Jeffrey Wade
Alabama has not expanded its Medicaid program, and as of 2023, it is one of ten states with no imminent plans to do so. This means that Alabama has left a significant amount of federal funding on the table, which could have been used to expand healthcare access for its residents. Despite this, there are still several options for Alabama residents seeking healthcare coverage through Medicaid or insurance.
Can you have insurance and Medicaid in Alabama?
| Characteristics | Values |
|---|---|
| Medicaid eligibility in Alabama | Children up to 146% of the federal poverty level (FPL); children up to 317% of FPL qualify for the Children's Health Insurance Program (CHIP); pregnant women up to 146% of FPL; parents up to 13% of FPL; elderly and disabled individuals with certain medical conditions and income limits |
| Alabama's acceptance of federal funding to expand Medicaid | No, Alabama has not accepted federal funding to expand Medicaid under the ACA |
| Number of Alabamans covered by Medicaid/CHIP as of October 2024 | 952,073 |
| Number of additional Alabama residents who would be covered if the state accepted expansion | 365,000 |
| Number of Alabama residents disenrolled from Medicaid during unwinding | 400,322 |
| Federal money Alabama left on the table in 2023 by not expanding Medicaid | $2 billion |
| Medicaid application options in Alabama | Online through Healthcare.gov for non-disabled adults under 65; online, by mail, fax, or in person for seniors and people with disabilities; by phone |
| Medicaid financial assistance | Helps lower Medicare premiums, prescription drug costs, and pay for expenses not covered by Medicare, including long-term care |
| Medicaid "QMB Program" | Pays Medicare premiums, deductible, and co-insurance for people on Medicare with income below the federal poverty level |
| Medicaid "SLMB Program" | Pays Medicare Part B premiums for people on Medicare with income below 120% of the federal poverty level |
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What You'll Learn
Medicaid eligibility and enrollment
Alabama has yet to expand Medicaid under the ACA, despite attempts by Democratic lawmakers to do so. This means that Medicaid eligibility in Alabama is more restricted than in states that have expanded Medicaid.
Children up to 141% of the federal poverty level (FPL) are eligible for Medicaid, and children up to 312% of FPL qualify for the Children's Health Insurance Program (CHIP). Pregnant women up to 141% of FPL are also eligible for Medicaid, and coverage for the mother now continues for 12 months after the baby is born. Babies whose mother was on Medicaid gets Medicaid coverage automatically for up to one year. During that year, the mother should apply at the welfare department or the health department.
Parents up to 13% of FPL and elderly and disabled individuals with certain medical conditions and income levels are also eligible for Medicaid in Alabama. For the elderly and disabled, eligibility is subject to both income and asset limits. Qualified Disabled Working Individuals can get Medicaid to pay their Medicare Part A premium. Additionally, individuals on Medicare with income below the federal poverty level can qualify for the Medicaid "QMB Program", which pays for Medicare premiums, deductibles, and co-insurance.
There are several options for submitting a Medicaid application in Alabama. Non-disabled adults under 65 can apply online through Healthcare.gov, and seniors and people with disabilities can also use this application pathway. Individuals can also apply by submitting paper applications by mail, fax, or in person to a district office, or by calling 1-800-362-1504. Many Medicare beneficiaries receive Medicaid financial assistance, which can help lower Medicare premiums, prescription drug costs, and pay for expenses not covered by Medicare, including long-term care.
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Medicaid application process
The Medicaid application process in Alabama can be completed through several methods, including online, by mail, fax, or in person. Non-disabled adults under the age of 65 can apply online through Healthcare.gov, while seniors and people with disabilities can use the same online application process. Paper applications can be submitted by mail, fax, or in person at a district office. Additionally, individuals can call 1-800-362-1504 for assistance or visit the Alabama Medicaid website to obtain a Medicaid Primer.
For individuals who are deaf, a TDD number is available: 1-800-253-0799. Those seeking free legal services in Alabama can contact the Legal Services Alabama office closest to their residence or call 1-866-456-4995 toll-free.
In terms of eligibility, children up to 141% of the federal poverty level (FPL) qualify, while children up to 312% of FPL are eligible for the Children's Health Insurance Program (CHIP). Pregnant women up to 141% of FPL are also covered, and their coverage continues for 12 months after the baby is born. Additionally, elderly and disabled individuals with specific medical conditions and income levels may qualify.
It is worth noting that babies whose mothers were on Medicaid automatically receive Medicaid coverage for up to one year. During this year, the mother should apply at the welfare or health department. Similarly, individuals receiving Family Assistance or SSI automatically receive Medicaid cards and do not need to apply separately.
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Medicaid financial assistance
Alabama has some of the strictest eligibility rules for Medicaid in the nation. To qualify for federal Medicaid funding, states must cover specific low-income groups, including children, pregnant women, parents of minor children, the elderly, and people with disabilities. The federal government sets baseline eligibility requirements, which states can modify, so the specifics vary by state. States that cover additional populations or extend coverage to those with higher incomes may be eligible for additional federal funding.
Alabama has not accepted federal funding to expand Medicaid under the ACA, despite efforts from Democratic lawmakers and support from the Alabama Hospital Association. According to a 2020 analysis by the Robert Wood Johnson Foundation, Alabama would experience the most significant decrease in its uninsured rate among the 15 states that had not yet expanded Medicaid at that time. The uninsured rate in Alabama is predicted to drop by 43% if the state were to expand Medicaid.
There are several options for submitting a Medicaid application in Alabama. Non-disabled adults under 65 can apply online through Healthcare.gov. Seniors and people with disabilities can also use this online application pathway. Paper applications can be submitted by mail, fax, or in person to a district office. Individuals can also call 1-800-362-1504 for assistance.
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Alabama's stance on Medicaid expansion
Alabama is one of ten states that has not expanded Medicaid, despite years of calls from hospitals, advocacy groups, and Democratic lawmakers to do so. Alabama's Medicaid program currently covers children, the elderly, and those with disabilities, while childless adults are never eligible, and parents qualify only if they make 18% of the federal poverty level.
In 2024, Alabama lawmakers weighed the benefits and challenges of Medicaid expansion by examining the approaches taken by two Southern states, Arkansas and North Carolina. House Health Committee Chair Paul Lee stated that the goal was to find a unique solution that would help uninsured working Alabamians afford coverage. However, individual senators, such as Senate Finance and Taxation General Fund Committee Chair Greg Albritton, have expressed opposition to expansion.
Alabama's decision not to expand Medicaid has left over 200,000 Alabamians in the "coverage gap," where they earn too much to qualify for traditional Medicaid but too little to afford private insurance or marketplace plans. This gap has had devastating consequences, with doctors reporting that their patients have died from preventable illnesses due to a lack of insurance coverage.
While Alabama has not expanded Medicaid, it has taken some steps towards improving access to healthcare for pregnant women. In April 2025, Alabama legislators unanimously passed a bill to expedite access to Medicaid for pregnant women, addressing the state's high maternal and infant mortality rates. The bill, called the "presumptive eligibility" legislation, allows Medicaid to pay for a pregnant woman's outpatient medical care for up to 60 days while her application for government-funded insurance is pending.
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Legal aid and advice
Alabama's Medicaid program is a state-run health insurance program for low-income residents who cannot get coverage through work or cannot afford a private health plan. It is jointly funded by the state and federal governments. Alabama Medicaid is free for eligible families and individuals, although there may be a co-pay for certain treatments or equipment.
If you are seeking legal advice or aid in Alabama, there are several options for free or low-cost services. AlabamaLegalHelp.org provides a directory of legal services, as well as information on how to find legal help and other resources. The website is funded by a grant from the Legal Services Corporation and is a project of Legal Services Alabama.
The University of Alabama Law also provides a list of free legal resources, including links to various legal services for free or low-cost representation. These include The Alabama State Bar Lawyer Referral Service, The Birmingham Bar Association Lawyer Referral Service, and Legal Services Alabama. The page also provides an interactive list of all 67 counties in Alabama, detailing the available resources in each county. Additionally, it offers information on Pro Bono programs across the state, with contact details for five specific programs.
For those seeking representation, Alabama's civil case offices have lawyers licensed to practice in the state who can provide legal counsel, advice, and representation. These lawyers handle a wide range of practice areas, including domestic violence, public benefits, housing issues, consumer protection, and more.
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Frequently asked questions
Yes, you can have both insurance and Medicaid in Alabama. Many Medicare beneficiaries receive Medicaid financial assistance that helps them lower Medicare premiums, prescription drug costs, and pay for expenses not covered by Medicare.
You can apply for Medicaid in Alabama online, by mail, fax, or in person at a district office. Non-disabled adults under 65 can apply online through Healthcare.gov.
Alabama has specific eligibility criteria for different categories, including children, pregnant women, parents, the elderly, and disabled individuals. The criteria are based on both income and asset limits.
The phone number for Alabama Medicaid is 1-800-362-1504.
No, Alabama has not accepted federal funding to expand Medicaid under the ACA. However, according to a 2020 analysis, expanding Medicaid would lead to the largest decrease in the uninsured rate among states that have not expanded Medicaid.
