Medicare Advantage Plans in Alabama

In the great state of Alabama, Medicare enrollment among residents tops 1,000,000 enrollees, with nearly half of the enrollees choosing Medicare Advantage (Part C). If you’re wondering why this alternative option to Original Medicare is so popular in Alabama, read on.

Medicare Advantage (Part C) plans, offered by private insurance companies, are available to people who are enrolled in Original Medicare (Part A and Part B). Medicare Advantage plans combine the benefits offered in Original Medicare with other coverages. Many Part C plans also offer prescription drug (Part D) coverage and other benefits not covered by Original Medicare, which can include dental, vision and hearing care.

Healthcare services covered by Medicare Advantage plans fall into the same two main parts as Original Medicare: Part A and Part B. However, most Part C plans include Part D coverage and some extras. Here’s a snapshot of your Medicare Advantage coverage:

• If you have Medicare Advantage, you still get Part A coverage of things like inpatient hospital care as well as some skilled nursing facility care, home health care and hospice care.
• If you have Medicare Advantage, you still get Part B coverage of things like outpatient care, doctors visits and durable medical equipment.
• If you have Medicare Advantage, your specific plan may cover some things not covered by Parts A and B like dental, vision and hearing.
• If you have Medicare Advantage, your specific plan may bundle Part D drug coverage.

Your Medicare Advantage plan may come with certain out-of-pocket costs. However, the costs associated with Medicare Advantage plans vary. You can choose from several plan options in Alabama, and some may have a $0 monthly premium. The average monthly Part C premium in Alabama in 2022 is $11.21.

No matter what plan you choose, you’ll have a cap on your annual out-of-pocket costs for covered healthcare, called the out-of-pocket maximum. This eliminates the possibility that your overall plan costs will be higher than what you anticipated. Original Medicare doesn’t have an out-of-pocket maximum.

The monthly Part B premium applies to Part C plans purchased in Alabama. Most people pay the standard amount of $170.10 per month in 2022. Medicare beneficiaries may get a quarterly or monthly bill directly from their insurer for this amount. Others may opt to have their premium automatically deducted from their Social Security or Railroad Retirement benefits.

In addition to premiums, Medicare Advantage plans in Alabama could have other associated costs. These may include copays to doctors, deductibles and coinsurance. These fees may vary based on whether or not you see a doctor within the plan’s network of providers.

A licensed GoHealth insurance agent, knowledgeable about the Medicare options in Alabama, will be happy to detail the plans available in your area and your potential out-of-pocket costs.

Original Medicare and Medicare Advantage are only available to eligible individuals. You must be either a U.S. citizen or a permanent legal resident who has lived here for at least five years to apply and receive benefits.

In Alabama, most people get Medicare because they are 65 or older. A portion of Medicare beneficiaries in Alabama also get Medicare because they have a disability.

If you’re eligible for Medicare due to disability, age is not a requirement. You are considered qualified and can sign up for a Medicare Advantage plan starting on the first day of the 25th month of receiving Social Security disability benefits, either from Social Security or the Railroad Retirement Board. If you have ALS (Lou Gehrig’s disease), you will be eligible for Medicare Advantage starting the first month you receive disability benefits.

Medicare beneficiaries in Alabama who have end-stage renal disease (ESRD) can get a Medicare Advantage plan. If you are on dialysis, you can get a Part C plan on or after the first day of the fourth month you begin treatment. Medicare coverage for people with ESRD starts as soon as you are eligible. Even if you delay signing up, you may have retroactive coverage with Medicare.

In Alabama, there are multiple Medicare Advantage enrollment periods:

• Initial Enrollment Period – If you are getting Medicare when you turn 65, this seven-month period will start three months before your birthday and end three months after.
• Medicare’s Open Enrollment Period – Also known as the Annual Enrollment Period, this period allows Alabamians to join, switch, or drop a plan from October 15 to December 7.
• Medicare Advantage Open Enrollment – If you already have Medicare Advantage on January 1, you can drop or change plans from January 1 to March 31.
• Special Enrollment Period – This enrollment period is year-round. You may qualify for a Special Enrollment Period if you lose your coverage or move. If so, you’ll be able to enroll in a Medicare Advantage plan outside of the dates above.

Medicare Advantage plans in Alabama often include prescription drug coverage. Some have $0 annual deductibles for prescription drugs. Many have low copays, provided you use a Medicare-approved pharmacy to fill your prescriptions.

You may also find low out-of-pocket costs for insulin with a Medicare program called the Part D Senior Savings Model. The savings program helps Medicare beneficiaries with diabetes afford much-needed medications more easily. The program is available through 16 Medicare Advantage plans in Alabama in 2022.