Health Insurance in Alabama
Health insurance has always been an essential element of a personal finance plan of any family. Buying appropriate health insurance coverage for your family is expensive as well as requires a comprehensive appraisal of all potential risks and its impact on your finances. More than 47 million Americans are uninsured, majority of whom are the working families. The unaffordable health insurance costs expose these families, especially the children, to financially crippling hazards. For those families who are not covered by their employers’ group plan, there are low-cost state sponsored health insurance programs.
According to the America’s Health Rankings 2008 list, Alabama climbed to the 40th position from its 45th position in the year 2007, showing a reasonable amount of improvement on its overall health score.. The state of Alabama, having the population of more than four million people, boasts of both private-market and public health insurance alternatives. The private-market health insurance consists of various types of health plans including family, Medicare supplemental, short-term, student, group and dental. Additionally, the state and federal government sponsored programs provide subsidized health coverage to the uninsurable residents of Alabama who meet specific eligibility requirements such as age, income and military service.
The Alabama Department of Insurance closely regulates all kinds of insurance sold through private-market health insurers as well as public health coverage programs. However, approximately 14% of the population remains uninsured, even as the debate continues to provide affordable health insurance in the state. Nearly 29.2% uninsured citizens come under the 200% FPL bracket, according to the Censor Bureau’s 2007 and 2008 Current Population Survey.
When considering purchasing health coverage, it is important to consult with a licensed health insurance agent/broker to avail the suitable health insurance alternatives.
INDIVIDUAL/FAMILY HEALTH INSURANCE
Below is the guidelines for applying for and obtaining individual health insurance in the state of Alabama. These regulations apply to all insurance companies offering individual or family health insurance in Alabama:
Pre-Existing Condition Exclusion Period
Look Back Period
Look Back Standard
Cancer screening for women, breast cancer screening, direct access to OB/GYNs, OB/GYN as primary care physician,
Market Rate Restrictions
Guaranteed Issue Options
STATE COBRA VARIATIONS FOR SMALL GROUPS
Below are the COBRA guidelines for small groups in the state of Alabama. For employer groups of more than 20 employees, refer to the federal COBRA guidelines:
Eligible Group Sizes
Extension of Benefits Period – Standard
Extension of Benefits Period – Disabled
Maximum Premium Increase
State Legislation Reference
SMALL GROUP HEALTH INSURANCE
Below is the guidelines for small group health insurance in the state of Alabama. These regulations apply to all insurance companies offering small group health insurance in Alabama:
Small Group Size
Must work for at least 6 months out of the
year, and 20 hours per week.
Premium Rating Factors
Rate Bands with Limits
Rate Adjustment Factors
Pre-existing condition exclusionary period
Same as Individual
STATE SPONSORED HEALTH INSURANCE PROGRAMS
There are several state sponsored health insurance programs in the State of Alabama to assist those without insurance in obtaining adequate coverage.
Some states offer specialized state-sponsored health insurance plans for qualified persons that are not eligible for individual health insurance due to pre-existing medical conditions. The guidelines for enrollment in these programs vary by state. The high-risk pool in the State of Alabama is summarized in the chart below:
Alabama Health Insurance Plan (5AHIP)
HIPPA Eligibility Required?
Blue Cross and Blue Shield of Alabama, United HealthCare
Pre-Existing Condition Waiting Period
Within 63 days of expiration of prior coverage
No more than 125% of standard rates
Lifetime Maximum Benefit
Exclusively available for people who have lost their group health insurance and have exhausted or have no COBRA option available
Children’s Health Insurance Program
Through shared funding from the federal government, the State of Alabama provides health insurance for uninsured children that meet certain eligibility guidelines. A summary of this program is outlined in the chart below:
Blue Cross Blue Shield of Alabama
Length of Coverage
12 months continuous coverage
Alabama resident, U.S. Citizen or eligible immigrant
Other Eligibility Requirements
Not covered under any health insurance
Not covered by or eligible for Medicaid
If previous coverage was voluntary dropped, 3-month waiting period is applied.
Pre-Existing Condition Exclusions
$50 to $100 per child, per year for the first 3 children per family (5no cost for additional children)
Medicaid is a state program partially funded through the federal government. Qualification guidelines, as well as the types of people that are eligible, will vary by state. The chart below provides a summary of the Medicaid programs in the State of Alabama.
Alabama Medicaid Agency
Alabama residents, U.S. Citizen or legal immigrant
Federal Poverty Line Income Limits
Working Parents – 19% of FPL
Non-Working Parents – 13% of FPL
Pregnant Women – 133% of FPL
Children – 100-133% of FPL
Alabama Health Care Options Matrix™ Guide
Provided by the Foundation for Health Coverage Education, the guide is a quick reference guide prepared by the non-profit Foundation for Health Coverage Education that outlines Alabama’s public and private health care choices for individuals and groups with various demographic profiles. It also provides a reference list of phone numbers and Web sites.
Family Health Insurance Guide by HealthInsuranceFinders.com
The guide created by HealthInsuranceFinders.com provides useful information regarding health insurance coverage including individual/family health insurance, group health insurance, separate child health insurance and state-sponsored programs that are available for low to middle income families.
Statehealthfacts.org is a project of the Henry J. Kaiser Family Foundation and is designed to provide free, up-to-date, and easy-to-use health data on all 50 states.