Alabama · waiver service
Elderly and Disabled (E&D) Waiver in Alabama
The E&D Waiver is a Medicaid 1915(c) waiver that pays for in-home care for older adults and people with disabilities who would otherwise need a nursing home. Services usually come through agencies, but members can switch to Personal Choices and use their budget to hire a family member. It is run by the Alabama Department of Senior Services with the Alabama Medicaid Agency.
Also called: E&D Waiver · Alabama Elderly and Disabled Waiver · Alabama Home and Community-Based Elderly and Disabled Waiver · E and D waiver
Who do you care for?
Quick facts
- Pay
- $2,320/month
- Adult children & other relatives
- Sometimes
- Spouse
- Sometimes
- Parent of a minor child
- Not right now
- Waitlist
- capped
Who qualifies for Elderly and Disabled (E&D) Waiver
- Older adult or person with a disability living in Alabama.
- Needs nursing facility level of care (medical review).
- Income up to $2,982/month and resources up to $2,000 (2026 Alabama Medicaid handout).
- Wants to live at home or in the community instead of a nursing home.
Who can be paid as the caregiver
- Adult children & other relatives Sometimes
- through the Personal Choices self-directed option, members can hire relatives such as adult children; in the regular agency model the agency picks the worker.
- Spouse Sometimes
- only through Personal Choices, and only in some cases.
- Parent of a minor child Not right now
- the E&D Waiver serves adults; no parent-of-minor payment is published.
- Living together
- not required either way.
Who employs the caregiver: Either. Agency-based services by default; members can choose Personal Choices to become the employer with a financial management services agency handling payroll.
Spouse rules differ by program — see spouse pay in Alabama.
How much Elderly and Disabled (E&D) Waiver pays
$2,320/month. The state does not publish a family-caregiver wage. In Personal Choices the member gets a budget set by the needs assessment and regional wages; reported budgets reach about $2,320/month. In the agency model, the agency sets the worker's pay.
Hours and budget: A case manager builds a person-centered plan of care. Services can include personal care, homemaker, respite, adult day health, companion services, home-delivered meals, skilled nursing, medical supplies, emergency response systems and home modifications.
Compare with other Alabama programs on the Alabama caregiver pay page, or across states in pay rates by state.
Is there a waitlist?
The E&D Waiver is not an entitlement. Slots are limited (reported at 15,000 per year) and a waiting list forms when they are full.
How to apply for Elderly and Disabled (E&D) Waiver
- Call the Alabama Department of Senior Services at 1-800-243-5463 (AgeLine) to start an application through your Area Agency on Aging.
- Complete the Medicaid financial application and the nursing-facility level-of-care review.
- Work with your case manager on a plan of care.
- If you want to pay a family member, ask to enroll in Personal Choices.
- Alabama Department of Senior Services – AgeLine · 1-800-243-5463 · official site
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Elderly and Disabled (E&D) Waiver questions
Does the E&D Waiver pay family caregivers?
Yes, through Personal Choices. Once enrolled in the waiver, the member can self-direct and hire a relative such as an adult child.
What is the income limit for the Alabama E&D Waiver?
Alabama Medicaid's 2026 handout lists an income limit of $2,982 a month and a resource limit of $2,000.
Is there a waiting list?
There can be. The waiver has a fixed number of slots, and a waiting list forms when they fill.
What services does the E&D Waiver cover?
Case management, homemaker, personal care, respite, adult day health, companion services, home-delivered meals, medical supplies, skilled nursing, pest control, emergency response systems and home modifications.
Who runs the E&D Waiver?
The Alabama Department of Senior Services operates it through local Area Agencies on Aging, under the Alabama Medicaid Agency.
Sources: medicaid.alabama.gov · alabamaageline.gov · medicaidplanningassistance.org · Updated 2026-10-08. Program rules change — always confirm with the program.
Where most Alabama caregivers are
Counties with the most residents aged 65 and older. The rules are the same everywhere in Alabama — pick yours for the local picture.
Across the line
States that border Alabama
Each state writes its own rules, and they differ more than people expect — a spouse who can be paid on one side of the line often cannot be on the other.