Alabama Medicaid Eligibility Guide
This guide provides comprehensive information about Medicaid eligibility in Alabama. Whether you're a child, parent, pregnant woman, or adult, this guide will help you understand if you qualify for Alabama Medicaid coverage and how to apply.
Important Note: Medicaid eligibility rules and income limits are subject to change. For the most up-to-date information, please contact the Alabama Medicaid office at 1-800-362-1504 or visit medicaid.alabama.gov.
General Eligibility Requirements
To qualify for Alabama Medicaid, you must:
- Be a resident of Alabama
- Be a U.S. citizen or have qualified immigration status
- Have or apply for a Social Security number (with some exceptions)
- Meet the specific eligibility criteria for at least one Medicaid pathway
- Meet income guidelines (which vary by program)
- Meet resource/asset limits (for certain programs)
Note: This guide covers the main Medicaid eligibility categories for children, pregnant women, parents, and adults. Additional pathways exist for seniors (65+), people with disabilities, and those with specific medical conditions. These specialized programs often have different income and asset requirements not detailed in this guide.
Medicaid Eligibility Pathways in Alabama
Alabama offers several pathways to Medicaid eligibility, each with specific requirements. Please note, a 5% income disregard may already be included or can be applied depending on circumstances.
1. Medicaid for Children
Who Qualifies:
- Children under age 19
- Alabama residents
- U.S. citizens or those with qualified immigration status
- Meeting income guidelines
Income Limits:
- Children (0-18): Up to 146% FPL
| Family Size | Children (0-18) (146% FPL) |
|---|---|
| 1 | $1,904 |
| 2 | $2,574 |
| 3 | $3,243 |
| 4 | $3,911 |
| 5 | $4,581 |
| 6 | $5,250 |
| 7 | $5,919 |
| 8 | $6,589 |
| Each Additional Person | +$669 |
2. Children's Health Insurance Program (CHIP)
Who Qualifies:
- Children under age 19
- Family income above Medicaid limits but at or below 317% FPL
- Alabama residents
- U.S. citizens or those with qualified immigration status
- No other insurance coverage
Income Limits:
Above Medicaid limits up to 317% FPL
3. Medicaid for Pregnant Women
Who Qualifies:
- Pregnant individuals
- Alabama residents
- U.S. citizens or those with qualified immigration status
- Meeting income guidelines
Income Limits: 146% of FPL
| Family Size* | Monthly Income Limit | Annual Income Limit |
|---|---|---|
| 2 | $2,574 | $30,888 |
| 3 | $3,243 | $38,916 |
| 4 | $3,911 | $46,932 |
| 5 | $4,581 | $54,972 |
| 6 | $5,250 | $63,000 |
| 7 | $5,919 | $71,028 |
| 8 | $6,589 | $79,068 |
| Each Additional Person | +$669 | +$8,028 |
*Note: Unborn child is counted as a family member when determining family size.
Important: Coverage extends for 12 months postpartum in Alabama.
Presumptive Eligibility: Temporary coverage for outpatient prenatal services while the full application is being processed.
4. Medicaid for Non-Disabled, Non-Elderly Adults
Alabama has not expanded Medicaid under the Affordable Care Act. Therefore, non-disabled adults without dependent children are generally not eligible for Medicaid, regardless of income.
4. Medicaid for Parents & Caretaker Relatives
Who Qualifies:
- Parents or caretaker relatives of dependent children under age 19
- Must live with and provide care for the child
- Alabama residents
- U.S. citizens or those with qualified immigration status
- Meeting income guidelines
Income Limits: 13% of FPL
Note: This percentage is an approximation. Alabama may use fixed dollar amounts rather than a strict percentage of the Federal Poverty Level for this category.
| Family Size | Monthly Income Limit | Annual Income Limit |
|---|---|---|
| 2 | $229 | $2,748 |
| 3 | $289 | $3,468 |
| 4 | $348 | $4,176 |
| 5 | $408 | $4,896 |
| 6 | $467 | $5,604 |
| 7 | $527 | $6,324 |
| 8 | $587 | $7,044 |
| Each Additional Person | +$60 | +$720 |
How Income is Counted for MAGI-based Healthcare Programs
Understanding how your income is counted is important for determining eligibility for Medicaid and other healthcare programs. Medicaid income limits are based on MAGI (Modified Adjusted Gross Income). To learn how MAGI income is calculated see: How Income is Counted for MAGI
How to Apply for Alabama Medicaid
There are several ways to apply for Medicaid in Alabama:
- Online: Visit medicaid.alabama.gov
- By Phone: Call 1-800-362-1504
- In Person: Visit your local Department of Social Services or Medicaid office
- By Mail: Request a paper application from your local Medicaid office
Affordable Care Act (ACA) Coverage
If you don't qualify for Medicaid in Alabama, you may be eligible for subsidized health insurance through the Health Insurance Marketplace.
Who Can Apply for Marketplace Coverage
Anyone who:
- Lives in the United States
- Is a U.S. citizen or national (or is lawfully present)
- Is not incarcerated
- Is not covered by Medicare
Premium Tax Credits and Subsidies
Premium tax credits help reduce your monthly insurance premiums. In Alabama (a non-Medicaid expansion state), you may qualify for premium tax credits if your income is between 100% and 400% of the Federal Poverty Level, and in some cases above 400% FPL.
| Family Size | Monthly Income at 400% FPL | Annual Income at 400% FPL |
|---|---|---|
| 1 | $5,216 | $62,592 |
| 2 | $7,052 | $84,624 |
| 3 | $8,884 | $106,608 |
| 4 | $10,716 | $128,592 |
| 5 | $12,552 | $150,624 |
| 6 | $14,384 | $172,608 |
| 7 | $16,216 | $194,592 |
| 8 | $18,052 | $216,624 |
| Each Additional Person | +$1,832 | +$21,984 |
The Coverage Gap in Alabama
Alabama has not expanded Medicaid under the ACA. This creates a "coverage gap" for adults who:
- Have income below 100% FPL
- Don't qualify for Alabama Medicaid under existing categories (parents, elderly, disabled, etc.)
- Don't earn enough to qualify for Marketplace subsidies (which start at 100% FPL)
If you fall into this coverage gap, you may want to:
- Check if you qualify for any of the Medicaid categories listed earlier in this guide
- Explore healthcare options at community health centers, which provide services on a sliding fee scale
- Consider catastrophic plans if you're under 30 or qualify for a hardship exemption
When to Apply
- During the annual Open Enrollment Period (typically November to January)
- Within 60 days of certain life events that qualify for a Special Enrollment Period (losing other coverage, marriage, birth of a child, etc.)
How to Apply for Marketplace Coverage
- Visit Healthcare.gov
- Call the Marketplace Call Center at 1-800-318-2596
- Get in-person help from a Navigator or Certified Application Counselor (find local assistance at Healthcare.gov)
What You'll Need to Apply
- Social Security numbers for everyone on your application
- Employer and income information for everyone in your household
- Current insurance information (if applicable)
- Immigration documentation (if applicable)
Disclaimer
This guide provides general information about Alabama Medicaid eligibility based on data available as of March 2025. Eligibility criteria, income limits, and application procedures may change. Always consult the official Alabama Medicaid website or call the Alabama Medicaid Recipient Call Center at 1-800-362-1504 for the most current information.
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