Alabama Health Insurance Guide 2025

Everything you need to know about health coverage in the Heart of Dixie

Key Facts for Alabama

Medicaid Expansion Not Expanded
Marketplace Type Federal (HealthCare.gov)
Open Enrollment Nov 1 - Jan 15
Medicaid Program Alabama Medicaid

Medicaid in Alabama

Alabama has not expanded Medicaid under the Affordable Care Act. This means Medicaid eligibility in Alabama is limited to specific categories of people, and many low-income adults do not qualify for coverage.

Coverage Gap Alert

Because Alabama hasn't expanded Medicaid, there is a "coverage gap" where some adults earn too much for traditional Medicaid but too little to qualify for marketplace subsidies. An estimated 150,000+ Alabamians fall into this gap.

Who Qualifies for Alabama Medicaid?

  • Children: Up to 317% of the Federal Poverty Level (FPL) through CHIP
  • Pregnant women: Up to 146% FPL
  • Parents/Caretakers: Very limited income thresholds (approximately 18% FPL)
  • Elderly and disabled: Must meet income and asset requirements
  • Childless adults: Generally do not qualify regardless of income

How to Apply for Alabama Medicaid

  • Online: Visit medicaid.alabama.gov
  • Phone: Call 1-800-362-1504
  • In Person: Visit your local county Department of Human Resources

Health Insurance Marketplace

Alabama uses the federal Health Insurance Marketplace at HealthCare.gov. This is where Alabamians can shop for and enroll in private health insurance plans.

2025 Open Enrollment

November 1, 2024 through January 15, 2025. Enroll by December 15 for coverage starting January 1, 2025.

How to Enroll

  1. Visit HealthCare.gov
  2. Create an account or log in
  3. Complete your application with income and household information
  4. Compare plans and see what subsidies you qualify for
  5. Select a plan and complete enrollment

Special Enrollment Periods

If you experience a qualifying life event (job loss, marriage, birth of a child, moving), you may be able to enroll outside of Open Enrollment. You typically have 60 days from the event to sign up.

Average Costs in Alabama

Health insurance costs in Alabama vary based on your age, location, tobacco use, and plan type. Here are some general guidelines:

  • Benchmark Silver Plan: Average of $400-550/month before subsidies for a 40-year-old
  • With Premium Tax Credits: Many Alabamians pay $0-100/month after subsidies
  • Bronze Plans: Lower premiums but higher out-of-pocket costs
  • Gold Plans: Higher premiums but lower out-of-pocket costs
Premium Tax Credits

If your household income is between 100% and 400% of the Federal Poverty Level, you likely qualify for subsidies that significantly reduce your monthly premium. Many subsidies have been enhanced through 2025.

Alternatives for the Coverage Gap

If you fall into Alabama's coverage gap (too much income for Medicaid, too little for marketplace subsidies), consider these options:

  • Community Health Centers: Federally Qualified Health Centers offer sliding-scale fees based on income
  • Hospital Charity Care: Many hospitals offer financial assistance programs
  • Short-Term Health Insurance: Limited coverage option (review exclusions carefully)
  • Health Sharing Ministries: Faith-based cost-sharing programs
  • Free Clinics: Various free clinics operate throughout Alabama

Frequently Asked Questions

Has Alabama expanded Medicaid?

No, Alabama has not expanded Medicaid under the Affordable Care Act. This means adults without dependent children generally cannot qualify for Medicaid regardless of income, creating a coverage gap for many low-income Alabamians.

What is the coverage gap in Alabama?

The coverage gap affects adults who earn too much to qualify for traditional Medicaid but too little to qualify for marketplace subsidies (which start at 100% of the federal poverty level). In Alabama, this affects an estimated 150,000+ residents who have limited options for affordable coverage.

When is Open Enrollment for Alabama health insurance?

Alabama uses the federal HealthCare.gov marketplace. Open Enrollment for 2025 coverage runs from November 1, 2024 through January 15, 2025. You can enroll or change plans during this period.

How do I apply for Alabama Medicaid?

You can apply for Alabama Medicaid through the Alabama Medicaid Agency online at medicaid.alabama.gov, by phone at 1-800-362-1504, or in person at your local county Department of Human Resources office.

Need Help Finding Coverage in Alabama?

Navigating health insurance without Medicaid expansion can be challenging. Our licensed agents can help you explore all your options.

Get Free Guidance