How Does Alabama Medicaid Work?
- Are you eligible for Medicaid in Alabama? Find out how Alabama Medicaid works, who's eligible to sign up and how it differs from Medicaid in other states.
What Is Alabama Medicaid?
Medicaid is a joint federal-state support program for people who need health insurance but have limited ability to pay for it. Medicaid in Alabama provides support for nearly 1 million state residents, mainly on the basis of financial and medical need. Alabama Medicaid makes use of a statewide network of healthcare providers, including several HMO and PPO systems, to give beneficiaries the widest possible access to care.
What Benefits Does Alabama Medicaid Cover?
The federal government sets guidelines for access, coverage and care for all state Medicaid systems. Program coverage standards include access to preventive and emergency care, rapid access to urgent care and timely appointments for routine outpatient visits. The list of covered medical procedures is long and complex, but as a rule, beneficiaries can get financial help paying for any medically necessary service with the recommendation of a participating Medicaid doctor.
Medicaid in Alabama also includes a prescription drug benefit as part of its standard coverage options. While not every brand name drug is on the covered list, and approval is often required for experimental or off-label drug applications, all of the most common classes of medication are included in the Alabama Medicaid drug schedule.
Many Medicaid participants in Alabama receive care for free at the point of service, though the co-payment required varies according to beneficiaries’ ability to pay. Alabama residents with exceptionally low income often have no payment due at the time of service, while those with marginal incomes may be asked for a co-payment, share of cost or both before benefits kick in.
Who Is Eligible for Medicaid in Alabama?
Residents of Alabama are eligible for Medicaid if they meet all of the federal standards, including income and asset limits that are adjusted for the state. Alabama Medicaid also factors in medical need, age and whether or not the applicant is pregnant as part of the eligibility determination. To qualify for Medicaid in Alabama, applicants must earn less than the modified annual gross income (MAGI), which in 2021 is set to 141% of the federal poverty level. The federal numbers are $12,880 a year for individual adults and $26,500 for a family of four in 2021, and the maximum qualifying incomes in Alabama are $18,160 and $37,365, respectively.
Children in Alabama are eligible for Medicaid or the Children’s Health Insurance Program (CHIP) if their family earns less than 312% of MAGI, or $116,578 annually for a family of four. Otherwise, children may enroll in traditional Alabama Medicaid with a family income of 141% of MAGI. Pregnant women may enroll in Medicare with an income of 141% of MAGI, though adult caretakers for children must earn less than 13% of MAGI to be financially eligible for Medicaid for themselves.
How Do I Enroll in Medicaid in Alabama?
If you are eligible for Medicaid in Alabama, you can enroll in several ways. Applications are available online through the Alabama Medicaid web portal. At this site, you will be asked to choose your category of application, such as Medicaid for Children, Medicaid for the Elderly and Disabled, or Medicaid for Parents and Caretaker Relatives. Clicking one of these links brings you to the appropriate application for your situation, which you can submit online.
If you need help with your application, or if you prefer to apply by phone, Medicaid offices in Alabama can be reached at (800) 362-1504. In-person assistance is available at Alabama Medicaid and social service offices, which can set an appointment for faster and safer service.
Contact Information for Alabama Medicaid
The central office for Medicaid in Alabama is located in Montgomery. The public can reach this office’s switchboard by calling (334) 242-5000. Telephone inquiries about specific Medicaid services, application categories, non-citizen status and emergency matters can be made by calling (800) 362-1504. Applications and general correspondence may be sent to the state Medicaid PO Box at:
PO Box 5624
Montgomery, AL 36103-5624
In-person appointments are sometimes available from the main office. If you need to visit with a Medicaid worker at this location, the office address is:
501 Dexter Avenue
Montgomery, AL 36104
If you believe you have information about fraud, abuse, waste or neglect of vulnerable people, you can contact Alabama Medicaid’s investigations office at (866) 452-4930, or call 911 in an emergency.