Alabama · self-direction option
Personal Choices in Alabama
Personal Choices is Alabama Medicaid's self-directed option for people already enrolled in a home and community-based waiver. Instead of getting care from an agency, the participant gets a monthly budget and uses it to hire their own caregiver, which can be a family member. A financial management services agency runs payroll, taxes and background checks.
Also called: Personal Choices Program · Alabama Personal Choices · Personal Choices Alabama Medicaid · self-directed care Alabama
Who do you care for?
Quick facts
- Pay
- $2,320/month
- Adult children & other relatives
- Yes
- Spouse
- Sometimes
- Parent of a minor child
- Not right now
- Waitlist
- possible
Who qualifies for Personal Choices
- Enrolled in an Alabama Medicaid home and community-based waiver first. The Alabama Department of Senior Services lists Personal Choices with the Elderly and Disabled (E&D) and Alabama Community Transition (ACT) waivers; secondary sources say State of Alabama Independent Living (SAIL) members can also self-direct.
- Able to direct your own care, or have a representative who can do it for you.
- Living at home or in a community setting, not in a nursing home.
- Personal Choices runs as a Section 1915(j) State Plan option, so the waiver's own medical and financial rules (nursing facility level of care; income limit $2,982/month and $2,000 in resources in 2026) still apply.
Who can be paid as the caregiver
- Adult children & other relatives Yes
- participants may hire relatives such as a son, daughter, adult grandchild, niece or nephew; the caregiver must be 18+ and pass a background screening.
- Spouse Sometimes
- program summaries say a spouse may be hired 'in some cases'; the state's public pages do not spell out the conditions, so confirm with your case manager.
- Parent of a minor child Not right now
- Personal Choices works through adult waivers, and no parent-of-minor payment rule is published.
- Living together
- the caregiver may live with the participant or elsewhere; living together is not required.
Who employs the caregiver: The member (or a representative) is the employer and hires, trains and fires the caregiver. A financial management services agency handles background checks, tax withholding and paychecks.
Spouse rules differ by program — see spouse pay in Alabama.
How much Personal Choices pays
$2,320/month. Alabama does not publish an hourly rate for Personal Choices. Each participant gets a budget based on a needs assessment and regional home-care wages; the participant decides the caregiver's wage within that budget. Secondary sources report budgets of up to about $2,320/month. Unused funds can sometimes be saved for other items that support the person's health and independence.
Hours and budget: A case manager assesses needs and sets a care plan; the plan is turned into a monthly budget. The participant chooses how many hours to buy and at what wage, within that budget.
Compare with other Alabama programs on the Alabama caregiver pay page, or across states in pay rates by state.
Is there a waitlist?
Personal Choices itself has no separate list, but you must first get a waiver slot. The E&D waiver has a limited number of slots, and a waitlist forms when they are full.
How to apply for Personal Choices
- Call AgeLine at 1-800-243-5463 to reach your local Area Agency on Aging / Aging and Disability Resource Center.
- Apply for a home and community-based waiver (E&D, ACT or SAIL) and complete the Medicaid financial and medical review.
- Once enrolled in a waiver, tell your case manager you want Personal Choices.
- Enroll with the financial management services agency, then have your chosen caregiver complete the hiring paperwork and background screening.
- Alabama Department of Senior Services – AgeLine · 1-800-243-5463 · official site
- Alabama Medicaid Agency – Personal Choices · official site
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Personal Choices questions
Can I get paid to take care of my mom in Alabama?
Yes, if your mother is enrolled in a qualifying Medicaid waiver such as the Elderly and Disabled Waiver and chooses Personal Choices. She (or her representative) can then hire you and pay you from her monthly care budget.
Can a spouse be paid under Personal Choices?
Possibly. Program summaries say spouses can be hired in some cases, but the state's public pages do not list the conditions. Ask the case manager or the Area Agency on Aging before counting on it.
How much does Personal Choices pay a family caregiver?
There is no set hourly rate. The participant's budget is based on assessed needs and local wages, and the participant sets the wage within it. Reported budgets reach about $2,320 a month.
Do I need to be on a waiver first?
Yes. Personal Choices is not a stand-alone program. You must first be enrolled in a home and community-based waiver, then choose self-direction.
Who handles taxes and payroll?
A financial management services agency. It runs background checks, withholds taxes and pays the caregiver, so the family does not have to run payroll.
Sources: medicaid.alabama.gov · alabamaageline.gov · medicaid.alabama.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.