The fastest-growing age group in Alabama in the last decade was adults aged 65 and above. In 2024, Alabama is home to more than 1.8 million senior adults aged 50 and above.
With more than 20% of the total population having access to Original Medicare, plans with additional coverage have become a necessity. Alabama residents with Medicare can now enroll in Medicare Advantage plans to access supplemental benefits.
Medicare, a fee-for-service plan administered by the federal government and funded by the General Revenue and Federal Insurance Contributions Act, provides medical and hospital coverage to people aged 65 and above, those with certain disabilities, and people with end-stage renal disease (ESRD).
These health insurance programs feature different plans that vary from State to State. Let’s examine the available plans in Alabama and how they benefit residents.
Medicare Advantage Plans in Alabama
Alabama, the Yellowhammer State, has more than five million residents, with 18% of the population aged 65 and above. Since Alabama’s life expectancy is just under 74, resources such as Medicare are necessary in the region to provide older adults with comprehensive healthcare coverage.
Growing age and medical needs go hand in hand. As senior adults approach 65, healthcare finances often become unmanageable.
Moreover, the annual price increment for prescription drugs and medical equipment has made it challenging to seek routine checkups at medical facilities.
Medicare Advantage plans in Alabama aim to reduce the costs associated with healthcare needs, including expenses for inpatient and outpatient care.
As of 2024, Medicare in Alabama has about a million beneficiaries. This 21% of the population leverages Medicare plans to lower out-of-pocket medical bills.
Individuals enrolled in Original Medicare have the option to join a Medicare Advantage plan, an alternative to Original Medicare, consolidating the benefits of Parts A and B with additional benefits through a private insurance provider.
An astounding 60% of the total Medicare beneficiaries are enrolled in private Medicare Advantage plans. This significant number represents that Alabama residents prefer Medicare Advantage plans over other Medicare programs in the State.
The State is served by a total of 93 Medicare Advantage plans. Since there are numerous Medicare Advantage plans available in the State, it’s vital for you to look into the benefits each plan offers and the premiums, costs, and deductibles associated with it to choose the right plan for yourself.
Medicare Advantage Networks
The Medicare Advantage plans in Alabama feature networks available in certain areas of the State. Each plan option is based on a ZIP code. These plans have varying copayments, premiums, and deductibles.
However, the standard plans start at $0 premium. Every Medicare-eligible person in Alabama has access to this $0 premium Medicare plan.
However, the average monthly premium for the Medicare Advantage plan is $18, with prescription drug coverage in 2024. The monthly premium in 2023 was $11.24, a decrease from $11.99 in 2022. Thus, prices significantly vary from plan to plan and provider to provider when it comes to Advantage plans.
Regardless of the premiums, all Medicare Advantage plans have one limitation. These plans are offered by private health insurance companies that collaborate with certain medical service providers, so they have a restricted network.
This means that beneficiaries cannot seek treatment outside of the network of choice. They require pre-authorization and referral from a primary care provider to consult a specialist outside of their chosen network.
General Analysis | Ratings of Medicare Plan Providers in Alabama
| Insurance Company | Medicare Rating | A.M. Best rating | Better Business Bureau (BBB) rating | J.D. Power ranking |
| Aetna | 4 stars | A | A+ | 6th out of 9 |
| Anthem | 4 stars | A+ | A+ | 5th out of 9 |
| Blue Cross Blue Shield | 4.5 stars | A+ | A+ | 5th out of 9 |
| Cigna | 4 stars | A- | Not Rated | 8th out of 9 |
| UnitedHealthcare | 3.5 stars | A | A- | 4th out of 9 |
Types of Medicare Advantage Plans
The State of Alabama has four types of Medicare Advantage plans. Depending on your healthcare needs, you can enroll in any of the following plans.
- Health Maintenance Organizations (HMOs)
- Preferred Provider Organizations (PPOs)
- Special Needs Plans (SNPs)
- Private Fee-For-Service Plans (PFFS)
Let us look into the details of these Medicare Advantage plans to help you make an informed decision.
Health Maintenance Organizations (HMOs)
An in-network provider, typically called an HMO provider, is an approved healthcare expert within the plan’s network.
In an HMO plan, beneficiaries receive care from a doctor, healthcare physician, or hospital within their network of choice.
In emergencies, beneficiaries require pre-authorization or referral from their primary healthcare provider to consult another specialist outside their network. HMO plans mostly include prescription drug coverage.
Preferred Provider Organizations (PPOs)
PPO, another type of Medicare Advantage plan, allows you to receive medical care from both in-network and out-of-network providers.
However, seeking out-of-network care typically costs more than your standard plan. This plan doesn’t restrict you to your primary care doctor.
You also don’t require a referral from your primary care physician to consult physicians outside your network. However, you incur relatively lower costs for medical experts and hospitals within the plan’s network.
Special Needs Plans (SNPs)
SNPs are ideal for beneficiaries with specific diseases who require specialized healthcare. Individuals with chronic conditions, living in nursing homes, or those who have both Medicaid and Medicare receive tailored benefits.
Generally, beneficiaries are limited to the plan’s network of providers. Pre-authorization is required to consult physicians outside the network. SNPs also include prescription drug coverage.
Private Fee-For-Service Plans (PFFS)
PFFS allows you to consult any Medicare-approved provider within Alabama. Hence, you’re not obligated to see a specific healthcare expert. Thus, PFFS plans work the same as Original Medicare, but you can visit any doctor at any hospital if they agree with the plan’s payment terms and conditions. These plans have fewer restrictions.
However, this plan establishes the pay rate for the doctor, the hospital, and the healthcare provider, as well as your out-of-pocket expense for the care you receive.
In some PFFS, you have a network of providers where you incur lower costs. However, your plan may not always have prescription drug coverage.
Top-Rated Medicare Advantage Plans in Alabama
| Company | Cost per month | Medicare Rating |
| Devoted Health | $0 | N/A |
| Wellcare by Allwell | $0 | 3 |
| Wellcare | $5 | 2.5 |
| Cigna | $5 | 3.7 |
| Aetna | $8 | 4 |
| AARP/UHC | $9 | 4.1 |
| Humana | $18 | 4.1 |
| Viva Health | $35 | 5 |
| Blue Cross and Blue Shield of Alabama | $80 | 4 |
Benefits of Medicare Advantage Plans in Alabama
Medicare Advantage plans provide a range of supplemental benefits with your standard coverage options.
These benefits include coverage for wellness programs, hearing services, dental care, vision care, transportation services, meal accommodation, telehealth services, OTC benefits, chronic condition management, etc.
Hence, Medicare Advantage plans work as a bundled coverage option for beneficiaries seeking an all-in-one solution.
Since Alabama has about 90 Medicare Advantage plans, it’s crucial to look into the supplemental benefits your plan of choice offers before enrolling yourself to choose the best available health coverage in your region.
Here are the common benefits offered to Alabama residents with Medicare Advantage plans.
Hospital and Medical Insurance
Medicare Advantage plans in Alabama combine hospital and medical insurance, providing the same coverage as Original Medicare Parts A and B. This ensures that you receive primary coverage with your healthcare services.
Prescription Drug Coverage (Part D)
Most Medicare Advantage plans include prescription drug coverage to lower the out-of-pocket costs of prescription medications. Therefore, in most cases, you don’t require additional prescription drug coverage with a Medicare Advantage plan in Alabama.
Dental Care
Medicare Advantage plans also offer preventive dental services, including routine checkups, scaling, and medically deemed necessary dental procedures.
Vision Care
Comprehensive Medicare Advantage plans also provide coverage for routine eye examinations, eyeglasses, and contact lenses, promoting better eye health.
Hearing Services
Some Medicare Advantage plans offer coverage for hearing exams. These plans typically cover hearing aids and other necessary equipment.
Wellness Programs
Many Medicare Advantage plans include wellness programs, such as gym memberships, fitness classes, and yoga classes, with the primary aim of bettering beneficiaries. Such plans help older adults achieve a healthy lifestyle and combat healthcare problems that arise from a lack of fitness.
Transportation Services
Various Medicare Advantage plans offer assistance with transportation services. These plans ensure you access medical care at facilities more conveniently since you don’t have to worry about transportation to and from a hospital.
Over-the-Counter Benefits
OTC benefits allow beneficiaries to purchase over-the-counter items, non-prescription medications, drugs, and health-related products.
Chronic Condition Management
Chronic condition management includes specialized care for individuals with long-term health problems. Medicare Advantage plans with this benefit are ideal for individuals who require comprehensive healthcare. However, such plans may have a higher premium.
Cost of Medicare Advantage Plans in Alabama
The average monthly premium in 2024 for a Medicare Advantage plan in Alabama is $15.09. Certain Medicare Advantage plans in the State also require you to pay out-of-pocket premiums, deductibles, copayments, and coinsurance.
These additional costs are associated with supplemental benefits and may vary from provider to provider. Therefore, you must familiarize yourself with deductibles, copayments, and coinsurance to avoid higher out-of-pocket premiums.
- Deductibles are expenses that you cover before Medicare provides coverage for health services. Thus, deductibles apply to all Medicare plans, including the standard Original Medicare.
- A copayment is a fixed payment for a doctor’s visit or a prescription drug. This amount is paid after you pay your deductibles, thus covering certain supplemental benefits.
- Coinsurance is a cost-sharing method in which you pay a percentage of the total amount for specific services after paying your deductibles. Your insurance plan covers the rest of the cost.
Medicare Advantage plans usually charge a copayment instead of the 20% coinsurance you pay under Original Medicare.
Also, Medicare Advantage plans significantly vary from provider to provider and plan to plan. Therefore, it is best to look into your plan’s requirements before signing up.
Medicare Eligibility and Enrollment in Alabama
What makes you eligible for Medicare in Alabama, and how can you enroll? Medicare has the same eligibility criteria across all the States. You qualify for Medicare if:
- You are 65 years old or above
- You have a medical disability
- You have end-stage renal disease (ESRD)
- You have amyotrophic lateral sclerosis (ALS)
You also require approval from the Social Security Administration for your age or disability, as it is an essential prerequisite to qualify for Medicare.
Enrolment Period in Alabama
You can enroll in a Medicare plan during the initial enrollment period or wait until the general enrollment period.
However, if you have been receiving your Social Security benefits four months before your 65th birthday, you will automatically get enrolled into Medicare. Otherwise, you must apply through mail or by contacting a local Social Security office.
Medicare has an initial enrolment period (IEP) and a general enrolment period (GEP). The initial enrollment period is 7 months, starting 3 months before your 65th birthday.
However, if you miss your IEP, you can access Medicare by applying for it during the general enrollment period (GEP) between January 1st and March 31st every year.
Why Is Medicare Vital for Alabama Residents?
1 in 3 Alabamians is 50 and older, and more than 18% of the population is above 65. These critical demographics emphasize the need for programs such as Medicare to assist senior adults in managing healthcare costs in Alabama.
Moreover, with its hot and humid summers, Alabama’s subtropical climate fosters mosquito proliferation. This increases the risk of diseases such as West Nile virus and Zika virus in the state.
Besides this, older adults are more susceptible to respiratory diseases due to the region’s increased mold and pollen counts. Under these circumstances, preventive measures are necessary.
Moreover, it’s vital for older adults to have access to comprehensive health coverage in case of emergencies. Services such as Medicare Advantage plans in the region provide affordable healthcare through bundled coverage plans that combat skyrocketing hospital bills.
Having access to a Medicare Advantage plan also provides seniors with supplemental benefits, unlike Original Medicare. Such plans not only save beneficiaries from high costs but also enhance the quality of life through additional benefits.
Resources for Medicare in Alabama
Numerous organizations across Alabama provide counseling and guidance to senior adults. These organizations have licensed advisors or volunteers to provide information regarding Medicare plans to effectively resolve Medicare queries.
| Organization | How you can get help | Website & Contact Info |
| Alabama Area Agencies on Aging | Alabama Area Agencies on Aging help senior adults access resources and services that support their independence and enhance their quality of life. These agencies manage various programs and assist other organizations for senior welfare. They also provide personalized counseling on Medicare. | Website | 205-333-2990 |
| Alabama Senior Medicare Patrol | The Alabama SMP program aims to educate senior adults on detecting and preventing Medicare fraud, errors, and abuse. You can address your concerns about potential fraud by telemarketers or healthcare providers. This agency also helps clarify any errors in Medicare statements or related bills. | Website | 800-243-5463 |
| State Health Insurance Assistance Program (SHIP) | SHIP program aims to provide guidance to seniors seeking advice regarding Medicare programs. Volunteers at SHIP offer free Medicare related guidance. They help resolve your Medicare enrolment queries. They can also help with Medicare claims and appeals. | Website | 800-243-5463 |
Find the Perfect Medicare Advantage Plan With Silveredge in Alabama
The State of Alabama offers numerous senior healthcare facilities to residents. One such facility is Medicare, which effectively lowers healthcare bills by providing senior residents with comprehensive coverage plans.
With over 90 Medicare Advantage plans available in the region, choosing the right plan may seem daunting. With Silveredge, you can compare the various plans in your region to make the right choice.
Licensed advisors at Silveredge not only help compare plans but also provide unbiased advice regarding the plans. Resolve your Medicare queries with Silveredge today!
