Alabama Medicare Guide

Get personalized Medicare advice from an advisor who cares! Schedule a free consultation with one of our licensed Alabama Medicare Advisors or give us a call at (888) 604-0055.

This Alabama Medicare guide will walk you through the basics you need to know, from enrollment steps to deciding between your different Medicare options.

Use this table of contents to jump to specific sections:

A Snapshot of Medicare in Alabama

There are over a million Alabama Medicare beneficiaries, making up 21% of the state’s total population. 20% of Medicare enrollees also receive full or partial Medicaid benefits, which are intended to help those with low income and resources. We’ll explain Medicaid more later on. When it comes to Original Medicare vs. Medicare Advantage, 49% of Alabama Medicare beneficiaries choose to remain on Original Medicare and 51% choose to move to a Medicare Advantage plan (source).

Alabama Medicare Eligibility and Enrollment Steps

Eligibility is the same for all US citizens. You’re eligible if:

You’re 65 or older
You have certain disabilities like ALS or End-Stage Kidney Disease

Medicare Enrollment Steps

1. Enroll in Original Medicare (Part A & Part B)

You’re able to enroll in Medicare up to three months before you turn 65, at the start of your Initial Enrollment Period (IEP). Your IEP is a seven-month window unique to your birth month. It starts three months before the month you turn 65 and ends three months after it. You may choose to enroll in Part B later if you’re still working and receiving employer coverage. Before you make the decision, be sure you’re eligible for a Special Enrollment Period, or you may owe the Part B late enrollment penalty!

2. Compare additional coverage options

If you’re on Original Medicare, you can add a Medicare Supplement (Medigap) plan to your Medicare package. You can also add a Part D (prescription drug) plan. Some people choose to switch to a Medicare Advantage plan, which replaces Original Medicare and provides Part A, Part B, and often Part D coverage. Original Medicare and Medicare Advantage have their pros and cons, which we’ll explain in more detail later on. For now, just know that this is an important decision that should be made based on your specific health and financial situation. That means you shouldn’t just do what Carol from your book club did!

We specialize in helping people understand their Medicare options and pick the best coverage for their needs. Schedule a free consultation with a licensed Alabama Medicare Advisor or call us at (888) 604-0055 to get personalized advice!

3. Get the most value from Medicare

Once you’ve chosen your Medicare coverage, you should find doctors, share your plan information with your pharmacy, and set up additional benefits that come with your coverage. We also encourage those on Medicare Advantage and Part D plans to review their needs and plan benefits every year during Medicare’s Annual Enrollment Period to be sure you’re always getting the most value from Medicare.

Alabama Medicare Advantage Plans

There are 75 Medicare Advantage plans in Alabama. The pricing and availability of plans will vary based on your county. For example, Jefferson County, AL has 42 Medicare Advantage plans from ten different insurance carriers and Houston County has 29 plans offered by seven insurance carriers.

Legally, Medicare Advantage plans have to provide at least the same amount of coverage as Original Medicare. They generally provide additional coverage for things like prescriptions as well as dental, vision, and hearing services. They also sometimes come with ancillary benefits like fitness perks, flex cards, and telehealth appointments.

Medicare Advantage plans cover more services and provide extra benefits and generally have low or no added premiums (plan holders still pay their Part B premium). But, what’s the catch?

Medicare Advantage plans have their downsides:

Limited networks
Preauthorization requirements for covered services
Higher out-of-pocket costs when compared to coverage through Original Medicare + Medigap

Alabama Medicare Supplement Plans

Medicare Supplement (Medigap) plans pair with your Original Medicare to help cover the 20% of costs that Original Medicare doesn’t pay. These plans seriously reduce your out-of-pocket costs. With Medicare Supplement Plan G, for example, you don’t owe anything for Medicare-covered services once you meet your Part B annual deductible ($226 in 2023).

Medigap plans have some big benefits:

You can see any doctor that accepts Medicare (about 90% of doctors nationwide)
You don’t need prior authorization for covered services
Your out-of-pocket costs are significantly reduced

Medicare beneficiaries have access to ten types of Medicare Supplement (Medigap) plans. These plans are labeled by letters A through N. Pricing may vary from one insurance company to another, but plans of a letter (e.g., all Medicare Supplement Plan Ns) are identical.

The best time to enroll in a Medigap plan is during the Medigap Open Enrollment Period, which occurs during the first six months that you have Part B coverage. During this time, you are guaranteed acceptance into any Medigap plan, and insurance companies cannot ask you about your health history. Outside of guaranteed issue periods, insurance companies can ask you questions about your health history and you could be denied coverage.

Alabama Part D Plans

Medicare Part D exists because Original Medicare doesn’t cover prescriptions. You can secure Part D coverage either through a Medicare Advantage plan that includes it (MAPD plan) or through a stand-alone drug plan. There are 24 stand-alone drug plans in Alabama. Like with Medicare Advantage, the plans and pricing available to you depends on your county.

We recommend getting Part D coverage when you first enroll in Medicare even if you don’t currently need it. Enrolling in a low-cost plan now can save you from the Part D penalty later on.

If you have questions about your Medicare options or want to compare plan benefits and pricing, schedule a free consultation with one of our licensed Alabama Medicare Advisors or give us a call at (888) 604-0055.

Get help paying for Medicare in Alabama

The cost of healthcare can get out of hand. These three government programs can help eligible, low-income individuals with Medicare costs.

Alabama Medicaid for Medicare-Eligible Individuals

Medicaid is a joint federal and state program that each state operates a little differently. The Alabama Medicaid Agency has multiple programs for those who are elderly or disabled. Institutional Medicaid helps those in nursing homes, hospitals, and ICF-IID facilities. Home and Community-Based Waivers are there for people who are aged, disabled, homebound, or mentally disabled.

In addition to these programs, Alabama Medicaid offers Medicare Savings Programs to help beneficiaries pay for Medicare costs.

Alabama Medicare Savings Programs

There are three Medicare Savings Programs in Alabama:

Qualified Medicare Beneficiary (QMB) Program
Specified Low Income Medicare Beneficiary (SLMB) Program
Qualified Individual-1 (QI-1) Program

Learn more about Alabama Medicare Savings Programs here.

Medicare Extra Help

Extra Help is a federal program that helps pay for costs associated with prescription drug coverage, including premiums, deductibles, and coinsurance. It’s also commonly called the Part D Low-Income Subsidy (LIS).

You automatically qualify for Extra Help if you:

Receive full Medicaid coverage from Alabama
Alabama pays your Part B premium
Are eligible for Supplemental Security Income (SSI)

If you don’t automatically qualify for Extra Help, you may still be eligible. Reach out to our licensed Alabama Medicare Advisors to get free support with your application.

Supplemental Security Income (SSI) Benefits

Eligible US citizens receive monthly payments from the SSI program. You’re considered eligible if you meet the following criteria:

You are 65 and older, blind, or have a disability
You have limited income and limited resources

You can apply for SSI Benefits online or by calling 1-800-772-1213 / TTY 1-800-325-0778.

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