Alabama Health Insurance Consumer Guide

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.

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. 

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, your coverage will take effect on February 1.⁶ 

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.⁷

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 or an approved enhanced direct enrollment entity.⁸ 

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.

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.⁹

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 2023.¹⁰ (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.⁹

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.¹¹ 

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.

In 2023, there are three private insurers that offer coverage through the Alabama Marketplace, and all three plan to continue to offer coverage in 2024: 

• Blue Cross Blue Shield of Alabama (plans available statewide)
• UnitedHealthcare 
• Celtic/Ambetter from Alabama (new as of 2023)

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.¹³

Alabama’s insurers have proposed the following average rate changes for 2024:¹⁴ 

Keep in mind that these average rate increases are for full-price plans. However, 97% the Alabama’s Marketplace enrollees are receiving premium tax credits that cover some or all of their monthly premium costs.¹¹ 

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 2025.¹⁵

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.

During the open enrollment period for 2023 coverage, 258,327 people enrolled in private plans through Alabama’s Marketplace.¹⁶ 

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.¹¹ 

Source: 2014,¹⁷ 2015,¹⁸ 2016,¹⁹ 2017,²⁰ 2018,²¹ 2019,²² 2020,²³ 2021,²⁴ 2022,²⁵ 2023,⁹ 2024²⁶

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)