Medicare Advantage in Alabama

Medicare Advantage (also known as Type C) is one way seniors can access the federal health benefits available through Medicare in Alabama. Like Original Medicare, this type of insurance covers many medical services for eligible adults aged 65+ or individuals with certain debilitating conditions. These services, categorized as Type A for in-patient care received in institutions such as hospitals or nursing homes and Type B for outpatient care such as X-rays and lab tests, are bundled into Medicare Advantage along with Type D drug benefits. 

The federal government pays for services covered by Original Medicare. In contrast, private insurance companies manage Medicare Advantage Plans and receive monthly payments for each beneficiary from the government to cover expected costs. While beneficiaries may not pay a monthly premium for Medicare Advantage, depending on the specific plan, they usually still need to pay the Type B premium, which is $164.90 in 2023. They may also need to pay a separate amount for Type D benefits, so individuals need to understand all the details of a plan to ensure costs are manageable before enrolling.

Alabama has one of the highest Medicare Advantage enrollment rates in the United States as of 2023. Of the 1,095,323 residents eligible for benefits, 57% are enrolled in Medicare Advantage Plans, compared to 48% nationwide. This figure reveals a growth of 6.42% in the percentage of beneficiaries accessing health insurance through Medicare Advantage. However, this is slightly below the 6.9% increase experienced across the country and suggests that uptake may be slowing in Alabama, possibly due to the state’s lower 1.9% growth in total people eligible for Medicare versus 2.66% nationwide.

This guide provides an overview of the eligibility requirements for Medicare Advantage, the types of plans available and what coverage typically includes. It also ranks the best health insurance providers in the state to help seniors choose policies suitable for their needs and their budgets.

The Top 10 Medicare Advantage Plans in Alabama

Private insurance companies in Alabama can operate over multiple counties and may offer many options for Medicare Advantage. The table below lists the top 14 providers based on enrollment numbers across their plans and includes costs as a range based on each provider’s lowest and highest plan prices to allow for easier comparisons. It also lists the Medicare star rating to show member satisfaction levels and overall performance. Information is current as of July 2023, and seniors can check Medicare.gov for any recent changes.

How Medicare Advantage Plans Work in Alabama

Depending on the insurance provider and the beneficiary’s geographic location in Alabama, they could have several MA plan options or just a handful. Since private insurers offer Medicare Advantage plans, their plans may be unique to the areas they serve or the intended recipients. There are four primary types of plans available in Alabama’s Medicare Advantage program. Health Maintenance Organizations (HMOs) are typically the most common, followed by Preferred Provider Organizations (PPOs). Private Fee-for-Service (PFFS) plans and Special Needs Plans (SNO) may have limited availability statewide.

What Medicare Advantage Plans Cover in Alabama

Medicare Advantage takes the place of Original Medicare, so MA plans must provide the same Medicare Part A and Part B coverage. Part A covers inpatient/hospital coverage, and Part B covers outpatient/doctor services. Most MA plans also cover Part D prescription drug coverage, which Original Medicare recipients must purchase separately. Even better, MA plans usually provide coverage for various additional perks such as vision care, wellness programs, hearing aids, telehealth and dental care. More than 90% of nationwide MA plans offered these and other health-related benefits in 2022.

*Select plans offer this coverage

** Most plans offer this coverage

Eligibility for Medicare Advantage in Alabama

Beneficiaries who qualify for Original Medicare also qualify for Medicare Advantage because the eligibility requirements are identical. Applicants must be aged 65 or older or younger if they have a disability that qualifies them at an earlier age. Disabled persons who’ve received Social Security Disability Insurance payments for two years or more qualify for Medicare. Individuals diagnosed with end-stage renal disease, also known as kidney failure, or Lou Gehrig’s disease, also known as ALS, qualify for Medicare Advantage, as well. 

To be eligible for Medicare Advantage in Alabama, applicants must have Medicare Parts A and B. They must also be U.S. citizens or authorized immigrants. If they’re applying for an SNP, they must meet additional plan requirements. Like Original Medicare, beneficiaries can only join a Medicare Advantage or switch an existing plan during specific enrollment periods. Those periods are detailed below.

• Initial Coverage Election Period: This is the initial 7-month period, coinciding with one’s 65th birthday, during which everyone is eligible to enroll in a Medicare Advantage plan.
• Annual Election Period (AEP): Also referred to as the Open Enrollment Period, this the time of year when anyone over 65 can enroll in Medicare Advantage for the first time or change to a new plan.
• Medicare Advantage Open Enrollment Period: During this period, those who are already enrolled in Medicare Advantage can switch to a different plan or switch back to Original Medicare.

Additionally, Medicare Advantage plan participants can change their plan outside of these enrollment periods under certain qualifying circumstances, such as moving to a new state.

State-Wide Medicare Advantage Resources

Local Medicare Advantage Resources