Alabama Medicaid covers roughly 940,000 residents, but the eligibility rules are among the strictest in the country. The state has not expanded Medicaid under the Affordable Care Act, which means working-age adults without dependent children are largely shut out no matter how low their income is. If you do fall into a covered category, the 2026 income limits determine whether you qualify. This guide breaks down every limit, explains who is and isn't covered, and walks through how to apply.
Who Alabama Medicaid Covers
Alabama divides Medicaid eligibility into distinct groups. The income rules differ substantially between them, so knowing which group you belong to is the first step.
Children (under 19). Children are the most broadly covered group. Medicaid covers children in households earning up to 146% of the Federal Poverty Level (FPL). The Children's Health Insurance Program (CHIP) extends coverage further, up to 317% FPL.
Pregnant women. Pregnant women qualify at the same 146% FPL threshold as children. Approval comes with a 12-month postpartum extension, so coverage continues for a full year after delivery.
Parents and caretaker relatives. Parents and guardians who live with and care for dependent children face a very tight income limit: approximately 18% FPL. This is one of the lowest parent eligibility thresholds in the United States.
Elderly, blind, and disabled adults (ABD Medicaid). Adults who are 65 or older, blind, or have a qualifying disability can access regular Medicaid with a monthly income limit of $1,014 for a single person or $1,511 for a couple. Asset limits also apply to this group.
Long-term care (nursing home and HCBS waivers). Alabamians who need nursing home care or Home and Community-Based Services (HCBS) waiver programs may qualify with incomes up to $2,982 per month. If income exceeds that cap, a Qualified Income Trust (also called a Miller Trust) can be used to establish eligibility.
Non-elderly adults without dependents. Alabama has not expanded Medicaid, so this group is not eligible regardless of income. Adults ages 19 to 64 who do not have dependent children and are not disabled, blind, or elderly are not covered under Alabama Medicaid.
Alabama Medicaid Income Limits 2026
Children and Pregnant Women (MAGI-Based)
Income for these categories is calculated using Modified Adjusted Gross Income (MAGI) rules. There is no asset test.
| Household Size | 100% FPL (Monthly) | 146% FPL Limit (Monthly) |
|---|
| 1 | $1,304 | $1,904 |
| 2 | $1,763 | $2,574 |
| 3 | $2,222 | $3,244 |
| 4 | $2,679 | $3,911 |
| 5 | $3,138 | $4,581 |
| 6 | $3,596 | $5,250 |
Note: Limits include the standard 5% income disregard built into MAGI rules.
CHIP coverage for children extends to 317% FPL, which is approximately $8,492 per month for a family of four.
Parents and Caretaker Relatives
The income limit for parents and caretaker relatives is approximately 18% FPL, or around $235 per month for a household of one. For a family of three, the limit is roughly $475 per month. These are among the lowest in any state.
Aged, Blind, and Disabled (ABD) Medicaid
| Filing Status | Monthly Income Limit | Asset Limit |
|---|
| Single individual | $1,014 | $2,000 |
| Married couple (both applying) | $1,511 | $3,000 |
| Married couple (one applying) | $1,511 | $3,000 |
Long-Term Care and HCBS Waivers
| Filing Status | Monthly Income Limit | Asset Limit |
|---|
| Single individual | $2,982 | $2,000 |
| Married (both in care) | $5,964 | $4,000 |
| Married (one applicant) | $2,982 | $2,000 for applicant; $162,660 for non-applicant spouse |
If your income exceeds the $2,982 monthly cap, a Qualified Income Trust may allow you to qualify. The excess income is deposited into the trust each month and is then spent on allowable costs.
SSI-Related Limits (Effective January 2026)
The 2026 Social Security cost-of-living adjustment increased the SSI-related Medicaid thresholds:
| Category | Monthly Limit |
|---|
| Individual (SSI standard) | $994 |
| Couple (SSI standard) | $1,491 |
| Nursing home institutional cap | $2,982 |
The Coverage Gap in Alabama
Because Alabama has not expanded Medicaid, adults earning between the traditional Medicaid income limits and 100% FPL ($15,650 per year for a single person in 2026) often have no affordable coverage options. They earn too much for traditional Medicaid but fall below the floor for ACA Marketplace subsidies, which start at 100% FPL.
An estimated 128,000 to 300,000 Alabamians currently fall into this gap. Advocacy groups and some state legislators brought an expansion analysis to the State House in early 2026, but no vote has been scheduled as of this writing.
If you are in this coverage gap, the best available options are:
- ACA Marketplace plans if your income is at or above 100% FPL ($15,650 for a single person)
- Community health centers that offer sliding-scale fees based on income
- Prescription assistance programs run by pharmaceutical manufacturers
What Alabama Medicaid Covers
Standard Alabama Medicaid benefits include:
- Doctor visits and specialist care
- Hospital inpatient and outpatient services
- Emergency room care
- Prescription drugs
- Mental health and substance use disorder services
- Dental care (limited for adults)
- Vision care (limited for adults)
- Home health services
- Long-term care (for those who qualify)
- Preventive services and screenings
Children enrolled in CHIP receive a comparable benefit package, including dental and vision.
How to Apply for Alabama Medicaid
There are four ways to submit an application.
Option 1: Apply Online
The fastest route for most applicants. Go to the Alabama Medicaid portal and submit Form 204 (for most applicants) or Form 205 (for elderly and disabled applicants). The online portal for elderly and disabled applicants is at eanddapplication.medicaid.alabama.gov.
Option 2: Apply by Phone
Call Alabama Medicaid at 1-800-362-1504. Phone applications are accepted Monday through Friday during business hours. A caseworker can walk you through the process and tell you which documents you need.
Option 3: Apply by Mail
Download Form 204 or Form 205 from the Alabama Medicaid website. Complete the form and mail it to your local Medicaid district office.
Option 4: Apply in Person
Visit a local Alabama Medicaid district office. To find the nearest office, use the office locator at medicaid.alabama.gov or call the main phone line.
Documents to Bring or Submit
Regardless of which application method you choose, you will need:
- Proof of Alabama residency (utility bill, lease, or government mail)
- Proof of identity (driver's license, state ID, or birth certificate)
- Proof of income (pay stubs, tax returns, or employer letter)
- Social Security numbers for all household members applying
- Immigration status documentation if applicable
- For elderly or disabled applicants: documentation of disability or age
Processing Time
Alabama Medicaid is required to process applications within 45 days for most categories. Applications for elderly and disabled individuals may take up to 90 days because disability verification takes longer. You will receive a written notice of approval or denial.
After You Apply
Once approved, you will receive a Medicaid ID card in the mail. Coverage is typically retroactive to the first day of the month you applied, and sometimes up to three months prior if you had medical expenses during that period. Alabama allows up to three months of retroactive coverage in some cases.
If your application is denied, you have the right to appeal. The denial notice will include instructions on how to request a hearing. You have 30 days from the denial date to file an appeal.
Renewing Your Coverage
Alabama Medicaid requires annual renewals. The state will send a renewal packet by mail before your coverage expires. Review and return it promptly. If your income or household situation has changed, update that information on the renewal form. Failure to respond can result in automatic termination of coverage even if you still qualify.
Check Your Eligibility
Not sure whether you qualify for Alabama Medicaid or another program? Use the free eligibility screener at BenefitsUSA.org/screener to get a quick estimate based on your household size, income, and situation. The screener also checks for other programs you may qualify for, including SNAP, CHIP, and ACA subsidies.
For full state-specific information on all Alabama assistance programs, visit the Alabama benefits guide.
Frequently Asked Questions
What is the income limit for Alabama Medicaid in 2026?
It depends on the category. Children and pregnant women qualify up to 146% FPL, which is approximately $3,911 per month for a family of four. Parents and caretaker relatives face a much stricter limit of around 18% FPL. Elderly and disabled adults can earn up to $1,014 per month (single) or $1,511 per month (couple). Nursing home and long-term care applicants qualify up to $2,982 per month.
Does Alabama have Medicaid expansion in 2026?
No. Alabama has not expanded Medicaid under the ACA. Working-age adults who do not have dependent children and are not elderly or disabled are not eligible for Alabama Medicaid regardless of income.
Can I apply for Alabama Medicaid if I'm a single adult with no children?
Only if you are 65 or older, blind, or have a qualifying disability. Non-elderly, non-disabled adults without dependent children do not qualify for Alabama Medicaid. This is due to the state's decision not to expand Medicaid.
How long does Alabama Medicaid approval take?
Most applications are processed within 45 days. Applications for elderly or disabled individuals can take up to 90 days because of the additional time needed to verify disability status.
What if my income is too high for Medicaid but I can't afford private insurance?
If your income is at or above 100% FPL ($15,650 per year for a single person), you may qualify for subsidized health insurance through the ACA Marketplace at healthcare.gov. Premium tax credits and cost-sharing reductions can significantly lower monthly premiums. If your income is below 100% FPL and you do not fit a traditional Medicaid category, contact a federally qualified health center for sliding-scale care options.
Does Alabama Medicaid cover dental and vision?
Limited dental and vision coverage is available for adults. Children enrolled in Medicaid and CHIP receive more comprehensive dental and vision benefits. Contact your Medicaid managed care plan or call 1-800-362-1504 for specifics on what is covered.
Can I get retroactive Medicaid coverage in Alabama?
Yes. In some cases, Alabama Medicaid can cover medical expenses incurred up to three months before your application date. You must have been eligible during that prior period. Ask about retroactive coverage when you apply.
How do I appeal a Medicaid denial in Alabama?
You have 30 days from the date on your denial notice to request a fair hearing. The notice will include appeal instructions and contact information. You can request a hearing by phone, mail, or in person at your local Medicaid district office.
