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Alabama Health Insurance Consumer Guide
We’ve created this guide to help you understand the Alabama health insurance options available to you and your family, and to help you select the coverage that will best fit your needs and budget.
An ACA Marketplace (exchange) plan – or Obamacare – is a good option for anyone who needs to buy their own individual or family health coverage, including people who aren’t eligible for Medicaid, Medicare, or an employer-sponsored health plan.
Alabama uses the federally run Marketplace, so you can enroll at HealthCare.gov. Three private health insurance companies offer plans through the Marketplace in Alabama.
Dental coverage in Alabama
In 2023, nine insurers offer stand-alone individual/family dental coverage through Alabama’s Marketplace.1
Alabama’s Medicaid program
Alabama has not expanded Medicaid under the ACA. Despite this, enrollment in Alabama Medicaid has grown by 51% since 2013.2
Medicare coverage and enrollment in Alabama
As of May 2023, nearly 1.1 million people in Alabama were enrolled in Medicare coverage.3 Our guide explains everything you need to know about Medicare coverage options and Medigap regulations in Alabama.
Short-term coverage in Alabama
A dozen insurers currently offer short-term health insurance in Alabama, and the state allows these plans to follow federal duration rules.4
Frequently asked questions about health insurance in Alabama
Who can buy Marketplace health insurance?
To enroll in private health coverage through the Marketplace in Alabama (HealthCare.gov), you must:5
- 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.6
When can I enroll in an ACA-compliant plan in Alabama?
You can sign up for an ACA-compliant individual or family health plan in Alabama between November 1 and January 15 during the annual open enrollment period. (for 2024 coverage, the deadline has been extended through January 16, 2024, due to the federal holiday that falls on January 15.)7
To have your coverage take effect on January 1, you need to complete your enrollment by December 15. If you apply between December 16 and January 15 (January 16, in 2024), your coverage will take effect on February 1.8
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 some people can enroll year-round even without a specific qualifying event.9
Enrollment in Alabama Medicaid and ALL Kids (CHIP) is available year-round, so if you’re eligible for either program, you can enroll anytime.
How do I enroll in a Marketplace plan in Alabama?
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.10
- Enroll via an approved enhanced direct enrollment entity.11
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.
How can I find affordable health insurance in Alabama?
You may find affordable health insurance coverage in Alabama by enrolling through HealthCare.gov. This is especially true if you qualify for subsidies, and most Alabama enrollees are subsidy-eligible.12
Under the Affordable Care Act, there are income-based subsidies – a type of financial assistance – called Advance Premium Tax Credits (APTC). APTCs can help reduce the amount you owe in premiums each month, depending on your income and the plan you select.
More than 95% percent of Alabama Marketplace enrollees were receiving premium subsidies in 2023.12 (Alabama was tied with Florida for the highest percentage of subsidy-eligible enrollees in the nation). These premium subsidies saved enrollees an average of nearly $680/month. After subsidies were applied, the average enrollee’s monthly cost was about $75/month.12
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. As of 2023, two-thirds of the people with Marketplace coverage in Alabama were receiving CSR benefits.13
Source: CMS.gov 13
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.
How many insurers offer Marketplace coverage in Alabama?
Three private insurers offer coverage through the Alabama Marketplace.14
US Health & Live/Ascension Personalized Care had initially filed plans to enter the Alabama market for 2023, but ultimately only expanded into Texas and Tennessee for 2023, and did not move forward with their plan to offer coverage in Alabama.15
Are Marketplace health insurance premiums increasing in Alabama?
The following average rate changes were approved for 2024 for Alabama’s individual/family health insurers:16
Alabama’s ACA Marketplace Plan 2024 Approved Rate Increases by Insurance Company
|Blue Cross and Blue Shield of Alabama||3.1%|
|Celtic/Ambetter from Alabama||0.86%|
Source: HeathCare.gov, and Alabama Department of Insurance.17
Keep in mind that these average rate increases are for full-price (unsubsidized) plans. However, very few enrollees pay full price. Nearly all (97%) of Alabama’s Marketplace enrollees are receiving premium tax credits that cover some or all of their monthly premium costs.13
These subsidies are adjusted to match changes in the benchmark plan (the second-lowest-cost Silver plan) in each area. And as a result of the American Rescue Plan and the Inflation Reduction Act, the subsidies are larger and more widely available than they used to be. This will continue to be the case through at least 2025.18
If the cost of your current plan is increasing for next year, you can explore other plans in the exchange that may be less expensive and offer similar benefits. Open enrollment (November 1 through January 15) is your opportunity to switch to a different plan.
For perspective, here’s a summary of how average unsubsidized premiums have changed over time in Alabama’s individual health insurance market:
- 2015: Average increase of 3%.19
- 2016: Average increase of 24.4%.20
- 2017: Average increase of 36%.21
- 2018: Average increase of 17.9%.22
- 2019: Average decrease of 2%.23
- 2020: Average increase of 3.3%.24
- 2021: Average increase of 5.1%.25
- 2022: Average increase of 6.7%.26
- 2023: Average increase of 0.42%.27
How many people are insured through the Marketplace in Alabama?
During the open enrollment period for 2023 coverage, 258,327 people enrolled in private plans through Alabama’s Marketplace.28
Effectuated enrollment is always a little lower than the number of people who initially select plans. As of early 2023, there were nearly 247,000 people with effectuated coverage through the Marketplace in Alabama.13
What health insurance resources are available to Alabama residents?
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.
Alabama State Health Insurance Assistance Program
A local service that provides assistance and enrollment counseling for Medicare beneficiaries and their caregivers.
Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org. Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.
- “Alabama dental insurance guide 2023” healthinsurance.org, Accessed September 2023
- “Total Monthly Medicaid & CHIP Enrollment and Pre-ACA Enrollment” KFF.org, May 2023
- “Medicare Monthly Enrollment” CMS.gov, April 2023.
- “Availability of short-term health insurance in Alabama” healthinsurance.org, Sept. 6, 2023
- ”A quick guide to the Health Insurance Marketplace” HealthCare.gov
- Medicare and the Marketplace, Master FAQ. Centers for Medicare and Medicaid Services. Accessed November 2023.
- Biden-Harris Administration Launches Window-Shopping Ahead of 11th ACA Marketplace Open Enrollment Period. Centers for Medicare and Medicaid Services. October 2023.
- “When can you get health insurance?” HealthCare.gov, 2023
- “Who doesn’t need a special enrollment period?“ healthinsurance.org, Accessed August 2023
- Find Local Help. HealthCare.gov. Accessed November 2023.
- “Entities Approved to Use Enhanced Direct Enrollment” CMS.gov, April 28, 2023
- “2023 Marketplace Open Enrollment Period Public Use Files” CMS.gov, March 2023
- “Effectuated Enrollment: Early 2023 Snapshot and Full Year 2022 Average” CMS.gov, March 15, 2023
- 2024 Affordable Care Act Final Rates. Alabama Department of Insurance. October 2023.
- “ACA rate changes for Alabama policies in the individual market” ALDOI.gov, July 25, 2022
- Alabama Rate Review Submissions. ratereview.healthcare.gov. Accessed November 2023.
- Alabama Rate Review Submissions. ratereview.healthcare.gov. Accessed November 2023. And 2024 Affordable Care Act Final Rates. Alabama Department of Insurance. October 2023.
- “Health Insurance Marketplaces 2023 Open Enrollment Report” CMS.gov, Accessed August 2023
- Analysis Finds No Nationwide Increase in Health Insurance Marketplace Premiums. The Commonwealth Fund. December 2014.
- FINAL PROJECTION: 2016 Weighted Avg. Rate Increases: 12-13% Nationally* ACA Signups. October 2015.
- Rates for some Obamacare plans to increase by 36 percent. AL.com. October 2016.
- Alabama, Hawaii, Missouri, Wyoming: Wrapping Up The 2018 Rate Hike Project W/An Assist From Avalere. ACA Signups. October 2017.
- 2019 Rate Hike Project Wrap-Up: FINAL/APPROVED Rate Changes For Alabama, Mississippi & Utah. ACA Signups. November 2018.
- Alabama: *Final* 2020 Avg. #ACA Exchange Premium Changes: +3.3%. ACA Signups. October 2019.
- 2021 Rate Changes. ACA Signups. October 2020.
- 2022 Rate Changes. ACA Signups. October 2021.
- UPDATED: FINAL Unsubsidized 2023 Premiums: +6.2% Across All 50 States +DC. ACA Signups. Accessed November 2023.
- “Marketplace 2023 Open Enrollment Period Report: Final National Snapshot” CMS.gov, January 2023
- “ASPE Issue Brief (2014)” ASPE, 2015
- “Health Insurance Marketplaces 2015 Open Enrollment Period: March Enrollment Report”, HHS.gov, 2015
- “HEALTH INSURANCE MARKETPLACES 2016 OPEN ENROLLMENT PERIOD: FINAL ENROLLMENT REPORT” HHS.gov, 2016
- “2017 Marketplace Open Enrollment Period Public Use Files” CMS.gov, 2017
- “2018 Marketplace Open Enrollment Period Public Use Files” CMS.gov, 2018
- “2019 Marketplace Open Enrollment Period Public Use Files” CMS.gov, 2019
- “2020 Marketplace Open Enrollment Period Public Use Files” CMS.gov, 2020
- “2021 Marketplace Open Enrollment Period Public Use Files” CMS.gov, 2021
- “2022 Marketplace Open Enrollment Period Public Use Files” CMS.gov, 2022