alabama Communities

Are residents allowed to leave (errands, visiting family, etc.) for non-medical reasons?

Not Available*

Are residents who leave required to quarantine when they return?

Not Available*

Are senior living communities required to cancel all group outings?

Not Available*

Are residents allowed to eat meals together in a common area?

Not Available*

Are residents allowed to gather in common areas for group activites?

Not Available*

*Note: This information was not available for this state, contact your local area agency on aging or senior living facility for more information.

COVID-19 Safety Measures for Staff and Residents

Rules for Alabama Communities

Are staff members regularly required to do a temperature check?

Not Available*

Are staff members regularly tested for COVID-19?

Not Available*

Are staff members members regularly required to do a health and safety screening, including questions about travel, contact with positive cases, etc?

Not Available*

Are residents regularly screened for COVID-19 symptoms?

Not Available*

Are residents regularly checked for elevated temperatures?

Not Available*

Are residents regularly tested for COVID-19?

Not Available*

*Note: This information was not available for this state, contact your local area agency on aging or senior living facility for more information.

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.

ALABAMA LAWS AND REGULATIONS

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. The creation of this plan of care includes input from physicians, residents or their third-party representatives.

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. Facilities can make exceptions for seniors who require care for 90 days or less if they are receiving hospice care for a non-mental health issue.

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 understand their medical conditions and are judged to be competent. They can also ask for assistance from licensed or unlicensed staff members.

Only medication packaged in single-dose units can be stored in the facility. Staff can help residents remember to take their medications, open them or pour liquid medications, but they cannot administer the medication. They may not give injections or prepare medications in any other way. Staff must record every medication given in the resident's medication administration record.

Staffing Requirements

No minimum staff-to-resident ratios exist for assisted living facilities in Alabama. All facilities need an administrator to oversee operations and personal care staff to provide resident care. If the facility plans to administer medication, it must have a registered nurse or licensed nurse practitioner and staff.

All facilities must have an automated external defibrillator (AED). There must always be one employee on-site certified in its use by the American Red Cross or the American Heart Association. 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 an LTC facility.

Reporting Abuse

All staff and employees in assisted living facilities in Alabama are legally required to report suspected abuse or exploitation of seniors. These include 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, it should be reported to local law enforcement or to the Abuse Hotline at (800) 458-7214.