Coverage gap: Alabama has not expanded Medicaid. Adults earning below $15,960/year (100% FPL) who don't fit traditional categories may have no affordable coverage option. Those above 100% FPL qualify for marketplace subsidies.
Alabama Medicaid Income Limits 2026
The following table shows the key income thresholds for Alabama in 2026:
| Household Size | 100% FPL | 138% FPL | 400% FPL (Subsidy Limit) |
|---|---|---|---|
| 1 | $15,960 | N/A | $63,840 |
| 2 | $21,640 | N/A | $86,560 |
| 3 | $27,320 | N/A | $109,280 |
| 4 | $33,000 | N/A | $132,000 |
| 5 | $38,680 | N/A | $154,720 |
| 6 | $44,360 | N/A | $177,440 |
Because Alabama has not expanded Medicaid, the 138% FPL threshold does not apply for adult eligibility. Adults earning between 0-100% FPL may fall into the coverage gap. Those earning between 100-400% FPL can access marketplace subsidies.
About Alabama Medicaid
Who Qualifies in Alabama
If you're an Alabama resident trying to understand your healthcare options, it's crucial to know that Alabama Medicaid has not expanded its program under the Affordable Care Act (ACA). This means that most low-income adults without children do not qualify for coverage, creating a "coverage gap." Currently, Alabama Medicaid primarily serves children (up to 146% of the Federal Poverty Level, or FPL), pregnant women (up to 146% FPL, with coverage extending 12 months postpartum), parents and caretaker relatives with extremely low incomes (up to 18% FPL), and individuals who are elderly or disabled. For example, a family of three where parents earn more than $373 per month would likely not qualify for Medicaid, though their children might be eligible for Medicaid or the Children's Health Insurance Program (CHIP), known as ALL Kids, which covers children up to 317% FPL. Eligibility for elderly and disabled individuals also includes asset limits, such as $2,000 for a single applicant. As of 2024, approximately 1.16 million Alabamians are enrolled in Medicaid or CHIP, representing 22.6% of the state's population.
If You're Near the Income Line
If your income is too high for Alabama Medicaid but still relatively low, you might find yourself in the coverage gap, where your income is too high for Medicaid but too low to qualify for marketplace subsidies. Approximately 92,000 adults in Alabama are in this situation. However, if your income is above 100% of the FPL, you may qualify for subsidies on HealthCare.gov, the federal marketplace. For example, if you qualify for subsidies, a benchmark Silver plan, which averages $497 per month in Alabama, could become much more affordable. It's important to report any changes in your income or household size, as these can affect your eligibility for either Medicaid or marketplace subsidies, potentially shifting you between programs. If you lost Medicaid coverage during the recent "unwinding" period, when continuous enrollment ended, you can reapply at any time if you believe you still qualify.
What Alabama Medicaid Covers
Alabama Medicaid provides a range of covered services, including doctor visits (up to 14 per year), prescription drugs (with some limits on brand-name medications), hospital care, and dental services for children under 21 and pregnant individuals. There are generally small copayments for some services, but providers cannot deny services if you are unable to pay the copayment. The program also offers various Home and Community-Based Waivers for eligible recipients at risk of needing nursing home care, which can provide services in your home or community. However, these waiver programs often have limited enrollment slots and may have waiting lists.
Options in the Coverage Gap
If you find yourself in the coverage gap without access to Medicaid or affordable marketplace plans, there are still practical alternatives in Alabama. Community health centers offer care on a sliding-scale fee basis, adjusting costs according to your income. Many hospitals provide charity care programs for uninsured patients who meet certain financial criteria. Additionally, free clinics across Alabama offer medical, dental, and vision services, and pharmaceutical products to uninsured, low-income residents. The uninsured rate in Alabama is around 8.4%, slightly higher than the national average. Should your income increase, even slightly, it's crucial to recheck your eligibility for marketplace subsidies, as you might then qualify for financial assistance to help pay for a HealthCare.gov plan.
Marketplace Insurance in Alabama
Alabama residents who do not qualify for Medicaid can purchase private health insurance through the federal marketplace at HealthCare.gov. The average benchmark (second-lowest cost Silver) plan in Alabama costs approximately $497/month for a 40-year-old in 2026.
Premium tax credits (subsidies) are available for households with income between 100% and 400% FPL. Here is what a 40-year-old individual in Alabama might pay for a Silver plan after subsidies, based on the $497/month benchmark:
| Income Level | Annual Income | Your Cost | Monthly Subsidy |
|---|---|---|---|
| 150% FPL | $23,940 | ~$80/mo | $417/mo |
| 200% FPL | $31,920 | ~$173/mo | $324/mo |
| 250% FPL | $39,900 | ~$277/mo | $220/mo |
| 300% FPL | $47,880 | ~$392/mo | $105/mo |
| 400% FPL | $63,840 | ~$497/mo | $0/mo |
These estimates are for a 40-year-old individual on a benchmark Silver plan in Alabama. Actual premiums depend on your age, household size, tobacco use, and plan choice. Households with income between 100-250% FPL also qualify for cost-sharing reductions (CSR) on Silver plans, which lower deductibles and copays. Alabama uses the federal marketplace at HealthCare.gov.
How to Get Coverage in Alabama
Your path depends on your income:
- Income above $15,960/year (100% FPL): You qualify for marketplace subsidies. Apply through HealthCare.gov during open enrollment (Nov 1 – Jan 15) or after a qualifying life event.
- Income below $15,960/year: Check if you qualify for traditional Medicaid (children, pregnant women, disabled). Apply through Alabama Medicaid.
- Children: Alabama's CHIP program covers kids in families up to 200-300% FPL regardless of expansion status.
Calculate Your Subsidy in Alabama
Enter your income, age, and household size to see if you qualify for Medicaid or marketplace subsidies in Alabama.
Frequently Asked Questions
What is the income limit for Medicaid in Alabama?
Alabama has not expanded Medicaid, so there is no standard income limit for adults. Traditional Medicaid covers specific groups (children, pregnant women, disabled, very low-income parents). Income limits for these groups vary. Children are generally covered up to 200-300% FPL through CHIP.
Does Alabama have Medicaid expansion?
No, Alabama has not expanded Medicaid. This creates a coverage gap for adults earning below 100% FPL who do not qualify for traditional Medicaid categories.
Am I eligible for health insurance subsidies in Alabama?
Alabama residents with household income between 100% and 400% FPL ($15,960 to $63,840 for an individual in 2026) qualify for premium tax credits that reduce the cost of marketplace health insurance. Apply through HealthCare.gov.
What is the Alabama Medicaid program called?
Alabama's Medicaid program is known as Alabama Medicaid. It provides health coverage for eligible low-income residents including children, pregnant women, seniors, and certain other qualifying groups.
What happens if I lose Medicaid coverage in Alabama?
If your Alabama Medicaid coverage ends due to income changes or redetermination, you qualify for a Special Enrollment Period on the marketplace. This gives you 60 days to sign up for a private plan through HealthCare.gov. If your income is between 100-400% FPL, you'll likely qualify for subsidies to help cover the cost.
I don't qualify for Medicaid or subsidies in Alabama — what can I do?
If you're in the coverage gap (earning below $15,960/year but not qualifying for traditional Medicaid), look into community health centers in Alabama that offer sliding-scale fees based on income. Many hospitals have charity care programs for uninsured patients. Free clinics and the 211 helpline can connect you with local resources. If your income changes, reapply — even small income increases could qualify you for marketplace subsidies.
Why didn't Alabama expand Medicaid?
Medicaid expansion has been a politically contentious issue in Alabama. The state legislature has not passed expansion legislation, leaving an estimated coverage gap for adults earning below 100% FPL. Advocacy groups continue to push for expansion, and several neighboring states have recently adopted it. Check with Alabama's legislative updates for the latest status.