Alabama Health Insurance
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Facts and Figures
- Insured 674,900
- Uninsured 0
-
Insurance
Carriers 13 -
Number of
Primary Care Physicians -
Number of
Hospitals -
Avg. Cost of
Health Insurance Age 4* $959
Breakdown of Insureds
- Private plans 3%
- Medicaid 19%
- Medicare 17%
- Employer-sponsored health insurance 59%
- Others 2%
Insurance Carriers
- Assurant Health
- Blue Cross and Blue Shield of Alabama
- Celtic Ins. Co.
- AARP-branded plans, insured by Aetna
- Golden Rule
- Great American Health Insurance
- Humana Health Insurance
- Standard Security Life Health Insurance
- The Mega Life and Health Insurance Company
- Time Insurance
- United HealthOne
- World Insurance
State Health Report Card
Immunization was successfully given to 92.6% of Alabama children and further improvement in their health care is expected because of increased health care funding. Unfortunately, many children (25.8%) live in poverty.
Alabama has a low drinking record but needs to address the state’s high rate of smoking and obesity.
Alabama Health Insurance Laws and Regulations
Applicants with pre-existing conditions are subjected to condition exclusions, where coverage for services or treatment relating to the diagnosed condition can be denied. Coverage for the pre-existing condition is only given after two years as mandated by law. Pre-existing conditions now include pregnancy. The look-back period has a maximum of five years. Alabama Health insurance companies can review your medical records for the past five years and will consider any condition or illness which received treatment in that time period as a pre-existing condition. Health insurers in Alabama can deny applicants health coverage because of an existing medical condition. However, getting sick after enrollment will not deny a policyholder coverage. With the guaranteed renewability provision, members can re-enroll and renew their policy as many times as they want. Small businesses shopping for Alabama health insurance quotes and having 2-50 employees can apply for group plans. Furthermore, rules and regulations are in place which guarantees issuance of these plans when signing up. Premium rates vary accordingly based on factors such as age, sex, and health condition. Self employed individuals can use a portion of their premium payments as tax credits. Coverage for prostate, breast, and colorectal cancer is mandated in all health insurance plans.
Heath Care Reform
Small business owners shopping for an Alabama health insurance quote can use tax credits to save on premiums for their employees’ Alabama health insurance coverage.
A $250 rebate check shall be sent to Medicare beneficiaries who fall into the coverage gap.
Employees who retire before the age of 65 can continue to have quality and affordable health coverage through a $5 billion early retiree reinsurance program before they reach Medicare eligiblity.
Alabama can now choose to get Federal Medicaid funding for its low-income population health coverage .
Doctors, nurses, and other Alabama health insurance providers shall be given a $1.5 billion fund (over five years) for loan repayments and scholarships if they choose to work in areas where medical services are scarce.
Alabama Community Health Centers will receive additional funding to provide health care services to more residents and help build new centers.
The Pre-existing Condition Insurance Program funded by the federal government will provide health coverage for uninsured residents with any qualifying pre-existing condition. This is a bridge program to 2014 when affordable coverage becomes available through Alabam health insurance exchanges and insurance companies can no longer deny coverage to Americans with pre-existing condition.
Alabama Health Insurance companies must now allow children until the age of 26 to remain as dependents under their parent’s policy provided they are not offered any health benefits by an employer.
Lifetime limits on health plans no longer applies and annual limits will be regulated.
Patients can now easily access services from physicians and emergency care. Women are no longer required to secure a referral from a primary care physician to visit a gynecologist.
State Government Insurance Programs Offered
COBRA
COBRA Consolidated Omnibus Budget Reconciliation Act or COBRA allows employees and their dependents to continue with their group health care coverage for up to 18 months should they lose their coverage through termination, layoff, or other change in employment status.
Pre-Existing Condition Insurance Plan (PCIP)
866-717-5826
PCIP A program under the Federal Government, this aims to provide health insurance coverage to individuals with pre-existing condition. Eligibility – legal US resident – resident of Alabama – without any form of health insurance coverage for at least six months – have at least one of the qualifying medical conditions
Medicaid
SOBRA: 800-362-1504
MLIF: 800-362-1504
Medicaid (MLIF and SOBRA) MLIF – Medicaid for Low Income Families SOBRA Medicaid is designed to provide coverage for children and pregnant women. Eligibility – legal US resident or legal alien – resident of Alabama – not eligible for ALL Kids coverage Income limits: – Pregnant Women: 133% FPL. – Children (ages 0–5): 133% FPL. – Children (ages 6–18): 100% FPL. – Parents or caretakers with children ages 0–18: 24% FPL. – Aged, blind and disabled: Singles with incomes up to 75% FPL and asset limit of $2,000, and couples with incomes up to 83% FPL with asset limit of $3,000
ALL Kids
888-373-5437
334-206-5568
877-774-9521
ALL Kids ALL kids is a health program administered by the state designed to provide coverage to children 18 and below belonging to low-income families without health insurance. Coverage starts on the first day of the next month after application and lasts for 12 months. Benefits of the program include doctor visits, check-ups, hospital care, emergency services, immunizations, prescription drugs, dental and vision care, and mental health/substance abuse services. Eligibility – US citizen or legal immigrant – Children 18 years and below – Not eligible for Medicaid – Unable to acquire coverage – Children 5 years and below must have income between 133% and 300% of the federal poverty level (FPL) – Children 6 and eighteen years old must have income between 100% and 300% of the FPL
AHIP
866-833-3375
334-263-8311
AHIP Two options: Indemnity and Managed Care plans are available under this program. This is designed for individuals who have used up their group plan coverage and cannot qualify for another group coverage application. This program is in compliance with the Health Insurance Portability and Accountability Act (HIPAA). Eligibility – resident of Alabama – previous plan must be a group, government, church, or COBRA – must have at least 18 months of continued health insurance coverage – lapse in previous coverage should not exceed 62 days
AL Child Caring Program
800-726-2289
AL Child Caring Program Program limited to outpatient coverage. Eligibility – applicants must not be eligible for ALL Kids or any other plan – school aged children must be enrolled in a school
Breast and Cervical Cancer Prevention
877-252-3324
Provides coverage for Pelvic exams, Pap smears, clinical breast exam, mammograms, ultrasound, colonoscopy, or biopsy, if needed. Eligibility requirements: – women aged between 40–64 – must be uninsured or underinsured – income must not be higher than 200% of the FPL – women below the age of 40 can have free breast cancer screening aslo9ng as they undergo a clinical breast examination.
Medicare
800-MEDICARE
800-633-4227
Medicare is administered by the federal government and provides health insurance coverage to Americans aged 65 and above or those younger than 65 but have a disability or end-stage renal disease. Coverage has four parts: Part A: provides inpatient care in hospitals and rehabilitative centers. Part B: provides doctor and some preventive services and outpatient care. Part C: provides Medicare benefits through Medicare Advantage. Part D: provides prescription drug coverage. Eligibility: 1. Must be a U.S. citizen or permanent U.S. resident. 2. Must be 65 years or older, with you or your spouse having worked in a Medicare-covered employment for at least ten years; or have a qualified disability or end-stage renal disease, regardless of age.
Health Coverage Tax Credit
866-628-HCTC
866-628-4282
Provides coverage for inpatient care, outpatient care (lab tests, x-rays, etc.), doctor visits, preventive care, major medical care (surgery, physical therapy, durable medical equipment, etc.), mental health and substance abuse care, and prescription drugs. Eligibility requirements: – Must be receiving TAA (Trade Adjustment Assistance) – Must be 55 years or older and receiving pension from the Pension Benefit Guaranty Corporation (PBGC). – Must not be enrolled in other state plans, or in prison – Must not be receiving 65% COBRA premium reduction – Must not be a dependent in tax returns – Must be enrolled in qualified health plans where you pay more than 50% of the premiums. – Individuals who are eligible for the federal Health Coverage Tax Credit can also use their credit funds to purchase a private health insurance product developed by Blue Cross Blue Shield of Alabama.
VA Medical Benefits Package
877-222-8387
The Veteran Affairs (VA) Medical Benefits provides standard health benefits plan to veterans enrolled in the program. Benefits are portable and can be accessed anywhere in the VA system. Benefits include preventive and primary care, and a full range of outpatient and inpatient services. Eligibility 1. Must have veteran status.
Health Insurance By County
- Autauga
- Baldwin
- Barbour
- Bibb
- Blount
- Bullock
- Butler
- Calhoun
- Chambers
- Cherokee
- Chilton
- Choktaw
- Clark
- Clay
- Cleburne
- Coffee
- Colbert
- Conecuh
- Coosa
- Covington
- Crenshaw
- Cullman
- Dale
- Dallas
- DeKalb
- Elmore
- Etowah
- Fayette
- Franklin
- Geneva
- Greene
- Hale
- Henry
- Houston
- Jackson
- Jefferson
- Lamar
- Lauderdale
- Lawrence
- Lee
- Limestone
- Lowndes
- Macon
- Madison
- Marengo
- Marion
- Marshall
- Mobile
- Monroe
- Montgomery
- Morgan
- Perry
- Pickens
- Pike
- Randolph
- Russell
- Shelby
- St. Clair
- Sumter
- Talladega
- Tallapoosa
- Tuscaloosa
- Walker
- Washington
- Wilcox
- Winston