Medicare in Alabama: Plans and Coverage (2026)

Medicare in Alabama runs on federal rules, with free SHIP counseling through the Alabama Department of Insurance and cost-saving programs through the Alabama Medicaid Agency.1,2

In This Guide

• Key Takeaways
• Original Medicare: Parts A and B
• Medicare Advantage in Alabama (Part C)
• Medicare Part D: Prescription Drugs
• Medigap in Alabama
• Help Paying for Medicare in Alabama
• Medicare Enrollment Periods
• Free Medicare Help: Alabama SHIP
• Frequently Asked Questions

About these numbers: The premiums and deductibles below come from CMS for calendar year 2026, effective January 1. Medicare costs change every year. For the most current figures, check Medicare's own cost pages or ask an Alabama SHIP counselor through ALDOI.

Original Medicare: Parts A and B

Original Medicare is run directly by the federal government and comes in two parts. The mechanics and costs are the same in Alabama as everywhere else in the country.

Part A (Hospital Insurance)

Part A covers inpatient hospital stays, limited skilled nursing facility care, hospice, and some home health care.3

The hospital deductible rose $60 from 2025.3 A benefit period begins the day you're admitted to a hospital or SNF and ends once you've gone 60 days in a row without inpatient hospital care or skilled care in a nursing facility. If you're readmitted after that gap, the deductible applies again.

Part B (Medical Insurance)

Part B covers doctor visits, outpatient care, preventive services, durable medical equipment, and mental health services. Original Medicare does not cover routine dental, vision, or hearing.3,6

• Monthly premium: $202.90 (higher if your 2024 income was above $109,000 for a single filer or $218,000 for a married couple, under the income-related adjustment)3
• Annual deductible: $283
• After the deductible: you pay 20% of the Medicare-approved amount for most services

Part B is technically optional, but almost everyone takes it. Skip it without qualifying for a Special Enrollment Period or a Medicare Savings Program and you'll owe a late penalty of 10% for every 12 months you could have had it, for as long as you keep Part B.7

Medicare Advantage in Alabama (Part C)

Medicare Advantage plans are an alternative to Original Medicare, sold by private insurers. They cover everything Parts A and B do, except hospice, which Original Medicare keeps covering. Most bundle in Part D drug coverage and extras like dental, vision, and hearing.6

Plan availability in Alabama varies by geography. Birmingham, Montgomery, Huntsville, and Mobile metros typically offer the widest selection of plans and carriers. Rural areas of the state, particularly in the Black Belt and parts of north Alabama, tend to have fewer plan choices. Plan options, networks, and costs change every year and differ by county, so check what's available at your specific address before you commit.

How These Plans Work

• You still pay the Part B premium ($202.90) on top of any plan premium. CMS estimates the average Medicare Advantage premium at about $14 a month in 2026, and many plans charge nothing extra. Some plans go further and may help pay part or all of your Part B premium.6,3
• Plans run on networks (HMO or PPO). Confirm that your doctors and hospitals are in-network before enrolling; emergency care, out-of-area urgent care, and temporary out-of-area dialysis are covered in or out of network.6
• Plans typically require prior authorization for certain services, which Original Medicare generally does not.6
• Every plan caps your annual in-network out-of-pocket spending (federally limited to $9,250 in 2026; many plans set it lower). Original Medicare has no such cap: CMS says there is no yearly limit on what you pay out of pocket unless you have supplemental coverage such as Medigap, Medicaid, employer, retiree, or union coverage.6

Use the Medicare Plan Finder at medicare.gov to compare plans by ZIP code. Enter your doctors and prescriptions to see which plans cover them and estimate your costs. An Alabama SHIP counselor through ALDOI can walk through the results with you at no charge.

Medicare Part D: Prescription Drugs

Part D covers outpatient prescription drugs. You can get it as a standalone plan alongside Original Medicare, or built into a Medicare Advantage plan.

The Inflation Reduction Act eliminated the coverage gap, the old donut hole, so that higher-cost middle stage is gone.4 Part D now moves through three phases:

1. Deductible: you pay full drug prices until you meet your plan's deductible (up to $615 in 2026).8
2. Initial coverage: you pay copays or coinsurance while your plan and drug manufacturers cover the rest.
3. Catastrophic: once your out-of-pocket spending reaches $2,100, covered drugs cost you nothing for the rest of the year.4

That $2,100 cap is the figure that matters most in Part D. The average standalone Part D premium for 2026 runs roughly $34.50 a month, though actual premiums vary by plan.3 Every plan must also offer the Medicare Prescription Payment Plan, which lets you spread your out-of-pocket drug costs into capped monthly payments across the year instead of paying in full at the pharmacy.4 People who qualify for Extra Help often pay much less, sometimes nothing.

Medigap in Alabama

Medigap policies are sold by private insurers to fill the gaps in Original Medicare: the deductibles, coinsurance, and copays. They work with Original Medicare, and a Medigap policy can't pay a Medicare Advantage plan's copays, coinsurance, deductibles, or premiums.6

Alabama uses the federally standardized plans, labeled A-D, F, G, and K-N, regulated by ALDOI.5 Plans C and F are closed to anyone who first became eligible for Medicare on or after January 1, 2020. Plan G is the popular choice for people newly eligible: it covers the Part A deductible, Part A and Part B coinsurance, and skilled nursing coinsurance, leaving only the $283 Part B deductible on you.9,3

Alabama has not adopted a birthday rule or any special guaranteed-issue protections beyond the federal standard. Your strongest opening is the federal Medigap Open Enrollment Period, the six months that start when you're 65 and enrolled in Part B. During that window an insurer must sell you any plan at the standard rate regardless of your health.5 Outside it, Alabama insurers may use medical underwriting, meaning they can review your health history, charge more, or decline you.

Medigap or Medicare Advantage?

You cannot use both at once. A Medigap policy can't pay your Medicare Advantage copayments, coinsurance, deductibles, or premiums, and while you're in an Advantage plan it's illegal for anyone to sell you a Medigap policy unless you're switching back to Original Medicare.6 Choose Medigap and you stay on Original Medicare with the freedom to see any provider who takes Medicare nationwide, paying a higher monthly premium. Choose Medicare Advantage and you trade some of that freedom for a provider network and often a lower upfront cost. The lock isn't permanent. If you join an Advantage plan for the first time and go back to Original Medicare within 12 months, federal law gives you a trial right to buy a Medigap policy and a separate drug plan.6 For a side-by-side look at the trade-off, see our guide to Original Medicare vs. Medicare Advantage.

Help Paying for Medicare in Alabama

If you're on a fixed income, two programs can reduce your Medicare costs.

Medicare Savings Programs

Alabama runs its Medicare Savings Programs through the Alabama Medicaid Agency. The state uses the standard federal income tiers, and it applies no resource (asset) test to these programs, so eligibility turns on income alone. The three tiers are the Qualified Medicare Beneficiary (QMB), Specified Low-Income Medicare Beneficiary (SLMB), and Qualifying Individual (QI) programs.2

QMB is the most generous tier, covering your Part B premium plus your deductibles and coinsurance. Federal law prohibits providers from billing a QMB enrollee for that cost-sharing.2 Alabama applies no resource (asset) limit to any of the three programs, so eligibility is based on income alone.2 The income figures are tied to the Federal Poverty Level and rise each year; the 2026 Alabama limits above took effect in February. Those published limits already fold in the $20 monthly general income exclusion, so they sit $20 above the bare poverty-level figure and are measured after that subtraction rather than against your gross pay.2 They are the federal standards, not a cutoff to screen yourself against: SSA tells staff to encourage people to apply even when income looks somewhat higher, so an Alabamian a little over these amounts should apply and let the agency decide.2 QI is also the one tier you must reapply for every year; qualifying once does not carry you into the next year.2 You apply directly through the Alabama Medicaid Agency at medicaid.alabama.gov, and enrolling in QMB, SLMB, or QI automatically qualifies you for Extra Help.2 For a fuller walk-through of the three tiers, the income math, and the application itself, see our guide to Alabama's Medicare Savings Programs.

Extra Help for Part D

Extra Help, also called the Low-Income Subsidy, pays Part D premiums, deductibles, and copays for people with limited income and resources.10 Since 2024 the partial-subsidy tier is gone, so everyone who qualifies now receives the full subsidy.

• Income limit (2026): up to about $1,995 a month for an individual, $2,705 for a couple, in the 48 contiguous states and DC (Alaska and Hawaii run higher)10
• Resource limits: $16,590 for an individual, $33,100 for a married couple, or $18,090 and $36,100 if you tell Social Security you expect to use some of your resources for burial expenses10
• If you already qualify for QMB, SLMB, or QI, you're enrolled in Extra Help automatically2
• QDWI, the Medicare Savings Program for people who lost premium-free Part A after returning to work, pays the Part A premium but does not carry Extra Help with it, so a QDWI enrollee has to apply to Social Security for Extra Help separately2,10

Apply through Social Security at its Extra Help application page, or call Social Security at 1-800-772-1213 (TTY 1-800-325-0778).10,11

Medicare Enrollment Periods

Miss a deadline and you can face coverage gaps or permanent penalties. These dates are federal and the same in Alabama as every other state.12

Changes made during Annual Open Enrollment take effect January 1. If you start collecting Social Security at least four months before you turn 65, you're enrolled in Parts A and B automatically; otherwise, you sign up through Social Security.12

If you delay Part B with group health coverage based on your own or a spouse's current employment, an 8-month Special Enrollment Period starts when that job or coverage ends. COBRA and retiree coverage do not count as coverage based on current employment, and if you're self-employed or your plan isn't available to everyone at the company, ask your insurer whether it qualifies before you delay; if it doesn't, sign up at 65. Miss it, and you wait for the General Enrollment Period and may owe a late penalty of 10% per 12-month delay, for as long as you keep Part B. This Special Enrollment Period does not apply if you're eligible for Medicare based on End-Stage Renal Disease (ESRD).13,7

Free Medicare Help: Alabama SHIP

You don't have to sort this out alone, and you don't need to pay a broker. Alabama's State Health Insurance Assistance Program (SHIP) is run through the Alabama Department of Insurance. Counselors are trained volunteers who give free, unbiased help and do not sell insurance.1

Alabama SHIP counselors can help you:

• Understand your Medicare options and what each part covers
• Compare Medicare Advantage, Part D, and Medigap plans side by side
• Apply for the Medicare Savings Programs and Extra Help
• Sort out billing questions, claims, and appeals

Because specific local contact details and hours vary, visit the ALDOI senior health insurance page for current contact information and to find a counselor near you.1

Learn More

Find personalized help comparing your Medicare plan options in Alabama at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.