Alabama Medicaid

Updated August 2026

Alabama Medicaid is administered by the Alabama Medicaid Agency — a standalone state agency, not a division of a larger department. The Agency is headquartered in Montgomery and operates Alabama's Medicaid program under both state and federal authority. As of 2025, approximately 1 million Alabamians are enrolled.

Alabama has not expanded Medicaid — adult eligibility is among the most restricted in the country

Alabama is one of the remaining states that has not adopted the ACA Medicaid expansion. Working-age adults without qualifying disabilities and without dependent children generally do not qualify at any income level. Parents qualify at only approximately 18% of the Federal Poverty Level — one of the lowest thresholds in the United States.

What is Alabama Medicaid?

Alabama Medicaid has historically operated primarily on a fee-for-service basis, meaning providers bill the state directly for services. This distinguishes Alabama from most states, which have moved most Medicaid members into full-risk managed care. The state's earlier Regional Care Organization (RCO) initiative was shelved in 2017 due to funding and regulatory hurdles. In its place, Alabama now uses the Alabama Coordinated Health Network (ACHN) — a care-coordination model that connects beneficiaries with providers and community resources across seven regions but does not itself deliver medical services — along with Integrated Care Networks (ICNs) for long-term care beneficiaries. Most members continue to receive medical care on a fee-for-service basis, with ACHN layered on top for coordination.

Because Alabama has not expanded Medicaid, the program serves a narrower population than expansion states. Eligibility is limited to children, pregnant women, parents with very low incomes, people who are blind or have disabilities, and seniors who qualify financially. Adults without dependent children do not qualify.

Who qualifies for Alabama Medicaid?

Alabama Medicaid serves several distinct eligibility categories. Income limits vary significantly by group.

Children under age 19 through ALL Kids (CHIP): up to 312% FPL — very broad coverage for children
Pregnant women: approximately 146% FPL — coverage continues for 60 days postpartum
Parents and caretaker relatives with dependent children: approximately 18% FPL — one of the lowest parent thresholds in the US
Aged (65+), blind, or disabled individuals: income and asset limits apply, linked to SSI standards
Breast and cervical cancer patients: limited Medicaid for treatment regardless of other eligibility
Former foster care youth: up to age 26, no income limit

Adults without dependent children who are not aged, blind, or disabled do not qualify for Alabama Medicaid at any income level. This is the direct result of Alabama's non-expansion status.

Alabama's children's coverage: ALL Kids

Children are the primary beneficiaries of Alabama's Medicaid program. ALL Kids is Alabama's Children's Health Insurance Program (CHIP), covering uninsured children through age 18 whose family income is above the standard Medicaid limit but at or below 312% FPL. ALL Kids charges small premiums on a sliding scale. Children at or below the standard Medicaid income limit are covered through regular Alabama Medicaid with no premium.

Alabama Medicaid and ALL Kids together provide the broadest children's health coverage in the state's public program portfolio. The income limit at 312% FPL is higher than many other non-expansion states.

Coverage gap and alternatives

Adults in Alabama who earn less than 100% FPL but do not qualify for Medicaid fall into a coverage gap: they earn too little for marketplace premium tax credits (which begin at 100% FPL) but do not qualify for Medicaid. Federally Qualified Health Centers (FQHCs) across Alabama provide primary and preventive care on a sliding-scale basis regardless of insurance status. Locate one at findahealthcenter.hrsa.gov.