Alabama State Veterans Homes: Who Qualifies, Cost, How to Apply

Some veterans pay nothing for room and board at Alabama's state veterans homes. The Alabama Department of Veterans Affairs (ADVA) application package says a veteran needing nursing home care is not billed room and board if he or she has a VA service-connected disability rating of 70% or more, is rated for total disability based on individual unemployability (TDIU), or needs the care for a service-connected condition.1 For every other resident, the ADVA package says an Alabama home charges a comprehensive care rate, paid one month in advance.1

If your dad or your husband can't safely stay at home anymore, and someone has mentioned "the veterans home," you probably want three answers fast: will he get in, what will it cost, and how long will it take. ADVA oversees five state veterans homes, in Alexander City, Huntsville, Bay Minette, Pell City and Enterprise.2 Here's what ADVA's own pages and its application form say about each of those questions.

In This Guide

• Key Takeaways
• Alabama's Five State Veterans Homes
• Who Qualifies for an Alabama State Veterans Home?
• What an Alabama State Veterans Home Costs
• When VA Covers Room and Board
• Doctors and Prescriptions After Admission
• How to Apply, Step by Step
• Frequently Asked Questions
• Learn More

Alabama's Five State Veterans Homes

State Veterans Homes are owned, operated and managed by state governments, not by the U.S. Department of Veterans Affairs. VA recognizes and certifies each State Veterans Home, surveys it every year, and leaves eligibility and admission rules to the state.5 ADVA describes Alabama's homes as a partnership between the State of Alabama, the federal government and private industry, and in 2022 ADVA said the four homes then operating had been run since 2004, under ADVA oversight, by HMR of Alabama.2

The opening dates and cities above are the ones on ADVA's Veterans Home Program page. The services ADVA lists for its homes include 24-hour nursing coverage, a physician on call 24 hours a day, and physical, occupational and speech therapy on site.2

ADVA's eligibility rules admit veterans who meet VA's criteria for either skilled nursing care or domiciliary/assisted living.2 Which level each Alabama home offers, and whether a given home has a bed at that level, is a question for that home's staff. For a wider view of VA help for an aging Alabama veteran, see our guide to VA senior care benefits in Alabama, and for how state homes work nationally, see how State Veterans Homes work.

Who Qualifies for an Alabama State Veterans Home?

Each state writes its own admission rules for its State Veterans Homes.5 ADVA's home pages say that to be eligible for any Alabama state veterans home, a veteran must meet all five of these requirements:2

• Service and discharge: an honorable discharge with at least 90 continuous days of active duty. A veteran who enlisted after September 7, 1980, or was commissioned after October 16, 1981, needs 24 continuous months or the full period for which he or she was called.
• Level of care: the veteran must meet VA's criteria for skilled nursing care or for domiciliary/assisted living.
• Alabama residency: the veteran must have lived in Alabama for the immediate past 12 months.
• A physician's examination showing the veteran doesn't need medical care the homes aren't equipped or staffed to provide, doesn't have behavioral traits that may be dangerous to the resident, other residents, staff or visitors, and doesn't have a diagnosis or confirmed history of mental illness which outweighs his or her medical condition.
• Immigration status: the veteran must meet the requirements of Alabama's immigration laws.

That qualifier on mental illness matters if your parent lives with depression, PTSD or another diagnosis. The National Association of State Veterans Homes' Alabama directory entry words the Alabama physician-exam requirement more broadly than ADVA does, listing any diagnosis or confirmed history of mental illness without ADVA's "outweighs their medical condition" language, and adding a 90-day window for the exam.2 ADVA oversees Alabama's state veterans homes, so ADVA's wording is the one to go by, and a doctor's examination that describes your parent's full medical picture is worth the effort.

ADVA's application package adds a screen that isn't on the list above: every applicant to Alabama's homes is checked against the Sex Offender Registry and run through a background check for active felony status, and anyone on the registry or in felony fugitive status is not considered for admission.4

What an Alabama State Veterans Home Costs

This is the part families find hardest to pin down, because ADVA doesn't post a price. ADVA's application package, ADVA Form 33, says Alabama's state veterans homes charge residents for comprehensive care, that every resident is responsible for full payment of the comprehensive care rate one month in advance, and that failure to pay will result in discharge. ADVA Form 33 gives no dollar amount for the comprehensive care rate, so ask the home you're considering for its current rate in writing.1

VA pays a per diem to the state toward an eligible veteran's care. VA's basic State home per diem is the lesser of half the daily cost of care or VA's basic per diem rate for the year, and 38 U.S.C. 1741 caps it at half the cost of care.3 That money goes to the State of Alabama, not to your family.

ADVA Form 33 also lists charges that sit outside the comprehensive care rate and are the resident's or sponsor's responsibility, including pharmacy charges and co-pays, physician specialist consultation fees, durable medical equipment including oxygen, and private duty nurses and sitters. Bed-hold charges apply to all residents of Alabama's homes.1 If your parent may already qualify for extra VA money toward nursing home costs, our guide to using Aid and Attendance toward an Alabama nursing home walks through that claim.

When VA Covers Room and Board

For some veterans, the bill is very different. Under 38 U.S.C. 1745 and 38 CFR 51.41, VA's payment to a State home for nursing home care is payment in full, and the home may not charge anyone other than VA for that care, when any one of these is true of the veteran:3

• The veteran needs nursing home care for a VA-adjudicated service-connected disability.3
• The veteran has a service-connected disability rated 70% or more and needs nursing home care.3
• The veteran is rated for total disability based on individual unemployability (TDIU) and needs nursing home care.3

ADVA Form 33 applies the same federal rule in Alabama: a veteran who meets any of these three and qualifies under 38 CFR Part 51, Subpart C, will not be billed for room and board or routine services at an Alabama state veterans home.1 ADVA's payment-in-full promise has an edge. Room and board and routine services are covered, but ADVA's list of other charges, like specialist fees or a private sitter, can still apply. Bring your parent's VA rating decision letter to the first conversation with the home.

If your parent is already covered by Medicaid in a nursing home, one federal rule is worth knowing: the $90-a-month VA pension cap does not apply at a State home that receives VA's section 1741(a) per diem. Under 38 U.S.C. 5503(d), VA pension for a veteran with no spouse or child who is covered by Medicaid in a nursing facility is capped at $90 a month after the month of admission. The 38 U.S.C. 5503(d) definition of nursing facility excludes a State home receiving VA's section 1741(a) per diem, so the $90 cap does not apply to a veteran in that setting.6 Ask the home and your county Veterans Service Officer how your parent's VA pension and Medicaid would be handled at that specific Alabama home.

Doctors and Prescriptions After Admission

Families are often surprised that moving into an Alabama state veterans home changes who the veteran's doctor is. ADVA Form 33 says that once a veteran is admitted, primary care is provided at the home, and the veteran may no longer receive primary care from the federal VA medical center.1

Medications work differently too. ADVA Form 33 says VA medications are provided only to veterans receiving non-service-connected VA pension with Aid and Attendance, or to some service-connected disabled veterans, and all other charges are billable.1 If your parent gets VA pension without Aid and Attendance, our Alabama Aid and Attendance guide explains how to apply for it.

How to Apply, Step by Step

ADVA uses one application package, ADVA Form 33, for all of Alabama's state veterans homes. ADVA encourages families to get help from their local Veterans Service Officer, and a county Veterans Service Officer can walk you through the forms.4

ADVA doesn't publish how long the waiting list for Alabama's homes runs. Ask each home you checked where your parent stands, and keep his medical records current so the Admissions Committee has them when his name comes up.

Learn More

Find personalized help getting a veteran parent into an Alabama state veterans home at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.