Alabama Health Insurance Marketplace Guide

To enroll in private health coverage through the Marketplace in Alabama (HealthCare.gov), you must:⁴

• Live in Alabama and be lawfully present in the United States
• Not be incarcerated
• Not have Medicare coverage 

So most people are eligible to enroll in Marketplace coverage. But qualifying for financial assistance (premium subsidies and cost-sharing reductions) depends on your income and also has some additional parameters. To qualify for financial assistance with your Marketplace plan you must:

• Not have access to affordable health coverage offered by an employer. If you’re eligible to enroll in an employer-sponsored plan but it seems too expensive, you can use our Employer Health Plan Affordability Calculator to see if you might qualify for premium subsidies in the Marketplace. 
• Not be eligible for Medicaid or CHIP.
• Not be eligible for premium-free Medicare Part A.⁵
• If married, file a joint tax return⁶ (with very limited exceptions)⁷
• Not be able to be claimed by someone else as a tax dependent.⁸

You may find affordable health insurance coverage in Alabama by enrolling through HealthCare.gov. This is especially true if you qualify for premium tax credits (subsidies), and most Alabama enrollees are subsidy-eligible.

During the open enrollment period for 2026 coverage, 91% of Alabama Marketplace enrollees qualified for premium subsidies. These premium subsidies saved enrollees an average of about $678/month. For enrollees who qualify for subsidies, the average after-subsidy premium was only $70/month in 2026.⁹

However, subsidy enhancements that had been in effect for five years were allowed to expire at the end of 2025, after Congressional Republicans refused to extend them. This means subsidies are no longer available to households with income above 400% of the federal poverty level, and it also means subsidies don’t cover as much of enrollees’ premiums in 2026.

The overall average net premium (including people who pay full price) was $65/month in 2025¹⁰ in Alabama’s Marketplace, and grew to $126/month in 2026,¹¹ due to the expiration of the federal subsidy enhancements.

If your household income isn’t more than 250% of the federal poverty level, you may also qualify for cost-sharing reductions (CSR). These subsidies can make your deductible and other out-of-pocket expenses smaller than they would otherwise be, as long as you select a Silver-level plan. 

Source: CMS.gov ¹²

If you’re eligible for APTC and CSR benefits you can utilize both as long as you select a Silver-level plan (APTC can be used with plans at any metal level, but CSR benefits are only available on Silver plans). 

Depending on your income and circumstances, you may find that you’re eligible for free or low cost health coverage through Alabama Medicaid or ALL Kids (CHIP). Check to see if you meet the criteria for these programs in Alabama.

The open enrollment period for 2027 health coverage in Alabama runs from November 1, 2026 through January 15, 2027.¹³ You’ll need to enroll by December 15 to have your coverage take effect on January 1.

(HHS had planned to shorten the open enrollment period starting in the fall of 2026, but that rule change was vacated by a judge. HHS has appealed that ruling,¹⁴ but has announced that the open enrollment period will not be shortened for 2027 coverage.)¹³

Outside of the open enrollment window, you may be eligible to enroll or make a plan change if you experience a qualifying life event, such as giving birth or losing other health coverage. And Native Americans can enroll year-round, without a specific qualifying event.

Enrollment in Alabama Medicaid and ALL Kids (CHIP) is available year-round, so if you’re eligible for either program, you can enroll anytime.

To enroll in an ACA Marketplace (exchange) plan in Alabama, you can: 

• Visit HealthCare.gov – the health insurance Marketplace website – to compare the available health plans, determine subsidy eligibility, and select the plan that best meets your needs . 
• Enroll in Marketplace coverage with the help of licensed agents, navigators, or certified application counselors.¹⁵
• Enroll via an approved enhanced direct enrollment entity.¹⁶ 

You can also call HealthCare.gov’s contact center by dialing 1-800-318-2596 (TTY: 1-855-889-4325). The call center is available 24 hours a day, seven days a week, except for holidays.

Four private insurers offer plans through the Alabama Marketplace in 2026, including Oscar Health, which was new to the Alabama market for 2026.¹⁷

All four will continue to offer plans in 2027.¹⁸

The following average rate changes have been proposed for 2027 by the insurers that offer individual/family health plans through the Alabama Marketplace, amounting to a weighted average rate increase of about 20.2%.¹⁹

Source: RateReview.HeathCare.gov²⁰

But because Congress let the federal subsidy enhancements expire at the end of 2025:

• Everyone with household income above 400% of the federal poverty level lost their subsidies as of 2026. Almost 18,000 Alabama Marketplace enrollees had income above 400% FPL in 2025 (or did not provide income details with their application).²¹
• Those with household income up to 400% of the poverty level are still eligible for subsidies in 2026, but their subsidies are smaller than they would have been if the subsidy enhancements had been extended. This will continue to be the case in 2027, although enrollees won’t experience the same level of sticker shock they had for 2026, because the expiration of the subsidy enhancements is already incorporated into the 2026 prices.

For perspective, here’s a summary of how average unsubsidized premiums have changed over time in Alabama’s individual/family health insurance market:

• 2015: Average increase of 3%²²
• 2016: Average increase of 24.4%²³
• 2017: Average increase of 36%²⁴
• 2018: Average increase of 17.9%²⁵
• 2019: Average decrease of 2%²⁶
• 2020: Average increase of 3.3%²⁷
• 2021: Average increase of 5.1%²⁸
• 2022: Average increase of 6.7%²⁹
• 2023: Average increase of 0.42%³⁰
• 2024: Average (unweighted) decrease of 3.7%³¹
• 2025: Average (unweighted) decrease of 4.8%³²
• 2026: Average increase of 20.7%³³

During the open enrollment period for 2026 coverage, 455,776 people enrolled in private plans through Alabama’s health insurance Marketplace.¹

This was a decline from the record-high enrollment in 2025, but it was still higher than any previous year other than 2025 (see chart below).

The sharp increase in enrollment in recent years was due in large part to the subsidy enhancements created by the American Rescue Plan and Inflation Reduction Act, which made coverage more affordable than it used to be. As noted above, these subsidy enhancements expired at the end of 2025.

The enrollment growth in 2024 was also partially driven by the “unwinding” of the pandemic-era Medicaid continuous coverage rule. Medicaid disenrollments resumed in the spring of 2023, and by April 2024, more than 93,000 Alabama residents had transitioned from Medicaid to a Marketplace plan during the unwinding process.³⁴

Source: 2014,³⁵ 2015,³⁶ 2016,³⁷ 2017,³⁸ 2018,³⁹ 2019,⁴⁰ 2020,⁴¹ 2021,⁴² 2022,⁴³ 2023,⁴⁴ 2024,⁴⁵ 2025⁴⁶ 2026⁴⁷

HealthCare.gov
The Marketplace in Alabama, where residents can enroll in individual/family health coverage and receive income-based subsidies. You can reach HealthCare.gov at 800-318-2596.

Alabama Department of Insurance
Licenses and regulates health insurance companies, agents, and brokers; can provide assistance to consumers who have questions or complaints about entities the Department regulates.

AIDS Alabama/Enroll Alabama
The federally-funded Navigator organization in Alabama.

Alabama State Health Insurance Assistance Program
A local service that provides assistance and enrollment counseling for Medicare beneficiaries and their caregivers. 

Alabama Medicaid Agency and ALL Kids (Alabama’s Children’s Health Insurance Program)