What is the Alabama Elderly and Disabled Waiver?
The Elderly and Disabled (E&D) Waiver is Alabama's 1915(c) Medicaid waiver for older adults and people with disabilities at risk of nursing facility placement; a case manager builds a person-centered plan that can include personal care, homemaker, respite, adult day health, companion services and home-delivered frozen meals.
The Alabama Department of Senior Services (ADSS) is the operating agency. Participants must meet nursing facility level of care and Medicaid's financial rules: the 2026 income limit for the waiver is $2,982 a month and the resource limit is $2,000.
Does the E&D Waiver pay for assisted living in Alabama?
No. Alabama Medicaid has no waiver that pays assisted living or SCALF fees; the E&D Waiver delivers services to people living in their own homes, which is the main reason Birmingham families plan to pay privately for assisted living.
That gap shapes the whole decision. A parent with modest income who wants Medicaid help usually has two paths: services at home through E&D or Personal Choices, or a Medicaid-certified nursing home if needs are higher. Families sometimes find a third path in Veterans Aid and Attendance, covered in our VA guide.
What is Alabama's Personal Choices program?
Personal Choices is ADSS's self-directed option, in which an enrolled person uses an allotted budget to hire the personal care they need, often including a family member other than a spouse, and can save part of the budget for items that sustain or improve their health.
It suits families who already have a trusted helper and want control over scheduling. Ask the case manager what training and paperwork the hired worker needs and how payroll is handled.
How do Birmingham-area families apply for the E&D Waiver?
Start with the area agency on aging for the county where the person lives: the Middle Alabama Area Agency on Aging (205-670-5770) handles E&D and ACT case management for Shelby, St. Clair, Blount, Walker and Chilton counties, and 1-800-AGE-LINE routes Jefferson and Bibb County callers to the right office.
| Area agency on aging | Counties (of our seven) | Main phone | Toll-free / ADRC |
|---|---|---|---|
| United Way Area Agency on Aging of Jefferson County (UWAAA) | Jefferson | (205) 458-3330 | 1-800-AGE-LINE (1-800-243-5463) |
| Middle Alabama Area Agency on Aging (M4A) | Shelby, St. Clair, Blount, Walker, Chilton | 205-670-5770 | 1-866-570-2998 |
| West Alabama Regional Commission Area Agency on Aging (WARC) | Bibb | 205-333-2990 | 1-800-432-5030 |
Have income and bank statements, insurance cards and a list of diagnoses and medications ready. Ask the intake worker whether there is a waiting list in your county and how slots are assigned.
At a glance
| The E&D Waiver can pay for | The E&D Waiver does not pay for | |
|---|---|---|
| Help at home | Personal care, homemaker and companion services | Room and board anywhere |
| Caregiver relief | Respite and adult day health | A full-time live-in caregiver by default |
| Food | Home-delivered frozen meals | Groceries |
| Setting | Services in the person's own home | Assisted living or SCALF fees |
Sources: CareScout 2025 Cost of Care Survey (Alabama release, March 2, 2026); Alabama Medicaid Agency 2026 income limits; Ala. Admin. Code chapter 560-X-25; Alabama Department of Senior Services; VA pension rate tables. See our editorial standards.
