Alabama has several affordable health insurance options. You can enroll in your employer’s plan or sign up for Medicare or Medicaid (if you qualify). There are government-funded health plans for children, direct plans from insurance companies, or you could use the Health Insurance Marketplace for Affordable Care Act options.

This guide explains your Alabama affordable health insurance options in detail.

What to know about insurance in Alabama

  • Marketplace plans: You can buy a private insurance plan in Alabama if you’re self-employed, if your employer doesn’t meet your needs, or if the plan doesn’t cover your spouse or dependents. Non-exchange plans are available through individual insurance companies, but you won’t qualify for financial help if you buy insurance outside of the Health Insurance Marketplace.
  • Open enrollment: For 2022 coverage in Alabama, open enrollment for individuals and families begins November 1, 2021 and continues through January 15, 2022.
  • Special enrollment: You may also qualify for special enrollment periods (SEP) if you experience certain events that trigger a SEP, such as loss of minimum essential insurance coverage, gaining or becoming a dependent through marriage or the birth or adoption of a child, losing a job, or becoming newly eligible for tax credits. You generally have 60 days from the date of the triggering event to enroll in coverage.
  • American Rescue Plan Act: In 2021, the American Rescue Plan Act was signed into law to help speed up the recovery from the health effects of COVID-19. This bill extended eligibility for health insurance subsidies to individuals with incomes over 400% of the federal poverty level and increased financial assistance to individuals with lower incomes for the next two years.
  • Health Insurance Marketplace: Because Alabama doesn’t operate a Consumer Assistance Program under the Affordable Care Act, you must go through HealthCare.gov to sign up for coverage through the Health Insurance Marketplace. Unless incarcerated, not lawfully present in the U.S., or on Medicare, any individual or family in Alabama may buy coverage through the Health Insurance Marketplace.
  • Coverage types: Roughly 47% of Alabama residents have insurance through employers, while 5.5% bought individual insurance coverage directly from an insurance provider. Another 16% of Alabamans have Medicare, 19.5% have Medicaid, and approximately 2% have medical benefits through the military. Nearly 10% of people in Alabama are uninsured.

How do I enroll in Alabama’s health insurance marketplace?

Enroll in the Alabama Health Insurance Marketplace using the federal government’s HealthCare.gov platform. This platform walks you through the entire enrollment process with easy-to-follow instructions. If you can’t sign up online, contact the marketplace call center at 800-318-2596 for assistance.

To create an online account, enter your name and email address, then confirm your email address. Log in to your new account to complete your enrollment application. You must enter all required information, including:

  • Household size
  • Social Security numbers, birth dates, home and/or mailing addresses, and employer and income information for each applicant seeking coverage
  • Documents for any naturalized citizens or legal immigrants in your household
  • Policy numbers for any health plans currently covering any household member
  • Details on how you’re filing your taxes and an estimate of total household income for the year you’re applying for coverage
  • Information about any professional helping you complete your application

Once you’ve finished your application, the system tells you whether you qualify for financial assistance with your premium and the amount of your premium tax credit if applicable. Compare your health insurance plan options and choose the best option for your situation to complete your enrollment.

The following insurance companies offer health insurance plans to Alabama residents on the marketplace:

  • Blue Cross Blue Shield of Alabama
  • Bright Health Insurance Company of Alabama

How do I enroll in Alabama individual and family insurance?

Individual health insurance providers and the plans offered cover single adults and families, so your options are the same for either situation. Coverage for individuals and families is identical, but monthly premiums and deductibles are typically higher for families. Be sure you understand the basics before purchasing health insurance for yourself or your family. There are some important considerations when shopping for individual coverage, whether for yourself or multiple people. These considerations include:

  • Medical needs
  • Preferred plan type
  • Premium affordability
  • Individual vs. family deductibles

Insurance for individuals in Alabama

Before shopping for individual health insurance plans in Alabama, calculate your monthly income to create a reasonable budget to cover your personal health insurance needs. For most plans, the monthly premium isn’t your only out-of-pocket cost. You also have to think about the deductible, the copay for each service, and the coinsurance requirements.

There are different types of plans you can choose from:

  • A Health Maintenance Organization plan (HMO) offers the best choice if you don’t make many visits to a doctor or a specialist or require prescriptions. It has lower monthly premiums and higher deductibles. HMO plans are the least expensive plans. However, there are restrictions with an HMO plan. You’ll need to get a referral if you want to see a specialist, you’ll need to name a primary care physician, and you’re limited to using the HMO plan’s in-network medical providers.
  • A Preferred Provider Organization (PPO) plan is a better idea if you regularly visit doctors or specialists. You’ll have more flexibility with a PPO plan, although you’ll pay more for it. You aren’t limited to in-network providers, you don’t need to name a primary care physician, and you’ll never need to obtain a referral to see a specialist.
  • A Point of Service Plan (POS) is a hybrid of an HMO and a PPO. You can use out-of-network providers, but any time you want to see a specialist, you’ll need to get a referral.

All plans sold through the Health Insurance Marketplace must cover a minimum set of essential health benefits (EHBs). Plans sold off the Health Insurance Marketplace should cover these benefits as well, but there are some exceptions, such as short-term plans. EHBs include:

  • Emergency and outpatient services
  • Hospital stays
  • Prescriptions
  • Maternity care
  • Lab servicesPreventive and wellness services
  • Mental health and substance abuse services
  • Pediatric services

Alabama also has a few state-mandated benefits.

To learn more about a plan’s benefits and level of coverage, read the Summary of Benefits and Coverage. All health insurance plans (except short-term and limited benefit plans) must provide this document, which details what is and isn’t covered. It also provides information on the out-of-pocket expenses you can expect, including deductibles, copays, and coinsurance. These documents are available on the marketplace, which allows you to compare plans based on premiums, benefits, provider networks, and other factors.

Insurance for families in Alabama

Searching for affordable health insurance plans for families in Alabama is a little more complicated than for individuals. Your insurance provider choices and most plan options are the same. However, you need to think about how each person might use the plan. A spouse may need maternity care or fertility services, while a child might need to be covered for a tonsillectomy or other common childhood procedure.

Review the plan details carefully to make sure the services you need are covered. If someone in your family receives specialty care, you should also check to make sure the specialist participates in the plan’s network.

You also need your household’s income to figure your budget for the best health insurance coverage you can afford. Even if a household member isn’t enrolling in your plan, you still need their income information to see if your family qualifies for help with insurance premiums. HealthCare.gov offers other suggestions on how to enroll in the Marketplace.

How much does health insurance cost in Alabama?

Each health insurance plan has a premium you pay each month to keep your policy active. You may also have a deductible (the amount you pay before your insurance begins paying out for certain services) and copays or coinsurance (the shared cost when you receive health care services). These amounts vary between plans and by metal level. Health insurance plans in Alabama are organized into four levels: Bronze, Silver, Gold, and Platinum.

Premiums were falling in many areas of the country in 2021, but not in Alabama. The average lowest premium for Bronze and Gold plans went up for the third consecutive year, while the average for Silver plans dropped in 2019 but rose in 2020, 2021, and 2022. Since 2018, the average lowest premium for Gold plans has seen the largest increase at $114, followed by Bronze plans at $64 and Silver plans at $53.

Average premiums in Alabama 2019 2020 2021 2022
Most affordable Bronze plan $359 $384 $401 $418
Most affordable Silver plan $505 $521 $549 $569
Most affordable Gold plan $599 $641 $669 $697

  • Bronze plans offer the lowest level of coverage and may be the most affordable health insurance plans for healthy people. These plans pay for 60% of your expected costs of care while you cover the other 40%. Expect the lowest monthly premiums but the highest deductibles. In 2022, the most affordable Bronze plan in Alabama costs $418 per month.
  • Silver plans cover 70% of expected costs while you pay 30% and have moderate monthly premiums. Deductibles are usually lower than Bronze plans and you may qualify for cost-sharing reductions if you choose a Silver plan. In 2022, the most affordable Silver plan in Alabama costs $569 per month.
  • Gold and Platinum plans cover 80% to 90% of your costs of care and you pay 20%, providing much lower costs when you need care. Deductibles are usually low, but these plans have some of the highest monthly premiums. In 2022, the most affordable Gold plan in Alabama costs $697 per month.

What kind of low-income health insurance is available in Alabama?

Over one million residents qualified for Alabama Medicaid in 2020 through various programs offered to children, pregnant women, families, the elderly, and disabled individuals. Alabama also offers ALL Kids, a program specifically for low-income children, and ALL Babies for pregnant women in certain areas of the state.

Medicaid in Alabama

Alabama Medicaid programs have set age requirements, income limits, participant populations, and other qualifying factors. Adults who aren’t elderly and don’t have minor children won’t qualify for Medicaid, no matter their income. To be eligible, you must be a low-income resident who meets at least one of the following criteria:

  • At least 65 years old
  • Pregnant
  • Responsible for a minor child
  • Have a disability
  • Have a household member with a disability

Apply for Alabama Medicaid online (or through the Alabama Medicaid Agency at 334-242-5000) at any time of the year. The Health Insurance Marketplace also assesses your Medicaid eligibility and makes a referral to the Alabama Medicaid Agency if appropriate.

ALL Kids in Alabama

ALL Kids is Alabama’s Children’s Health Insurance Program (CHIP) administered by the Alabama Department of Public Health. This program provides low-cost, comprehensive health care coverage to children under age 19 based on income limits. To meet eligibility requirements, your child must:

  • Be an Alabama resident
  • Be a U.S. citizen (or an eligible immigrant)
  • Not be covered by Medicaid or other insurance
  • Not reside in an institution

Apply online or mail in your completed paper application. If you need assistance, call 888-373-KIDS (5437).

ALL Babies in Alabama

ALL Babies is Alabama’s low-cost, comprehensive health care coverage program developed by CHIP for pregnant women living in Macon, Montgomery, or Russell counties. Your family size and income determine whether you’re eligible for ALL Babies or Alabama Pregnancy Medicaid. Apply online or through the mail and call 888-373-5437 if you need help filling out your application.

What are Alabama’s Medicare options for seniors and people with disabilities?

Alabama residents aged 65 or older (and those under age 65 with qualifying disabilities) have several Medicare options available.

  • Original Medicare is the basic form of Medicare managed by the federal government. It consists of Part A (inpatient care), and Part B (preventive care and outpatient medical services). It pays for hospital care, preventive services, durable medical equipment, and other medical services, but does not cover prescriptions. Supplemental plans are available to help with prescription costs – these plans are known as Medicare Part D.
  • Medicare Advantage Plans are sold by private insurance companies. Although plans must offer at least the same coverage as Original Medicare, Medicare Advantage Plans often cover extra services such as prescription medications, dental, and vision.

If you choose Original Medicare, you can also purchase supplemental plans to extend your coverage. Medicare Part D covers prescription medications, while Medicare Supplement Insurance (Medigap) covers deductibles, copays, and other out-of-pocket Medicare costs. If you have questions about Medicare, contact your local Area Agency on Aging.

Alabama Medicaid offers three Medicare Savings Programs to low-income individuals or couples. To qualify, you must be:

  • Eligible for Medicare Part A
  • Live in Alabama
  • A U.S. citizen or legal immigrant
  • An income below set limits

Alabama’s Qualified Medicare Beneficiary Program pays your Medicare Part B premium, Medicare Part A premium under certain conditions, and Medicare deductible. Its Specified Low Income Medicare Beneficiary Program and Qualified Individual-1 Program pay your Medicare Part B premium only. Apply online or request an application by calling 800-362-1504 and mail your completed application to the District Office that serves your county.

Eligibility

To qualify for Medicare, you must be at least 65 years old or have a qualifying disability. In most cases, a qualifying disability is a condition that makes you eligible for at least 24 months’ worth of payments from the Social Security Disability Insurance program. You may be able to qualify sooner if you have end-stage renal disease or amyotrophic lateral sclerosis (Lou Gehrig’s disease).

Enrollment

If you start receiving your Social Security or Railroad Retirement Board benefits at least four months before you turn 65, you’ll be automatically enrolled in Medicare. Otherwise, you must fill out an application online or contact your local Social Security office. You can enroll in Medicare during the following periods:

  • Initial enrollment: Your initial enrollment period starts three months before your 65th birthday and ends three months after your 65th birthday. If you’ve never had Medicare, you can enroll during this period. If you started receiving Medicare when you were younger, you can also make changes to your plan.
  • General enrollment: Choose this enrollment period if you missed your initial enrollment period. The Medicare general enrollment period is January 1 to March 31. You can choose Original Medicare, Medicare Advantage, Medigap, or Part D.
  • Medicare Advantage open enrollment: You can make changes to your Medicare Part C, also known as Medicare Advantage, from January 1 to March 31.
  • Open enrollment: You can join, switch plans, or drop your coverage from October 15 to December 7 each year.
  • Special enrollment periods: You may qualify for a special enrollment period if you lose your coverage or have changes to your eligibility outside the regular enrollment periods.

Medicare Resources

If you need help signing up for Medicare, Medicare Advantage, Medigap, or prescription drug coverage, call 800-243-5463 to find your local Alabama State Health Insurance Assistance Program office. Trained counselors are available to help you with all your Medicare questions for free.

Are there short-term health insurance plan options in Alabama?

Short-term, limited-duration plans help fill temporary gaps in your health insurance coverage, such as when you’re between jobs or waiting for Medicare coverage to start. Short-term health insurance plans in Alabama are often cheap health insurance, but these plans aren’t required to cover essential health benefits, even though they’re considered to be major medical coverage.

These plans are often medically underwritten, so if you have a health condition, you could be turned down for coverage or charged a higher premium. Short-term plans aren’t the same as the plans you purchase on the Health Insurance Marketplace that must cover all essential health benefits.

Alabama Insurance FAQs

Does Alabama require health insurance?

No, Alabama isn’t one of the states that require health insurance.

Do I have to use the Health Insurance Marketplace in Alabama?

No, you can purchase the same types of health insurance plans you find on the Health Insurance Marketplace from individual insurance companies. However, you won’t qualify for premium tax credits or cost-sharing assistance if you purchase your plan off the marketplace.

What types of alternative health insurance plans (like cost-sharing plans) are available in Alabama?

Alabama has several faith-based health care sharing plans available. Members sare medical expenses rather than paying monthly premiums to an insurance company. You don’t need to be a member of a particular denomination (or even religious), to participate in a plan. Health care sharing plans are cheaper than traditional health insurance, but aren’t required to cover pre-existing conditions, so these plans typically aren’t a good idea unless you’re in good health.

Do I need health insurance if I have HSA/FSA?

Flexible spending accounts are only available through employers and you don’t need health insurance to have one. Anyone can open health savings accounts, but you must purchase an HSA-compatible High Deductible Health Plan from an individual insurance provider before getting one of these accounts.

Do I need short-term disability coverage in Alabama if I have health insurance?

Short-term disability coverage covers non-medical expenses like lost wages for three to six months if you’re hurt or develop an illness outside of work. Your health insurance only covers medical expenses, so it’s a nice complement to this coverage.

Do I need long-term disability coverage in Alabama if I have health insurance?

Long-term disability coverage covers non-medical expenses your health insurance wouldn’t. LTD plans generally cover lost wages and other expenses and benefits can last for years or until retirement age. Your employer may offer LTD coverage or you can purchase a policy from an insurance company.

What does ALL Kids in Alabama cover?

ALL Kids coverage includes doctor visits, hospital care, emergency services, immunizations, prescriptions, mental health and substance abuse services, and dental and vision care for children younger than 19.

What does ALL Babies in Alabama cover?

ALL Babies coverage includes maternity care, doctor visits, emergency services, prescriptions, immunizations, mental health and substance abuse services, and dental and vision care for pregnant women living in Macon, Montgomery, and Russell counties only.

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Insurance and healthcare consultant

Tammy Burns is an experienced health insurance advisor. She is ACA-certified for health insurance and other ancillary, life, and annuity products.

She’s always been driven by a desire to help people, spending more than 25 years as a practicing nurse in hospitals, private doctors’ offices, home health, and hospice. As a nurse, Burns supported patients filing insurance claims with Medicare, Medicaid, and private insurance companies, as well as responding to billing questions from confused patients.

Seeing firsthand how unsuspecting patients are frequently confused by an overly complex system they don’t understand led Burns to become an insurance agent and healthcare consultant, now helping people understand the medical system. Since becoming an agent, she has worked with some of the largest and most reputable insurance carriers and agencies in the nation, and she has built a large and loyal clientele by way of her commitment to transparency and personalized service.

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