Alabama is one of ten states that has not expanded Medicaid under the Affordable Care Act, which means tens of thousands of low-income adults fall into a coverage gap with no affordable health insurance options. If you live in Alabama and need health coverage in 2026, understanding exactly who qualifies for Medicaid, who gets left out, and what alternatives exist can make a real difference.
This guide covers Alabama Medicaid income limits for 2026, which groups are covered, who falls into the gap, and the best alternatives including the ACA Marketplace, ALL Kids CHIP, community health centers, and other programs.
Who Qualifies for Alabama Medicaid in 2026
Alabama Medicaid is available only to specific categories of people. Unlike Medicaid expansion states, Alabama does not cover non-disabled adults without dependent children regardless of income. Eligibility is limited to these groups:
- Children under 19
- Pregnant women
- Parents and caretakers of dependent children (at very low income levels)
- Adults age 65 and older
- Adults who are blind or have a qualifying disability
- Medicare beneficiaries who need help with cost-sharing (Medicare Savings Programs)
If you are a non-disabled adult between ages 19 and 64 without dependent children, you do not qualify for Alabama Medicaid at any income level.
Alabama Medicaid Income Limits 2026
The following table shows income limits by eligibility category, based on 2026 federal poverty level guidelines.
| Category | Income Limit (% FPL) | Monthly Limit (Individual) |
|---|
| Children (under 19) | 146% FPL | approximately $1,905/month |
| Pregnant women | 146% FPL | approximately $1,905/month |
| Parents and caretakers | 18% FPL | approximately $235/month |
| Adults with disabilities (SSI) | SSI standard | $994/month (individual) |
| Couples (SSI) | SSI standard | $1,491/month |
| Nursing home / long-term care | 300% SSI | $2,982/month |
| Medicare Savings Program (QMB) | 100% FPL | $1,255/month (individual) |
Income limits for parents and caretakers are among the lowest in the country at 18% FPL, roughly $235 per month for a single parent. This means most working parents do not qualify even if their income is modest.
Postpartum coverage for pregnant women was extended to 12 months after delivery, meaning new mothers keep Medicaid coverage through the first year after birth.
The Coverage Gap: Who Falls Through
Alabama's coverage gap affects adults who earn too little to qualify for ACA Marketplace subsidies but too much (or do not meet the category rules) for Medicaid. Specifically:
- Non-disabled adults without dependent children at any income level
- Parents earning above 18% FPL but below 100% FPL ($15,060/year for one person)
- Adults who do not qualify under disability or age categories
Approximately 90,000 Alabamians fall into this gap. They have incomes too low to access ACA subsidies (which start at 100% FPL) but do not qualify for traditional Medicaid. Without coverage, routine care is paid out of pocket.
If your income falls below 100% FPL and you are a non-disabled adult without dependents in Alabama, you are in the coverage gap. There is currently no state-funded program that covers this population.
ALL Kids: Coverage for Children Above Medicaid Limits
Children in families that earn too much for Medicaid may still qualify for ALL Kids, Alabama's Children's Health Insurance Program (CHIP). ALL Kids covers children under 19 with low premiums and copays.
ALL Kids income limits for 2026:
| Household Size | Medicaid Limit | ALL Kids Limit (approx. 317% FPL) |
|---|
| 1 child (family of 2) | $2,633/month | up to $5,717/month |
| Family of 3 | higher threshold | scaled by household size |
| Family of 4 | higher threshold | scaled by household size |
ALL Kids is administered by the Alabama Department of Public Health. Children who already have private insurance are generally not eligible.
Benefits under ALL Kids include doctor visits, prescriptions, dental care, vision care, mental health services, and hospital care. Premiums and copays are low compared to private insurance.
To apply for ALL Kids, visit the Alabama Medicaid Agency website or call 1-888-373-5437.
ACA Marketplace: The Main Option for Most Gap Adults
For Alabama adults who fall above 100% FPL, the ACA Marketplace at HealthCare.gov is the primary alternative to Medicaid. Alabama uses the federally facilitated Marketplace, so all enrollment happens through HealthCare.gov.
2026 ACA subsidy income ranges:
| Household Size | 100% FPL | 400% FPL |
|---|
| 1 person | $15,060/year | $60,240/year |
| 2 people | $20,440/year | $81,760/year |
| 3 people | $25,820/year | $103,280/year |
| 4 people | $31,200/year | $124,800/year |
If your income is at or above 100% FPL, you likely qualify for a premium tax credit that reduces your monthly premium. For incomes up to 250% FPL, you also qualify for cost-sharing reductions on Silver plans that lower deductibles and out-of-pocket costs.
One major change for 2026: the enhanced subsidies in place since 2021 expired on December 31, 2025. This means many Alabama residents will see higher after-subsidy premiums in 2026 compared to prior years. Four insurance companies offer plans through Alabama's Marketplace, and the open enrollment period runs from November 1 through January 15.
If you recently lost employer coverage, had a baby, got married, or experienced another qualifying life event, you can enroll outside open enrollment during a special enrollment period.
Community Health Centers and Free Clinics
If you fall in the coverage gap or cannot afford insurance premiums, Alabama has a network of Federally Qualified Health Centers (FQHCs) and free clinics that provide care on a sliding-scale fee or at no cost.
How FQHCs work:
- Fees are based on your household income as a percentage of the federal poverty level
- Patients at or below 100% FPL typically pay a nominal fee of $20 to $50 per visit
- Services include primary care, dental, mental health, and pharmacy
- Care is available regardless of ability to pay or insurance status
To find an FQHC near you, use the HRSA tool at findahealthcenter.hrsa.gov and enter your zip code.
Some notable Alabama FQHCs include:
- Central North Alabama Health Services (Huntsville area)
- Thrive Alabama (north Alabama)
- Capstone Health (Tuscaloosa area)
- Northeast Alabama Health Services
Free clinics are available in several Alabama cities including Huntsville, Birmingham, Montgomery, and Mobile. These clinics typically serve uninsured adults and operate on donated services and volunteer providers.
Medicare Savings Programs for Low-Income Seniors
Alabama seniors who qualify for both Medicare and Medicaid (dual eligibles) can receive help with Medicare premiums, deductibles, and copays through Medicare Savings Programs.
2026 income limits for Medicare Savings Programs:
| Program | Covers | Income Limit (Individual) | Income Limit (Couple) |
|---|
| Qualified Medicare Beneficiary (QMB) | Part A and B premiums, deductibles, copays | $1,255/month | $1,703/month |
| Specified Low-Income Medicare Beneficiary (SLMB) | Part B premium only | up to 120% FPL | up to 120% FPL |
| Qualifying Individual (QI) | Part B premium only | up to 135% FPL | up to 135% FPL |
Apply for Medicare Savings Programs through the Alabama Medicaid Agency at medicaid.alabama.gov or call 1-800-362-1504.
Long-Term Care Medicaid
For Alabama seniors and adults with disabilities needing nursing home care or home and community-based services, Medicaid long-term care has different income and asset rules.
The income cap for nursing home Medicaid in 2026 is $2,982 per month (300% of the SSI standard). Asset limits are $2,000 for an individual.
Long-term care Medicaid also covers home health services and the HCBS waiver programs that allow eligible people to receive care at home rather than in a nursing facility. These waiver programs typically have waitlists in Alabama.
How to Apply for Alabama Medicaid
Alabama Medicaid applications can be submitted through several channels:
- Online: Visit medicaid.alabama.gov and use the online application portal
- By phone: Call 1-800-362-1504 to apply or get assistance
- In person: Visit your local county Department of Human Resources (DHR) office
- By mail: Download and mail the paper application available on the Medicaid website
Documents typically required:
- Proof of identity (driver's license, state ID, passport)
- Proof of Alabama residency (utility bill, lease agreement)
- Proof of income (pay stubs, tax returns, benefit award letters)
- Social Security numbers for all household members
- Birth certificates for children
- Immigration documents if applicable
Processing times vary but Alabama is required to process most applications within 45 days (or 90 days for disability-based applications).
Check Your Eligibility Now
Not sure which program you qualify for? Use the free Benefits Navigator screener at benefitsusa.org/screener to check eligibility for Medicaid, CHIP, ACA subsidies, SNAP, and other programs at once. The screener is free and takes about five minutes.
For state-specific Alabama benefits information, visit the Alabama benefits overview page.
Frequently Asked Questions
Does Alabama have Medicaid expansion in 2026?
No. Alabama has not expanded Medicaid under the Affordable Care Act as of 2026. The state legislature has not passed expansion, which means non-disabled adults without dependent children do not qualify for Medicaid regardless of their income level. Alabama is one of about ten states that have not expanded.
Who qualifies for Medicaid in Alabama in 2026?
Alabama Medicaid covers children under 19 (up to 146% FPL), pregnant women (up to 146% FPL), parents and caretakers with very low incomes (up to 18% FPL), adults with disabilities receiving SSI, adults age 65 and older, and Medicare beneficiaries who need help with cost-sharing. Non-disabled adults without dependent children do not qualify.
What is the Alabama Medicaid coverage gap?
The coverage gap refers to Alabama adults who earn too little for ACA Marketplace subsidies (below 100% FPL) but do not qualify for Medicaid. This primarily affects non-disabled adults without children. Approximately 90,000 Alabama residents fall into this gap and have limited options for affordable health coverage.
What are the income limits for Alabama Medicaid in 2026?
Key income limits for 2026: children qualify up to 146% FPL (approximately $1,905/month for a single person), pregnant women qualify up to 146% FPL, parents and caretakers qualify up to 18% FPL (approximately $235/month), and SSI recipients qualify at $994/month for an individual. Nursing home Medicaid has an income cap of $2,982/month.
What health coverage options exist if I don't qualify for Alabama Medicaid?
If your income is above 100% FPL, you can enroll in an ACA Marketplace plan through HealthCare.gov with premium tax credits. If your income is below 100% FPL and you do not qualify for Medicaid, your options include community health centers and FQHCs that provide sliding-scale care, free clinics in major Alabama cities, and federally funded prescription assistance programs. Use findahealthcenter.hrsa.gov to find a health center near you.
How do I apply for ALL Kids (CHIP) in Alabama?
Apply for ALL Kids by visiting medicaid.alabama.gov, calling 1-888-373-5437, or applying in person at your local DHR office. ALL Kids covers children under 19 in families that earn too much for Medicaid but cannot afford private insurance, up to approximately 317% FPL.
Did Alabama Medicaid income limits change in 2026?
Yes. SSI-linked Medicaid limits updated in January 2026 to reflect the 2.8% federal cost-of-living adjustment. The individual SSI monthly income limit is now $994 and the couple limit is $1,491. The nursing home income cap is $2,982 per month (300% of SSI). FPL-based categories like children and pregnant women updated when new 2026 FPL guidelines were published.
Can I get Medicaid if I am pregnant in Alabama?
Yes. Pregnant women in Alabama qualify for Medicaid up to 146% FPL regardless of whether they have other dependents. Coverage includes prenatal care, delivery, and postpartum care. Alabama extended postpartum coverage to 12 months after delivery. To apply, contact the Alabama Medicaid Agency or visit your local DHR office.
