Virginia Medicaid Alzheimer's Assisted Living (AAL) Waiver

Waiver Description

This Virginia Medicaid waiver, Alzheimer’s Assisted Living (AAL), is intended to help aging Virginia residents who have been diagnosed with Alzheimer’s disease or other related memory disorders, such as vascular or frontotemporal dementia (FTD), Lewy Body, or stroke. This waiver provides care and supports to help individuals in assisted living communities only. In addition to supervision and personal care, this waiver covers meals, transportation assistance, housekeeping services, and therapeutic activities offered by the participant-chosen assisted living residence.

Begun in 2013, this pilot program will expire the end of June 2018 and will not be renewed. This waiver is not available to persons who reside in homes or in skilled nursing residences. There are several other state assistance programs that do help seniors to age in place or in other care settings.  More information is available in our overview of all Virginia elder care benefits.

Eligibility Guidelines

In addition to being a resident of Virginia, there are four eligibility criteria for candidates:

1) Age – applicants must be at least 65 years of age or be disabled and at least 18 years old. Please bear in mind, regardless of age, all applicants must have a diagnoses of Alzheimer’s Disease or another related dementia.

2) Residential – applicants must live in or be willing to move into an assisted living residence that has been approved by the Virginia Department of Social Services.

3) Health – applicants must be diagnosed with Alzheimer’s or one of the other previously mentioned types of dementia and be at the level of impairment where they cannot recognize a physical risk or make decisions to provide for their own safety.

4) Financial – applicants must be recipients of the Auxiliary Grant Program. In addition, applicants must qualify for Virginia Medicaid, which considers both the applicant’s income and assets. In 2018, persons who have income less than $809 per month qualify for full benefits. Persons over 65 whose monthly income exceeds $809 and is less than $2,250 can qualify through a special income standard for seniors who require long term care. For those who have income over $2,205, that doesn’t necessarily mean that they won’t be able to qualify for this Medicaid Waiver. Working with an independent Medicaid adviser to re-structure assets and income could ensure that the applicant has maximized savings and benefits.

One’s financial assets are also considered, with the exceptions of personal possessions, one’s principle home, a vehicle, and prearranged burial expenses. In regards to the home, it must be valued at or under $572,000 and the applicant, spouse, or a dependent must live in the home. Via the Alzheimer’s Assisted Living Medicaid Waiver, the applicant will not remain in the home, and if no spouse or dependent is living in the home, the home will remain exempt for up to six months after the applicant has moved to an assisted living facility.

Individuals must have countable resources valued at less than $2,000. However, if an applicant is married and their spouse is not also applying for Medicaid services, joint assets up to $123,600 can be allocated to the non-applicant spouse. The applicant spouse is still able to retain up to $2,000 in joint assets. Medicaid planners can aid in helping married couples qualify while saving the most wealth possible for the healthier spouse. Learn more.

Benefits and Services

This waiver is intended to prevent the unnecessary institutionalization of the elderly in nursing home by providing services in less expensive assisted living communities. The state pays for the costs of care at the assisted living but is not permitted to pay for the room and board charges. Examples of care services covered include: 

• Assistance with activities of daily living such as bathing, grooming, transferring and eating
• Assistance with the instrumental activities of daily living such as laundry, housekeeping, meal preparation and medication administration
• Therapeutic, social and recreational activities provided in or by the assisted living residence
• Transportation assistance for medical appointments

How to Apply / Learn More

This program is available statewide across Virginia and is administered by the Department of Medical Assistance Services’ (DMAS) Division of Long-Term Care. However, only 200 participants will be able to into the program in any period. Persons may fully qualify but find themselves on a waiting list for services. In official terminology, this is not a Medicaid entitlement program. There’s no guarantee one will receive services simply because all eligibility requirements are met.

To check waiting list status, learn more about the program, or to apply, one should contact their local department of health. More information about the program is available here.