People in the Yellowhammer State have plenty of health care options. According to a study by U.S. News, Alabama has the 46th best health care in the country when it comes to access, quality, and good public health.
Health insurance options in Alabama
According to the AL Department of Insurance, there are several ways for residents to get health care:
- From your employer
- Through your spouse's employer
Individual or family plans
- Through HealthCare.gov
- Directly from a health insurance company
Where do most Alabamans get their health insurance coverage?
|Individual or family||5%|
|Source: Kaiser Family Foundation, Health Insurance Coverage of the Total Population|
Ten percent of Alabamans are uninsured. That’s about equal with the national average. This is a good sign for policyholders, as more uninsured people leads to higher rates for insured people.
Alabama health insurance companies
Where should you turn for health insurance in Alabama? These are the top providers in your state that offer health insurance plans through the marketplace:
- BlueCross BlueShield of Alabama
- Bright Health
Alabama medical insurance costs and rate factors
Alabamans spend an average of $7,281 on health care expenditures every year, less than the national average. How much does insurance cost for AL residents? Health insurance rates vary from person to person, based on these factors:
Health insurance plan type
Paying more in monthly premiums gets you a higher level of coverage. Marketplace plans come in metal tiers: bronze, silver, gold, and platinum.
So, how much should you expect to pay in Alabama every month? These are the average monthly costs for each plan type for a middle-aged AL resident in 2020:
|Source: Kaiser Family Foundation, Change in Average Marketplace Premiums by Metal Tier|
In AL, you’ll be paying about 23 percent more for a gold plan than a silver plan. That’s because gold plans cover 80 percent of medical services, while bronze plans cover 60 percent.
You may also be eligible for a catastrophic plan if you’re under 30 or have other exemptions. Catastrophic plans have low monthly premiums but a high yearly deductible of $8,150. Even with a higher monthly premium, you may save money with a bronze or silver plan if you need to use your insurance. A catastrophic plan helps you avoid bankruptcy from medical bills, but it won’t cover your day-to-day care.
Body mass index
According to the CDC, a high body mass can lead to several serious health conditions. Because of this, health insurance companies will analyze your BMI to determine your risk-level. A high BMI often leads to high monthly premiums.
In 2017, AL had a 36.3 percent obesity rate, the fifth highest in the country. 40 percent of state residents who used QuoteWizard to shop for health insurance have a BMI in the obese range.
Smokers pay more for health insurance because of the high risks caused by tobacco use. About 20.9 percent of Alabamans are smokers, the tenth highest rate in the country.
According to HealthCare.gov, older people pay up to three times more for health care than younger people. Alabamans using QuoteWizard to compare health insurance plans are, on average, 41 years old.
You may be surprised to find out that your zip code plays a large role in your insurance costs. That’s because every state has different rules, regulations, and providers in their health care marketplace.
Many insurers use a community rating to determine your monthly premiums. That means rates are partly based on the combined claims everyone files. So, if your neighbors files lots of claims, your rates could spike.
That’s why the health of your state impacts your costs. According to America’s Health Rankings, AL is unfortunately the 47th healthiest state in the country.
Alabama health insurance laws
The Affordable Care Act says that health insurance companies can’t use certain factors to determine your insurance rates.
- Pre-existing conditions: Insurance companies used to charge people with pre-existing conditions more for health insurance. Now, providers can’t raise your rates because of a pre-existing condition.
- Gender: Women used to pay more for health care. But the ACA mandates that insurance companies cannot charge men and women different premiums for the same plan.
- Insurance and medical history: People with previous medical conditions or lapses in insurance used to have a difficult time finding health coverage. The ACA doesn’t allow providers to analyze these factors to determine pricing.
There’s a cap on how much you can pay out-of-pocket for marketplace plans. In 2020, the out-of-pocket maximum is $8,150 for an individual plan and $16,300 for family plans.
AL law requires insurance companies to offer at least some coverage for the following services:
- Alcoholism treatment
- Breast cancer treatment
- Prostate cancer screening
- Drugs to treat life-threatening illnesses
Medicare and Medicaid in Alabama
Medicare and Medicaid are both government-funded health care programs that offer affordable coverage. Medicare helps seniors, while Medicaid covers low-income families and children.
Medicare is for residents 65 and over. There are several coverage options within Medicare. These include parts A, B, C, D, and supplemental coverage plans. You may also qualify for one of the following Medicare Savings Programs:
Qualified Medicare Beneficiary (QMB):
- Single person with a monthly income lower than $1,084.
- Couple with a monthly income lower than $1,457.
Specified Low Income Medicare Beneficiary (SLMB):
- Single person with a monthly income lower than $1,296.
- Couple with a monthly income lower than $1,744.
Qualified Individual (QI):
- Single person with a monthly income lower than $1,456.
- Couple with a monthly income lower than $1,960.
Medicaid aids low-income families and children. These are the state’s Medicaid financial requirements:
|Household Size||Maximum Yearly Income|
Alabama office of the insurance commissioner
- Jim L. Ridling
- Insurance Hotline:
- (334) 269 – 3550
- Office Hours:
- Monday - Friday
8:00 am to 5:00 pm
- File a Consumer Insurance Complaint
- Complaint Page
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