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Home > States > Health insurance in Alabama

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Alabama Health Insurance Consumer Guide

We’ve created this guide, including the FAQs below, 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, and nearly all Alabama Marketplace enrollees qualify for financial assistance with the cost of their coverage.1

Explore our other comprehensive guides to coverage in Alabama

Dental coverage in Alabama

In 2023, nine insurers offer stand-alone individual/family dental coverage through Alabama’s Marketplace.2

Alabama’s Medicaid program

Alabama has not expanded Medicaid under the ACA. Despite this, enrollment in Alabama Medicaid has grown by 51% since 2013.3

Medicare coverage and enrollment in Alabama

As of May 2023, nearly 1.1 million people in Alabama were enrolled in Medicare coverage.4 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.5

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:6

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:

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 . 

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 1.11 

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.12

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: 

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.15

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 2023.15 (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.15

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.16 

Source: CMS.gov 16 

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.17

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.18

Are Marketplace health insurance premiums increasing in Alabama?

The following average rate changes were approved for 2024 for Alabama’s individual/family health insurers:19

Alabama’s ACA Marketplace Plan 2024 Approved Rate Increases by Insurance Company

Source: HeathCare.gov, and Alabama Department of Insurance.20

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 were receiving premium tax credits in 2023 that covered some or all of their monthly premium costs.16 

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 202521 (it could be extended past that, but only with an act of Congress).

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/family health insurance market:

How many people are insured through the Marketplace in Alabama?

During the open enrollment period for 2024 coverage, 386,195 people enrolled in private plans through Alabama’s health insurance Marketplace.31

This was by far a record high, dwarfing enrollment in previous years (see chart below). Before 2024, the highest enrollment had come in 2023, when 258,327 people enrolled through Alabama’s Marketplace.32 

The sharp increase in enrollment in recent years is due in large part to the subsidy enhancements created by the American Rescue Plan and Inflation Reduction Act, which have made coverage more affordable than it used to be.

The enrollment growth in 2024 was also partially driven by the “unwinding” of the pandemic-era Medicaid continuous coverage rule. Medicaid disenrollments resumed in the spring of 2023, and by November 2023, more than 216,000 people had been disenrolled from Alabama Medicaid.33 CMS reported that as of October 2023, more than 21,000 of those individuals had transitioned to an Alabama Marketplace health plan. 34

Source: 2014,35   2015,36 2016,37  2017,38  2018,39  2019,40  2020,41  2021,42  2022,43  202315

What health insurance resources are available to Alabama residents?

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)

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.

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