If you reside in Alabama and are 65 years of age or older, or soon will be, you might be interested in learning more about Medicare plans in Alabama and your options for coverage.

Medicare is a federally run national insurance program for senior citizens, those with specific disabilities, and people with long-term health issues.

However, Medicare encompasses more than just one health plan. There are several parts, some of which are accessible by commercial insurance firms and others through the federal government. As a result, numerous factors to consider when deciding which Medicare plan in Alabama is ideal for you.

Details about Medicare in Alabama

The following details on Medicare trends in Alabama for the 2022 plan year were provided by the Centers for Medicare & Medicaid Services (CMS):

  • A total of 1,065,866 Alabama citizens were Medicare beneficiaries.
  • The typical Medicare Advantage monthly premium in Alabama declined from $11.19 in 2021 to $11.21 in 2022.
  • In Alabama, 91 Medicare Advantage plans will be available in 2022, up from 82 in 2021.
  • Medicare Advantage plans, including those with no premiums, are available to purchase for all Alabama citizens with Medicare.
  • Alabama will offer 12 different Medigap policies in 2022.

Alabama Medicare options

There are numerous components that makeup Medicare. Next, we’ll discuss several of these components and how they function in Alabama.

Primary Medicare

The main parts that can be obtained from the federal government are Parts A and B. They combine to form what is known as original Medicare.

Hospital expenses are covered under Medicare Part A. This covers any inpatient medical care you could get in a hospital, mainly restricted treatment at a skilled nursing facility or home.

General medical services are covered by Medicare Part B. It includes coverage for preventative care and other medically required outpatient treatments and procedures that you receive from a general practitioner or specialist.

Even though parts A and B may appear to be rather extensive, original Medicare may not offer enough coverage. Private insurance providers provide you with the choice of acquiring extra protection to fill in these gaps.

What Are Medicare Advantage Plan Types Available in Alabama?

Although there are many different individual plans available in Alabama, the following plan types can help you focus your search depending on your preferences:

  • Health Maintenance Organization (HMO): HMO insurance policies cover visits to hospitals, clinics, and other healthcare facilities that are part of your plan’s network. It will not cover any visits to individuals outside your provider network (unless those visits are for emergency or urgent care). You’ll need a recommendation from your doctor to receive specialist treatments.
  • Preferred Provider Organization (PPO): Unlike an HMO, a PPO plan gives you more freedom to see medical professionals outside your network (albeit at a higher cost). You can anticipate paying less in coinsurance and co-payments for in-network providers.
  • Private Fee-for-Service (PFFS) plans: PFFS plans typically place little restrictions on the medical professionals you can see. However, these plans reserve the right to determine the number of hospital stays, doctor visits, and other medical services they will pay for.
  • SNP insurance programs limit eligibility to people with chronic medical conditions (such as HIV/AIDS, end-stage renal disease, or diabetes) or who reside in institutions (like nursing homes). There are Dual Special Needs Plans (D- SNPs) for those who are Medicaid and Medicare-eligible.
  • The Medicare Advantage Prescription Medication Plan (MA-PD) combines prescription drugs and health insurance into a single plan. As an alternative to the Medicare Part D plans you would have to sign up for if you had Original Medicare and required prescription drug coverage, this kind of plan is available.
  • Medical Savings Account (MSA): An MSA plan is a savings account that is credited with money from the insurance company. You can utilize the savings fund to cover some of your medical costs, even though these frequently have large deductibles.

Private Health Insurance providers in Alabama

In Alabama, a variety of private insurance providers provide Medicare Advantage plans, including:

  • Medicare Aetna
  • Ascension is finished
  • Alabama Blue Cross and Blue Shield
  • Cigna
  • Humana
  • Lasso Health Services
  • UnitedHealthcare
  • Medicare Viva
  • Wellcare

Enter your precise ZIP code while looking for plans in your county because not all these Alabama Medicare Advantage plans are offered there.

Medicare Supplement Plans in Alabama

Medicare supplement plans assist in covering expenses like copays, coinsurance, and deductibles that basic Medicare does not. These plans are referred to as Medigap policies at times.

In Alabama, there are numerous insurance providers of Medigap plans. Some of the businesses providing Medigap plans in this state in 2022 include:

  • UnitedHealthcare and AARP
  • Alabama Blue Cross and Blue Shield
  • Cigna
  • Penn Colonial
  • Excellent Southern
  • Humana
  • Lumico
  • Pan-American
  • The State Farm

In Alabama, there are a total of 12 distinct plan options. You can look at those offered locally by putting your ZIP code into Medicare’s Medigap plan finder.

Alabama’s top HMO Medicare Advantage Plan

The ideal HMO Medicare Advantage Plan for you depends on your needs, even though we looked at the right ones in Alabama. When seeking an HMO plan with prescription coverage, six basic benefits, and a high CMS star rating, we discovered that VIVA Medicare’s Medicare Plus plan is the right choice.

An HMO often has lower costs than other types of insurance. However, it forbids you from receiving care outside your network unless it’s an emergency. You will also need a reference to make an appointment with a specialist.

Right Medicare Advantage Plan in Alabama Without Drug Coverage

There are numerous different plans you can choose from if Alabama prescription Part D drug coverage is not what you’re after. Our research indicates that for those looking for a Medicare Advantage Plan that provides either prescription drug coverage or does not, has six essential benefits, and has a high star rating from the CMS, the VIVA Medicare Select plan provided by VIVA Medicare is the right option.

Alabama’s top Medicare Advantage plan for minimal out-of-pocket expenses

There are numerous Medicare Advantage Plans in Alabama that have minimal or no premiums. Despite this, you can still be required to pay more out of pocket. Our analysis reveals that the Aetna Medicare Freedom Plan by Aetna Medicare might be your right choice if you’re seeking a Medicare Advantage Plan with a low in-network max out-of-pocket limit, medication coverage, six essential benefits, and a high star rating from the CMS.

Alabama’s Medicare Advantage Plans: Statistics

We discovered that Alabama has ten healthcare facilities that provide Medicare Advantage Plans. To determine whether plan elements are uncommon versus frequent, we conducted the following research on Medicare Advantage Plans in Alabama.

  • 68.2% of Alabama’s Medicare Advantage Plans—a combination of HMO, MSA, and PPO—offer medication coverage.

Preferred Provider Organization plans make up 55.0% of the plans available in Alabama, followed by Health Maintenance Organization plans (35.7%) and Medical Savings Account plans (9.4%). We found that 68.2% of plans cover prescription drugs.

  • In Alabama, 70% of Medicare Advantage Plans have a $0 premium.

According to our analysis, 40 of Alabama’s health plans have no premiums, representing 70% of the state’s available health plans. The average cost of plans with non-free premiums is $67.80.

  • In Alabama, most insurance policies frequently include vision, dental, hearing, fitness, and telemedicine benefits.

We discovered that most state health plans include telemedicine, fitness, dental, and hearing benefits. On the other hand, it’s uncommon to find a plan that provides house adaptations, emergency response equipment, and in-home assistance.

Alabama Medicare enrollment

Medicare plans in Alabama may be available to you if:

  • Applicants are 65 years or older.
  • Have a disability of any age for which you have been receiving Social Security Disability Insurance for at least 24 months.
  • You are of any age and have amyotrophic lateral sclerosis (ALS) or end-stage renal disease (ESRD).

When is the Alabama Medicare plan enrollment period?

Three months before turning 65, you can start the online Medicare application process. Your initial registration term begins at this time. This window is from three months before your 65th birthday to three months afterward.

Additional enrollment periods consist of:

  • Initial enrollment in Medigap: After turning 65, you have up to six months to sign up for Medigap coverage.
  • General enrollment period: If you didn’t sign up for a Medicare or Medicare Advantage plan during your initial enrollment period, you could do so from January 1 through March 31.
  • Enrollment in Medicare Part D and add-ons: If you didn’t sign up for Medicare Part A but did sign up for Part B during the general enrollment period, you have until June 30 to select a Part D prescription drug plan.
  • Open enrollment: You can sign up for, cancel, or change your Part C or Part D plan from October 15 to December 7 or return to your original Medicare.
  • Special enrollment period: You may be eligible for a special enrollment period of 8 months for a valid reason, during which time you can sign up for Medicare or change your Part C, Part D, or Medigap plan.

Advice for Alabama Medicare enrollment

Consider how each Medicare plan might impact you while selecting one in Alabama. These kinds of inquiries should be kept in mind:

  • How much will it cost? Aside from premium rates, consider what you can anticipate paying out-of-pocket for medical services or medicines.
  • What is the plan’s layout? If you’re thinking about a Medicare Advantage plan, bear in mind that there are various methods that these plans can be set up in Alabama. Do you prefer to go directly to network experts on your own, or do you choose to have a primary care doctor manage your care?
  • Is the network appropriate for your requirements? Networks vary in their degree of narrowness. Check to see if your usual doctors are included in the network of the insurance plan you’re considering, especially if you already have a rapport with them.


The conclusion

Alabama has almost 1 million Medicare beneficiaries. Several private insurance providers in Alabama offer various Medicare Advantage and Medigap plans. The overall cost of Alabama’s Medicare Advantage plans for 2022 has reduced monthly premiums.


Frequently asked questions

Who in Alabama is eligible for Medicare?

Alabama follows the same Medicare rules as the rest of the nation. You need to be eligible to be 65 years of age or older or have a serious sickness or disability, such as kidney failure.

Which Medicare plan is the right in Alabama?

Aetna is the top supplier of affordable Medicare Advantage plans in Alabama, giving enough coverage for those with common medical requirements. The company with the highest rating, five stars, is Viva Health. And for those who value provider flexibility, Blue Cross and Blue Shield of Alabama is the trusted option.

What is Alabama’s Medicare income eligibility threshold?

Medicare eligibility has no income restrictions. Instead, you are eligible if you are 65 years or older or have a qualifying medical condition. Low-income individuals could be qualified for both Medicaid and Medicare. A person must make less than $13,590, a couple less than $18,310, or a family of four less than $27,750 annually to be eligible for Medicaid in Alabama.

How much does Plan G cost per month?

What is the price of Medicare Plan G? Medicare Plan G will cost a 65-year-old between $120 and $364 per month in 2022. Because every insurance provider has a unique pricing strategy for its plans, there is a wide range of prices for Medicare supplement coverage.

What Medicare Supplement plan is the cheapest?

The least expensive Medigap plan is Plan K, with an average monthly cost of $77 for 2022. A high-deductible plan is an additional low-cost option for those interested in protecting themselves against high medical costs. A select few companies only provide these plans, and Mutual of Omaha’s high-deductible Plan G has a monthly premium of roughly $54.

What is the right Medicare Supplement plan?

For most folks, we advise Medigap Plan G from AARP/UnitedHealthcare, which is about $159 per month for a 65-year-old. You will receive thorough medical coverage from a reputable organization with this plan. All Supplement plans, however, include specific benefits that will assist shield you from the out-of-pocket medical costs that Original Medicare (Part A and Part B) would incur.


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