Understand Medicare in Alabama
Medicare, the United States federal medical insurance program, provides coverage for more than 500,000 people in Alabama who qualify for Medicare. You can get Medicare if you’re 65 or older or have a qualifying disability.
Your disability typically qualifies if you’ve received at least 24 Social Security or Railroad Retirement Board (RRB) disability insurance payments. You can also enroll in Medicare Advantage Plans if you have End-Stage Renal Disease (ESRD) or amyotrophic lateral sclerosis (ALS).
Most people have premium-free Part A but, if you have to buy it, the cost can reach up to $499 per month in 2022. Part B costs $170.10 per month but can be more if you have higher income. There are 64 Medicare Advantage Plans in the state that are an alternative to Original Medicare. Learn more about your Medicare options in Alabama.
Medicare Plans in Alabama
|Compare ratings of Alabama’s Medicare plan providers:|
|Insurance company||Medicare rating||A.M. Best rating||BBB rating||NCQA rating||J.D. Power ranking|
|Aetna||4 stars||A||A+||2.5 to 4.5 stars||Fifth out of 10|
|Anthem Blue Cross Blue Shield||4 to 4.5 stars||A+||A+||Not rated||Sixth out of 10|
|Cigna||4 stars||A-||Not rated||2.5 to 4.5 stars||Seventh out of 10|
|UnitedHealthcare||3.5 stars||A-||A-||4 stars||Fourth out of 10|
Medicare Plan Options in Alabama
Residents of Alabama have multiple Medicare plans to choose from. Many are tiered to help Alabama seniors find the plan that is best suited to their lifestyle and medical needs. For example, seniors and individuals with disabilities who don’t need much coverage can apply for Original Medicare. Alabama’s Medicare Advantage program might be a better option if you need more comprehensive insurance. Some Medicare policies offer additional prescription drug add-ons or supplementary coverage.
|Original Medicare (Parts A and B)||Original Medicare is the basic Medicare plan, which is a fee-for-service form of insurance. It has two parts: Part A hospital insurance and Part B medical insurance. Part A covers hospital stays and periods spent at skilled nursing facilities, lab tests an individual has performed, and hospice care. Part B covers doctor’s office visits and home health care services. It may also cover some preventive care, such as screenings for cancers and mental illnesses, including depression. With Original Medicare, you’ll pay a deductible along with your share of the fees incurred during an inpatient or outpatient visit:
|Medicare Advantage Plans (Part C)||Medicare Advantage plans, also known as Part C, are an alternative to Original Medicare offered by private insurance companies. These plans include both Part A and Part B coverage, except for hospice care. Most services are provided by network providers, and you may need primary care physicians, referrals for specialists, and prior authorizations for treatment and medications. Medicare Advantage offers additional coverage for essential needs, such as prescription drugs, dental and vision care. Some Medicare Advantage Plans also cover gym memberships and transportation to and from medical appointments. Part C may also pay for adult day care services:
|Medicare Prescription Drug Coverage Plans (Part D)||Many Medicare Advantage policies add Part D drug coverage automatically to their package, but you can also add Medicare prescription drug coverage to Original Medicare. Medicare prescription drug coverage is offered to all Medicare enrollees, but you may have to pay a penalty if you wait to enroll after being initially eligible. Medicare Part D plans may not all cover the same drugs or have the same costs as Medicare Advantage policies. Standalone Part D coverage is provided by Medicare-approved private insurers. Most plans require a deductible and a copay for each prescription drug:
|Medicare Supplement Insurance Plans (Medigap)||Some Alabama seniors purchase a Medicare Supplement Insurance policy, also known as Medigap. These plans are intended to fill in the gaps Original Medicare doesn’t cover. Some of these gaps include medical coverage while overseas, Part A and Part B copays, and excess Part B charges. Medigap doesn’t pay for anything related to Medicare Advantage. You cannot have a Medigap plan and a Medicare Advantage Plan at the same time.
Medicare in Alabama by the Numbers
|People enrolled in Original Medicare||Average plan cost||Annual state spending per beneficiary||Spending per beneficiary compared to the national average|
|569,907||Plan A: $0 to $499 per month*
Plan B: $170.10 per month**
*Most people pay no premium, but this can vary depending on how long they paid Medicare taxes.
**This is the average number, but it can vary based on income.
Medicare Resources in Alabama
Learning about your Medicare options is important. Seniors and their caregivers have a number of Alabama organizations that they can turn to if they need guidance including the state’s Area Agencies on Aging (AAAs), local public health agencies, and nonprofit groups. These organizations also offer a variety of services and programs aimed at promoting a high quality of life for aging residents.
Alabama Area Agencies on Aging
The 13 AAAs located throughout Alabama connect seniors with resources and services that help maintain their independence and quality of life. These agencies administer programs in their local communities and support other organizations and activities. At your local AAA, you can get one-on-one counseling about your Medicare options. Trained counselors can also advise you about available programs that may help lower your out-of-pocket health care costs.
Contact information: Website | 800-243-5463
State Health Insurance Assistance Program
Seniors in Alabama who need help and guidance on selecting the best Medicare option for their needs can turn to the counselors of the SHIP program. These trained volunteers can provide free, unbiased advice about Medicare, Medicare Advantage, Medigap, Medicaid, and long-term care insurance. SHIP counselors can also assist you with Medicare claims and appeals. You can contact a SHIP counselor through your local AAA or the Aging & Disability Resource Center’s Ageline.
Contact Information: Website | 800-243-5463
Alabama Senior Medicare Patrol
The Alabama SMP program exists to educate Medicare-eligible seniors about how to detect and prevent fraud, abuse or errors. The program’s trained volunteers can help you address concerns about possible fraud or Medicare abuse by telemarketers, health care providers, medical equipment suppliers, and others. They can also help you sort out possible errors on your Medicare statements and related medical bills.
Contact Information: Website | 800-243-5463