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Medicare in Alabama

Medicare in Alabama info that everyone can cheer for, including costs, coverage, and eligibility

Reviewed by: Brett Braithwaite, Licensed Insurance Agent. Written by: Aaron Garcia.

Key Takeaways

  • Medicare in Alabama is partially funded by the federal government and is available to all legal U.S. residents aged 65 and older.

  • Original Medicare (Parts A and B)Original Medicare is a fee-for-service health insurance program available to Americans aged 65 and older and some individuals with disabilities. Original Medicare is provided by the federal government and is made up of two parts: Part A (hospital insurance) and Part B (medical insurance). provides hospital and medical benefits. Medicare AdvantageMedicare Advantage (Medicare Part C) is health insurance for Americans aged 65 and older that blends Medicare benefits with private health insurance. This typically includes a bundle of Original Medicare (Parts A and B) and Medicare Prescription Drug Plan (Part D). in Alabama is an alternative that replaces Parts A and B from Original Medicare while often providing other services like vision, hearing, dental, and prescription drug coverage.

  • The cost of Medicare plans in Alabama starts with several standard charges and factors in your income, work history, and specific needs.

 

Living in The Heart of Dixie brings with it a fundamental decision that impacts nearly all areas of an Alabaman’s life, including relationships, quality of life, and even, depending on the season, health.

So, which is it: Roll Tide or War Eagle?

The health-related decision that doesn’t get as much attention in The Cotton State? What kind of Medicare plan do you have? To get the most out of your healthcare when you’re 65 and older, here are some questions you should be asking: What are the available Medicare plans in Alabama? Can I purchase Medicare Advantage in Alabama? Does it matter if I live in northern Alabama versus down south?

To find you the answers you need, we’ve put together what you need to know about Medicare in Alabama.

Who Qualifies for Medicare in Alabama?

You may be eligible to enroll in Medicare in Alabama if you’re a legal U.S. resident and:

How Do I Sign Up for Medicare in Alabama?

Are you or a loved one approaching 65? There are several ways to sign up for Medicare in Alabama.

  • Apply online at the Social Security Administration website [1]
  • Visit your local Social Security office [2]
  • Call SSA at 1-800-772-1213 (TTY: 1-800-325-0778)
  • Did you work for the railroad? Call the Railroad Retirement Board at 1-877-772-5772
  • Sign up with impartial guidance by calling GoHealth.

Medicare in AL: When to enroll

Knowing how to enroll in Medicare plans in Alabama is essential. But not knowing when to enroll can leave you stuck in an unwanted plan or lifelong enrollment penalties. If you’re enrolling for the first time or want to make changes to your existing plan, Medicare in Georgia has specific enrollment periods.

Initial Enrollment Period (IEP)

The Initial Enrollment Period is a seven-month window when you can enroll in Medicare in GA the year you turn 65. Your IEP opens three months before your birth month and closes three months after. This is known as the seven-month rule. For example, if you turn 65 in July, your IEP begins April 1 and ends Oct. 31.

Medicare Part C & D Open Enrollment Period

Held each year from Oct. 15 to Dec. 7, this enrollment period is when you can change from Original Medicare to Medicare Advantage in Alabama (or vice versa). You can also swap prescription drug plans.

Medicare General Enrollment Period

If you haven’t enrolled in Medicare in Alabama because you missed your IEP, the General Enrollment Period is your first chance to sign up. The GEP is held annually from Jan. 1 to Mar. 31.

Medicare Advantage Open Enrollment Period

This enrollment period allows those with Medicare Advantage in Alabama to change back to Original Medicare or swap Medicare Advantage plans. This window opens each year from Jan. 1 to Mar. 31.

What Is the Official Site for Medicare?

The official site for Medicare is Medicare.gov. This is where you can manage and learn about your account. To sign up for Medicare in Alabama online, you’ll need to visit the Social Security Administration website at SSA.gov.

How Can I Find Out What My Medicare Benefits Are?

Think you’re already enrolled in Medicare in Alabama but aren’t sure? There are several ways to check your status. You can verify your status on the Medicare website, call Medicare at 1-800-633-4227 or visit your local office.

You can also check with GoHealth. Our licensed insurance agents will review your coverage and show you how to get the most from your plan. And if other options are better fits, we’ll show you how.

What Are the Different Plans of Medicare?

Medicare plans in Alabama are broken down into four parts: Original Medicare (Parts A and B), Medicare Advantage (Part C), Medicare Prescription Drug Plan (Part D), and Medicare Supplement Insurance (Medigap). If you’re new to Medicare in Alabama, the first choice you’ll need to make is whether you want to enroll in Original Medicare or Medicare Advantage. Here’s an overview of each:

Original Medicare in Alabama

Original Medicare plans in Alabama consist of two main parts: A and B. Each of these covers different things for Medicare enrollees.

  • Part A: Helps cover hospital, nursing home, skilled nursing, hospice, and some home health care
  • Part B: Provides coverage for preventive and medically necessary care

Medicare Advantage in Alabama

Medicare Advantage (Part C) replaces Original Medicare (Part A & B), but offers the same Part A and B benefits or coverage as Original Medicare. Along with receiving Part A and B benefits, Medicare Part C often bundles additional services like dental, hearing, vision and prescription drug coverage.

Medicare Prescription Drug Plan (Part D)

Need medications? Medicare Part D offers stand-alone drug coverage provided by private insurance companies. If you have Original Medicare, you’ll need to add Part D separately. If you have Medicare Advantage in Alabama, call your carrier to see if Part D is included in your plan.

Medicare Supplement Insurance (Medigap)

Are you enrolled in Original Medicare? You may need help controlling the high out-of-pocket costs associated with Part A and B Medicare plans in Alabama. Medigap is a group of up to 10 different supplemental insurance policies you can purchase separately to help with these costs. If you buy Medigap, you’ll pay for it separately from Original Medicare.

Do You Get Free Medicare When You Turn 65?

According to the Social Security Administration, “Most people age 65 or older are eligible for free Medical hospital insurance (Part A) if they have worked and paid Medicare taxes long enough. You can enroll in Medicare medical insurance (Part B) by paying a monthly premium.” [3]

In other words, you may receive part of your coverage at no cost, but you’ll probably have to pay for some of it. The price of Medicare plans in Alabama starts with a few standardized charges — but what you end up paying comes down to your needs and the plan you choose.

To help explain, here’s a breakdown of how much you can expect to pay for Medicare in Alabama in 2021:

Medicare in AL: Part A

Premium:

  • Typically no-cost if you or your spouse worked 10 or more years
  • You or your spouse worked between 7.5 and 10 years: $259 a month
  • You or your spouse worked fewer than 7.5 years: $471 a month

Deductible:

  • $1,484 each plan period

Copayments & coinsurance:

  • Hospital stays: $0 copay for Days 1-60 following deductible payment; daily charges for Days 61 and after
  • Skilled Nursing Facility: $0 for Days 1-20 (each plan period); daily charges for Days 21 and after

Medicare in AL: Part B

Premium:

  • $148.50 monthly and up (income-based)

Deductible:

  • $203 each plan period

Copayments & coinsurance:

  • Most preventative services: $0
  • Medicare-approved services: 20% coinsurance

 

Medicare in AL: Part D

Premium:

  • Income-based; varies by plan

Deductible:

  • No more than $445 in 2021

Copayments & coinsurance:

  • Plan- and drug-specific

What Are 4 Types of Medicare Advantage Plans?

Interested in Medicare Advantage in Alabama? Unlike Original Medicare that is highly standardized, Medicare Advantage is offered by private insurance companies. That means that Medicare Advantage plans can be more catered to individual needs and often include extras like vision, dental, hearing and even Part D benefits. Plus, the Parts A and B coverage you get replaces Original Medicare, so you’ll get at least the same level of care if you have Medicare Advantage in Alabama.

But Medicare Advantage is structured differently than Original Medicare. To better understand your choices of Medicare Advantage in Alabama, here are the four types typically offered:

  • Health Maintenance Organization (HMO): With an HMO, your primary care physician refers you to other providers within your network.
  • Preferred Provider Organization (PPO): In a PPO, you still have a PCP but have more flexibility to see out-of-network providers
  • Private Fee-for-Service (PFFS): In PFFS plans, providers are paid separately for each service they provide.
  • Special Needs Plans (SNP): SNPs are designed specifically for certain diseases or conditions. [4] D-SNP assists dual eligible individuals, and C-SNP is for people with chronic diseases.

What Are the Top 5 Medicare Plans?

This answer really comes down to personal preference. There is a lot to choose from when shopping for Medicare plans in Alabama. Whether you want to mix and match Original Medicare, Part D and Medigap — or you’re looking into Medicare Advantage — it’s important to put together your own list of top Medicare options for you. Here are some resources to help whittle down your choices.

  • Pros and Cons: First things first — Original Medicare vs. Medicare Advantage in Alabama
  • Enrollment Checklist: What to know before you enroll
  • Medicare Star Rating System: Providers and plans are graded on a 5-star scale. Learn how to read your stars here.
  • Pro tips: Looking for little-known tips to enrolling in Medicare in Alabama? Check here.
  • Contact GoHealth: Still need help with Medicare in Alabama? Our licensed insurance agents will shop for plans in your area and explain how they’ll fit your needs.

What Is the Downside to Medicare Advantage Plans?

The answer here is different for everyone. Medicare Advantage in Alabama may work for some and not others. But if you’re looking at the differences between Medicare Advantage and Original Medicare in Alabama, here are the main characteristics people often consider:

For more help, we’ve broken down the Pros and Cons of Original Medicare (Parts A and B) and Medicare Advantage. Or call GoHealth — our licensed insurance agents will discuss the upsides of all your options and help find one that works for you.

Medicare in Alabama by the Numbers

Thousands of older adults enroll in Medicare every day across the United States. The latest CMS data shows that 985,296 people are enrolled in Medicare in Alabama. The total number of beneficiaries enrolled in Medicare Advantage in Alabama is 427,055. The previous year, 387,735 enrolled in Medicare Advantage. Medicare Advantage participation in Alabama went from 40.01% to 43.34% year over year. If you’d like to dive deeper into how Medicare in Alabama breaks down across the state, we provide a glance at who is using Medicare, and how.

Outline of Alabama
985,296
Beneficiaries with Part A & Part B
427,055
Medicare Advantage Beneficiaries
43.34%
Medicare Advantage Participation Rate
54.85%
% Female
45.15%
% Male
1.01
Average HCC Score
$9,813.08
Actual Per Capita Costs
20.91%
% Eligible for Medicaid
33.54%
% of Beneficiaries with an Emergency Department Visit
17.48%
Hospital Readmission Rate
78.40%
% Non-Hispanic White
19.17%
% African American
0.78%
% Hispanic
1.65%
% Other/Unknown

Table reflects the latest Beneficiary Demographics data: 2018, All Beneficiaries by State, Centers of Medicare & Medicaid Services (CMS)

Average HCC Score: The Hierarchical Condition Category score gauges a population’s overall health. The score is based on a value of 1.0. Populations with an HCC score of less than 1.0 are considered relatively healthy. The score can be used to estimate health costs.

Alabama Medicare Resources & Contacts

Beneficiaries spend an average of $9,813.08 each year on Medicare in Alabama. To be certain you are not leaving anything on the table, let us help. A GoHealth licensed insurance agent can assess your coverage or explain which Alabama-based resources, like these, may be able to help:

Alabama Department of Senior Services

1-334-242-5743
1-877-425-2243

https://alabamaageline.gov/

What should I know about the Alabama Department of Senior Services?

Info and help with food, prescription drug costs, caregiver resources, and more

Alabama Department of Insurance

1-334-269-3550

https://www.aldoi.gov/

What should I know about the Alabama Department of Insurance?

Find the latest info on insurance regulations, consumer protections and file complaints

Alabama Medicaid

1-334-242-5000

https://medicaid.alabama.gov/

What should I know about Alabama Medicaid?

One-stop for Medicaid in AL. Apply for benefits, learn about what’s offered, and report fraud.

Southern Alabama Regional Council on Aging (SARCOA)

1-334-793-6843

http://www.sarcoa.org/

What should I know about the Southern Alabama Regional Council on Aging (SARCOA)?

An Area Agency on Aging serving southern AL; connects seniors with local benefits and services.

Top of Alabama Regional Council of Governments (TARCOG)

1-256-830-0818
1-800-243-5463

http://tarcog.us/

What should I know about the Alabama Department of Military & Veterans Affairs?

Northern AL’s Area Agency on Aging provides support for seniors and caregivers.

Nationwide Resources

Speak with an insurance agent that is licensed in Alabama about your Medicare questions.

1-855-792-0088 TTY: 711

Monday - Friday, 8 AM - 9 PM CT

Medicare & Medicaid

If you have general questions about Medicare in AL, or need help with current Medicare benefits.

1-800-MEDICARE (1-800-633-4227)

Social Security Administration

You can reach the SSA by phone for general questions. Not all questions can be answered over the phone.

Also, SSA.gov provides online resources for the following: Review information, apply for benefits, or manage your account online

Speak to SSA Representative, Monday - Friday, 8 AM - 7 PM ET

Medicare Learning Guides

Healthcare is personal. So is choosing insurance. If you are new to Medicare, a beneficiary researching options, or a caregiver, we have tailored Medicare Guides for you.

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New to Medicare Guide

Helpful information to get you started with enrolling in Medicare.

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Costs, coverage and enrollment details for each Medicare plan.

Low Income & Medicare Guide

For individuals with a qualifying income status.

A Caregiver’s Guide

For those helping a loved one with Medicare.