Written by a parent, not a doctor. Nothing here is medical advice.

Childhood Cancer Lantern
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Alabama program

A Medicaid care-at-home route (Elderly and Disabled waiver)

A route to Medicaid and care at home for a child with nursing-home-level needs.

What it is

A route to Medicaid and care at home for a child with nursing-home-level needs.

The Elderly and Disabled waiver can help a child who needs substantial care at home. It can consider the child’s income separately from yours. A cancer diagnosis alone does not establish the required care needs.

Eligibility rules
  • The waiver includes children from birth and requires Alabama residency.
  • A physician must certify nursing-home-level care.
  • On this route only your child's own income and savings count: under $2,982 a month and under $2,000 in savings in 2026. Your income is not counted. The care test is decided separately by a physician's certification.
What you get
  • Medicaid coverage and approved services at home.
  • A route that can look at your child’s income rather than family income.
What the help includes
  • Approved services appear in a waiver plan of care alongside Medicaid coverage.
  • Intellectual-disability waivers have additional disability and care-level rules. Leukemia alone does not meet those rules, although a child with a separate qualifying disability may need that review.
If you decide to apply
  1. Ask the hospital social worker to contact the aging and disability line with you at 1-800-243-5463.
  2. Have ready: the treatment plan, your child’s own income and a record of daily care.
  3. Ask your doctor whether the nursing-home-level care test fits your child’s needs.

Alabama Medicaid Agency, with the Department of Senior Services taking enquiries · 1-800-243-5463 · Official page ↗

After you ask
  • The social worker can contact the Department of Senior Services or Area Agency on Aging at 1-800-243-5463 about an assessment. Ask for the recorded referral date, remaining assessments, priority and current waiting-list status in writing. The agency can explain what must happen before services start.
  • The waiver has a fixed number of places and often a waiting list; ask where your child would sit on it and what happens while you wait.
Good to know

Many children receiving routine cancer treatment will not meet this care test. A place or start date is not assured.

Other details
  • The state aging and disability line takes inquiries despite the program’s age-focused name.
  • A child already on Medicaid can still need an assessment for additional waiver services. Intake can begin before Medicaid enrollment. SSI-linked Medicaid is a separate route explained in the SSI card.

Federal background: Disability-related Medicaid and care-at-home waivers. SSI is a separate route to Medicaid in Alabama; its card explains that option.

Official sources
Ask your social worker

“Could our child’s care needs meet this waiver’s test, and what help or waiting would it involve? If you think it fits, could you help us request an assessment?”

Why I’m asking: I want to know whether our child’s care needs open a Medicaid route beyond the family income limit.

More background and detailed requirements
Additional program information and published rules

Who does what

The three parts, side by side. The agency decides; nobody on this page does.

You

Ask for the waiver by name, keep a note of who you spoke to, and ask where you are on the list.

Your social worker

The oncology social worker says honestly whether the level-of-care test can be met, and helps with the call.

The care team

A physician has to certify nursing-home level of care in writing.

Who decides
The Alabama Medicaid Agency decides, on a physician's level-of-care certification.
Ask your social worker
“We are over the income line. Can our doctor certify nursing-home level of care so we can ask about the Elderly and Disabled waiver?”

How to apply

First step: Talk with the social worker about an E&D assessment through 1-800-243-5463, including financial category and care needs.

  1. Ask the oncology social worker whether a nursing-home level of care can honestly be certified for your child right now.
  2. If it can, call 1-800-243-5463 and ask for the Elderly and Disabled waiver by name, for a child.
  3. Ask, in writing, where you sit on any list and what the wait has been.

Where it starts: Call the state ageing and disability information line and ask for the Elderly and Disabled waiver for a child. Ask the hospital social worker to make the call with you, because the line is built for older callers.

What to gather

  • The diagnosis letter and the treatment plan
  • A written description of what care at home takes each day
  • The child's own income, if any

How long: The intake office confirms the current assessment and waiting-list status; no individual start date is promised.

What a yes looks like

A Medicaid number plus a waiver plan of care naming the services approved.

What a no looks like, and the next move

Usually the level-of-care test. Ask which criterion was not met and whether the answer changes if care at home gets heavier.

Watch out

  • The level-of-care test asks for nursing-home level need, which many children in ordinary treatment will not meet.
  • Intellectual-disability waivers have separate qualifying criteria. Cancer neither establishes those criteria nor disqualifies an otherwise eligible child.
  • The intake office confirms current waiting-list status; approved enrollment caps do not show vacant places.

Dates that change this

2026-09-10: Whether Alabama has elected the Katie Beckett route for children was not established: the state plan page that would settle it could not be read. Ask the Medicaid Agency directly rather than assuming there is no such route. (not yet confirmed against the final rule)

2022-10-01: Federal approval of this waiver runs to September 30, 2027 on the current listing; renewal terms are not verified.

The numbers and the rules

The arcane layer, kept on purpose. Checked September 11, 2026.

What it is worth

The Elderly and Disabled waiver offers Medicaid and approved home services when financial, nursing-facility care and enrollment tests are met.

Covers: Full Medicaid once enrolled · Care at home instead of a nursing facility · Case management through the waiver

Legal protection: The child's own income, rather than the family's, can be what decides

What it costs the family: unknown: no premium or cost-share figure was published for this waiver.

The eligibility facts, as published

Age
0 and older
Income
For the special-income route, Alabama’s 2026 sheet lists $2,982 monthly individual income; the SSI-related individual resource limit is $2,000. Medicaid identifies the child’s applicable category and countable finances rather than deciding from parental income alone.
Level of care
a physician must certify nursing-home level of care
Residency
Alabama
Processing standard
The intake office confirms the child’s referral, assessment and waiting-list status. Approved waiver term October 1, 2022–September 30, 2027 allows 15,000 unduplicated annual participants and 12,355 at one time; these are caps, not available places.

Decisions this site cannot make: Physician certification of nursing-home level of care · Alabama Medicaid waiver enrolment

Expect friction on: Waiting lists and yearly participant caps are not published · Built for adults and older people, so a children's path has to be asked for by name

The trap: Intellectual-disability waivers have separate qualifying criteria. Leukemia alone does not establish those criteria, but it does not disqualify a child who otherwise meets them.

Where I read this

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