Memory Care in Alabama

Table of Contents

Memory Care in Alabama

Table of Contents

• The Cost of Memory Care in Alabama
• Alabama Medicaid Programs for Memory Care
• Can You Use Medicare to Pay for Memory Care in Alabama?
• More Ways To Pay for Memory Care in Alabama
• Memory Care Laws and Regulations in Alabama
• Free and Low-Cost Resources for Seniors in Alabama

Because of the specialized staff training and resources required to provide high-quality memory care, memory care typically costs more than other types of residential care. On average, memory care will cost 20-30% more than assisted living.

To calculate memory care costs, we added 25% to the assisted living costs reported in the 2021 Genworth Cost of Care Survey.

In Alabama, the average cost of memory care is $4,379, which is over $1,000 less than the national average of $5,625. Communities in Alabama charge a similar amount to those in Georgia ($4,419) and Mississippi ($4,375). However, the average costs of memory care are higher in Florida and Tennessee at $5,000 and $5,131, respectively.

The costs of memory care vary across the state of Alabama. Seniors residing in the capital city of Montgomery pay an average of $4,375, while those in the coastal city of Mobile pay around $4,404 per month. The most affordable options can be found in Dothan ($2,688) and Gadsden ($3,504). Anniston is the highest-cost option at an average of $5,964 each month.

In Alabama. Medicaid covers some of the costs of memory care through its Elderly and Disabled Waiver Program. Services that are covered by Medicaid include meals, transport, case management and personal care. The number of services offered to seniors is dependent on the severity of their care requirements. The aim of this program is to avoid or delay nursing home placement by providing the required services in a residential community or home setting.

• Who Is Eligible: Applicants must require a nursing home level of care, be a U.S. citizen or legal resident, reside in Alabama and meet certain financial requirements.
• How To Apply: Seniors or their loved ones can contact their local Area Agency on Aging to start the application process.

SAIL Waiver Program

The State of Alabama Independent Living Medicaid Waiver Program (SAIL) aids seniors with neurological conditions such as Alzheimer's and Parkinson's. The program covers the cost of in-home care services and thereby helps delay the move to a nursing home facility. It's operated by the Alabama Department of Rehabilitation Services. A range of care services is offered, including personal emergency response systems, personal care, case management, medical supplies and assistive technology. All services must be supplied by a Medicaid-certified home care agency. 

• Who Is eligible: Applicants must qualify for nursing home care and be diagnosed with a neurological disorder. The onset of the disorder must have occurred before the age of 60. Applicants are required to be citizens or legal residents and currently reside in Alabama and must meet the financial requirements as set out by the state.
• How To Apply: Seniors can apply for this program by contacting the Alabama Medicaid Office at (800) 362-1504

Medicaid Eligibility for Seniors in Alabama

Medicaid eligibility is based on several factors, including age, income and disability status. Income levels can't exceed $2,523 per month for individuals and $5,046 for couples. Single households have an asset limit of $2,000; for two-person households with both persons applying, the limit is $4,000.

2022 Medicaid Income Limits for Seniors in Alabama

In order to qualify for Medicaid in Alabama, seniors must meet certain additional requirements. These include being a citizen or legal resident of the United States and currently residing in Alabama. Seniors must be at least 65 years of age or be disabled. Applicants will need to provide proof of citizenship, age and income.

Eligibility requirements: 

• U.S. citizen or legal resident
• Alabama resident
• Age 65 years or older, or 
• Under 65 and blind and/or disabled 

In addition, applicants must provide the following documents:

• Medicare and Social Security cards
• Deeds to any owned property
• Power of attorney documents
• Bank statements for the past 60 months
• Copies of burial arrangements
• Copies of all insurance policies
• Proof of citizenship or legal resident status

How To Get Help Applying for Medicaid in Alabama

Seniors and their loved ones who require assistance navigating the complex application process have several options in Alabama. The Alabama Medicaid Office and the Alabama Department of Senior Services both provide telephonic and in-person assistance.

Unfortunately, Medicare does not generally cover the cost of Memory Care. Most Memory Care Facilities are considered to be "social settings," so Medicare does not cover the cost incurred in these facilities. The only exception to that is if you are receiving memory care services in a Nursing Home. While this situation is much less common, Medicare would sometimes cover the cost, depending on a number of circumstances.

That being said, Medicare does still cover qualified doctor visits, medications, etc., as it would if you were still at home, but it will not cover the cost of care received at the Memory Care Facility.

In addition to the state programs mentioned above, those looking for resources to finance memory care may consider:

• Long-Term Care Insurance: Depending on the policy details, long-term care insurance may be used to pay for memory care services. It's best to sign up for a policy early, as coverage will likely be denied if one already has long-term care needs. More information about the intricacies of long-term care insurance can be found at longtermcare.acl.gov.
• Reverse Mortgages: Reverse mortgages allow some homeowners to take out a loan as an advance from the eventual sale of their primary residence. This can be a good way to fund memory care in the short-term, but the loans will need to be paid back after the sale of the home. The most commonly used type of reverse mortgages for seniors is the Home Equity Conversion Mortgage, which is the only reverse mortgage insured by the federal government.
• Veterans Benefits: The Department of Veterans Affairs offers several programs that veterans and their spouses may use to cover health care needs such as memory care. More information about these programs can be found on the VA website.

Memory Care Regulation

In Alabama, memory care services are provided in specialty care assisted living facilities, which are assisted living facilities that accommodate residents with severe cognitive impairments. These facilities are licensed by the Alabama Department of Public Health and certified by the Board of Health. They are monitored through random inspections by the Board of Health, and they must renew their licenses on an annual basis.

Facility Scope of Care

Prior to admission, specialty care assisted living facilities must screen prospective residents to evaluate their clinical history, mental status, physical function and behavioral health. Facilities must provide assistance with the activities of daily living, health monitoring and services and medication services. These facilities are also required to implement a daily activity program to meet residents' individual needs and provide general observation and health supervision to track changes in health condition, or physical or cognitive abilities.

Admission Requirements

While specialty care assisted living facilities may admit a wide range of residents, there are certain restrictions as well. The below table gives an overview of admission requirements.

Residents Who May Be Admitted

• Those with Alzheimer's disease, related dementias or a degree of cognitive impairment that would make them ineligible for admission to an assisted living facility
• Those who are incapable of self-care tasks but have sufficient cognitive ability to direct others to provide assistance

Residents Who May NOT Be Admitted

Those who:

• Require medical or skilled nursing care for an acute or chronic condition that is expected to exceed 90 days
• Have a wound that needs care beyond basic first aid
• Cannot make decisions related to personal safety
• Cannot direct their care
• Pose a danger to themselves or others

Care Plan Requirements

Within 30 days prior to admission, a prospective resident must have a medical examination conducted by a physician, and a plan of care must be developed by the facility, the client and if appropriate, the client's sponsor. Each resident is given an annual physical exam and monthly assessments by the facility that identifies changes to their weight and ability to self-administer medication. Additionally, comprehensive assessments must be completed for residents who experience a decline in health status or behavior, significant weight loss, two or more falls in a 30-day period, adverse reactions to prescribed medications, harmful behavior or an accident that results in an injury.

Medication Management Requirements

A resident may keep, manage or self-administer their own medications if they have a physician's order, or they may receive assistance with self-administration by any assisted living facility staff member. Medications that are managed and kept in custody by the facility must be unit-dose packaged.

A resident in a specialty care assisted living facility who is unable to self-administer medications may have medications administered only by an RN, a physician or an LPN who is currently licensed in Alabama.

Facility Requirements

Units in specialty care assisted living facilities may be single or double occupancy. Bathrooms and bathing facilities may be shared, and there must be at least one bathtub or shower for every eight residents and one toilet and sink for every six residents. Facilities must have a secure perimeter to safely accommodate residents who may wander. Exterior doors must have either panic hardware or electrically controlled door hardware, and locks on exterior doors must be electrically locked or electrically delayed-egress locking devices.

Staffing Requirements

Specialty care assisted living facilities must have an administrator, a medical director, at least one RN, a unit coordinator and a staff of personal care providers. Minimum staffing levels depend on the size of the facility and the time of day, but there must be at least two staff members on duty at all times. If necessary, the facility must exceed minimum staffing requirements to ensure residents' needs are met.

There must be at least one CPR-certified staff member on-site at all times, and facilities with an AED machine must have a staff member who has up-to-date certification from the American Heart Association or the American Red Cross in AED utilization.

Medicaid Policy

Alabama doesn't provide public funding for specialty care assisted living facilities through Medicaid or non-Medicaid programs.

Reporting Abuse

Anyone who has a concern or complaint regarding a resident's quality of care or treatment in a specialty care assisted living facility should contact the state's Long-Term Care Ombudsman office. Complaints can be filed in writing, over the phone or in person by contacting the local Area Agency on Aging office.

Seniors and their loved ones in Alabama will find a variety of resources to provide information, support and assistance as needed.