--- title: "Alabama Medicaid Home Care Waivers: E&D & Personal Choices" url: https://fundingltcmarketplace.com/states/alabama/home-care-medicaid/ description: "Alabama's seven Medicaid home care waivers, such as the E&D Waiver and Personal Choices: 2026 limits ($2,982 income, $2,000 assets) and how to apply." last_updated: 2026-10-20 author: George A. Mellendorf, CLTC, LTCP (Central States Insurance Services, Inc.) publisher: Funding LTC Marketplace note: Educational content; not legal, tax or financial advice. Markdown copy of the HTML page at the URL above. --- Alabama · Home & Community Care # Alabama Medicaid Home Care Waivers: E&D and Personal Choices Last updated 2026-10-20 **Quick answer:** For most older adults, Alabama's main Medicaid home care program is the Elderly & Disabled (E&D) Waiver. In 2026, income can't exceed $2,982 a month, countable resources must be $2,000 or less on the first day of the month, and the applicant must need nursing-facility level of care. ## At a glance (2026) - Monthly income limit, Elderly & Disabled (E&D) Waiver: $2,982 (300% of the SSI rate) - Countable resource limit, individual: $2,000, measured on the first day of the month - Medical requirement: Nursing-facility level of care - Who runs the E&D Waiver: Alabama Department of Senior Services (ADSS), through local Area Agencies on Aging - Enrollment: Limited slots; a waiting period is possible ## How Alabama's Medicaid home care waivers work Alabama Medicaid pays for care at home through home and community-based services (HCBS) waivers. A waiver lets someone who would otherwise qualify for a nursing home get help where they live. Alabama runs seven of them. Four use a **nursing-facility level of care** standard: - the Elderly and Disabled (E&D) Waiver - the Alabama Community Transition (ACT) Waiver - the State of Alabama Independent Living (SAIL) Waiver - the Technology Assisted (TA) Waiver for Adults The Intellectual Disabilities (ID), Living at Home (LAH) and Community Waiver Program (CWP) waivers serve people who meet an intermediate-care-facility standard for intellectual disabilities instead. For most older adults, the **E&D Waiver** is the main program. In 2026 the applicant's income can't exceed **$2,982 a month**, and countable resources must be **$2,000 or less on the first day of the month**. The applicant must also meet nursing-facility level of care. Covered services include: - case management - homemaker and personal care services - skilled and unskilled respite - adult day health and companion services - home-delivered meals, medical supplies and skilled nursing - a personal emergency response system - minor home modifications **Personal Choices** is Alabama's self-directed option inside the waivers. A participant can hire and manage their own caregivers, sometimes including a family member, instead of using an agency. For E&D participants, Personal Choices starts through the local Area Agency on Aging. **If income is over $2,982:** Alabama is an income-cap state. An applicant with more income can still qualify by setting up a **Qualified Income Trust** (a "Miller trust") and depositing the excess each month. **If a spouse stays at home:** spousal impoverishment rules protect part of the couple's assets and income for the at-home spouse. The 2026 federal maximum resource allowance is $162,660. ## Example Ruth, 82, lives alone in Huntsville. She gets $1,900 a month from Social Security and a small pension, and has $1,600 in checking. After a fall, she needs daily help with bathing and dressing. Her income is under $2,982, her countable resources are under $2,000, and her physician documents nursing-facility level of care, so she can apply for the E&D Waiver through her Area Agency on Aging. If a slot isn't open right away, she may be placed on a waiting list. Her family should plan for private-pay help in the meantime. Illustrative example; names and figures are hypothetical. ## Common mistakes - Assuming a waiver works like an entitlement. E&D slots are capped, and a waiting period is common. - Spending down unevenly: the $2,000 test applies on the **first day of each month**. - Giving money to family to qualify faster. Alabama applies Medicaid's five-year look-back to transfers for nursing-home and waiver services. - Depositing income into a Miller trust incorrectly. The trust must meet Medicaid's rules, and the excess must actually be deposited each month. ## Questions and answers ### Does Alabama Medicaid pay family members to provide care? In some cases, yes, through the Personal Choices self-directed option, depending on the waiver and the person's plan of care. Ask the Area Agency on Aging what applies to your situation. ### Does the E&D Waiver pay for assisted living? No. The E&D Waiver's listed services are in-home and community services. They don't include room and board in assisted living. ### How do I apply? Contact the Alabama Department of Senior Services at 1-800-243-5463 (or your local Area Agency on Aging) to be screened for an E&D Waiver slot. Financial eligibility is then confirmed with Alabama Medicaid. ### What if my income is over the limit? A Qualified Income Trust can bring countable income under the $2,982 cap. An elder-law attorney or an experienced Medicaid planner should set it up. ## Sources - Alabama Medicaid, [Medicaid Income Limits for 2026](https://medicaid.alabama.gov/documents/3.0_Apply/3.2_Qualifying_Medicaid/3.2_Medicaid_Income_Limits_2026_3-11-26.pdf) - Alabama Medicaid, [Home and Community Based Waivers – 2026 (Form 206)](https://medicaid.alabama.gov/documents/3.0_Apply/3.2_Qualifying_Medicaid/3.2.1_Medicaid_for_Children_POCRs/3.2.1_Form_206_Waiver_HBCS_2-4-26.pdf) - Alabama Medicaid, [Elderly and Disabled Waiver](https://medicaid.alabama.gov/content/6.0_LTC_waivers/6.1_HCBS_Waivers/6.1.2_Elderly_Disabled_Waiver.aspx) - Alabama Medicaid, [Personal Choices](https://medicaid.alabama.gov/content/6.0_LTC_Waivers/6.3_Other_LTC_Programs/6.3.3_Personal_Choices.aspx) - Alabama Medicaid, [Eligibility Groups Summary (Qualifying Income Trust; 300% rule)](https://medicaid.alabama.gov/documents/3.0_Apply/3.1_General_Info/3.1_Medicaid_Eligibility_Groups_Grid_3-11-26.pdf) - Alabama Department of Senior Services, [Medicaid Waiver Programs](https://alabamaageline.gov/medicaid-waiver-programs/) - CMS, [2026 SSI and Spousal Impoverishment Standards](https://www.medicaid.gov/federal-policy-guidance/downloads/cib04272026.pdf) [← Back to the full Alabama guide](https://fundingltcmarketplace.com/states/alabama/)