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Medicare provides health coverage to millions. It doesn’t cover everything, so it’s important to consider additional health insurance. Here’s everything about Medicare Alabama residents need to know.
The Best Medicare in Alabama:
- Best Overall in Alabama: Viva Health
- Most Affordable in Alabama: Cigna
- Best for PPO: Aetna
- Best for Dual Eligibility: Humana
- Best for Virtual Care: UnitedHealthcare
What is Medicare?
Medicare has several parts. Each part covers a different aspect of health care. Here’s a breakdown of each part and what it covers:
Part A: Part A covers hospital care. This includes inpatient hospital care and skilled nursing care. Part A also covers hospice care and home health care.
Part B: This part covers services from a doctor. It also covers durable medical equipment and outpatient care. Part B of Medicare may also cover home health care.
Part C: Medicare Advantage plans are Part C of Medicare. Parts A and B are often called Original Medicare. Most people on Medicare have Parts A and B. Part C is optional coverage that may offer additional benefits and lower out-of-pocket costs than Parts A and B alone.
Part D: Part D offers prescription coverage. You can buy standalone Medicare Part D plans that work with Original Medicare. You can also buy a Medicare Advantage plan that includes Part D coverage.
Most people are eligible for Parts A and B of Medicare at age 65. Part A is free if you paid Medicare taxes for at least 10 years. Most people pay Medicare taxes while working. Those who haven’t worked enough to receive Part A for free can pay a premium. Almost everyone pays a premium for Part B of Medicare.
If you’re already receiving Social Security, Parts A and B will start automatically the first day of the month you turn 65. If you’re not receiving Social Security, you’ll need to contact Social Security to enroll for Medicare.
Younger people can be eligible for Medicare if they qualify for Social Security Disability benefits. Medicare benefits start when your Social Security benefits start. People with end-stage renal disease are also eligible for Medicare. They can sign up by contacting Social Security.
Many people enroll in a Medicare Advantage plan or a Medicare supplemental insurance plan. These plans help cover the out-of-pocket costs associated with Original Medicare. Let’s say you have a 2-day hospital stay. With Original Medicare, you’ll need to pay:
- Your Part A deductible of more than $1,000 for hospital services
- Your Part B deductible of almost $200 if you haven’t already
- 20% of any doctor services you receive in the hospital after the deductible
Medicare Advantage plans and Medicare supplement plans help with these costs. Each Medicare Advantage plan has its own copays, coinsurance and deductibles, but these are lower than Original Medicare. Medicare supplements also vary in what they cover, but all help with your out-of-pocket costs.
Legalities of Medicare in Alabama
The Department of Health and Human Services oversees Medicare. Social Security handles enrollment, and it may deduct your Part B premium from your Social Security benefits. Social Security doesn’t make Medicare rules or pay any healthcare costs.
The Alabama Department of Insurance oversees insurance companies that operate in Alabama. Insurance companies offer Medicare supplemental insurance and Medicare Advantage plans. If you have a complaint or an issue with your insurance company, you would report that to the Alabama Department of Insurance.
Types of Medicare Advantage Plans
Medicare Advantage plans may offer coverage that Original Medicare doesn’t. Some plans cover a gym membership or transportation to medical appointments. Here are the most common types of Medicare Advantage plans:
HMO: A health maintenance organization (HMO) requires you to seek care from a network of providers. You may have more flexibility in an emergency. You also need a referral from your primary care provider before you can see a specialist. If you see a provider outside your network, you may have to pay all the costs out of pocket.
PPO: A preferred provider organization (PPO) is more flexible than an HMO. You don’t usually need a referral to see a specialist. A PPO has a network, and you pay less by seeing providers within the network. If you see a provider outside of your network, you may pay more.
People who have Medicare and Medicaid may be eligible for a Special Needs Plan (SNP). These plans have networks and may function like a PPO or HMO.
How to Sign Up for Medicare in Alabama
Signing up for Medicare in Alabama is surprisingly simple. If you are already receiving Social Security benefits when you become eligible for Medicare, you don’t need to do anything. Your Medicare will start automatically.
If you aren’t on Social Security when you’re eligible for Medicare, you’ll need to enroll. You can enroll online or call Social Security. If you turn 65 and have health benefits through an employer, you’ll still want to take at least Part A of Medicare. Your health insurance company may want you to enroll in Part B as well. Talk to your human resources department about how to proceed.
You have a few enrollment periods to sign up for Medicare benefits:
Initial enrollment: Your first enrollment period is 3 months before the month you turn 65, the month you turn 65 and 3 months after that. Let’s say you turn 65 in July. Your initial enrollment would run from April 1 to October 31.
Special enrollment: You receive a special enrollment period if you didn’t sign up during your initial enrollment because of having group coverage. Special enrollment lasts for 8 months after the month your coverage ends. If your coverage ends in March, your special enrollment would last until November 30.
General enrollment: You can enroll in Medicare from January 1 to March 31 each year. Coverage starts on July 1.
If you don’t enroll in Part B during your initial enrollment or special enrollment, you may have to pay a late enrollment penalty. The penalty is 10% for each year you wait, and you pay the penalty for as long as you have Medicare.
Average Cost of Medicare Advantage Plans in Alabama
Thinking about a Medicare Advantage plan? Here are the average costs of several Alabama plans:
Each plan also has copays and/or coinsurance for doctor visits and other services.
Best Medicare Insurance Providers in Alabama
It’s best to compare several plans before you decide on your insurance. Here are the 5 best Medicare insurance providers, based on our research:
1. Best Overall in Alabama: Viva Health
Viva Health earned our top spot due to its high ratings (4.5 stars out of 5) and local expertise. Viva Health is based in Alabama, so you can talk to someone in person if you have questions or concerns.
Viva Health also offers a fitness center benefit, an extensive network of doctors and hospitals, an allowance to use toward over-the-counter meds and dental coverage. Its plans are affordable and comprehensive.
2. Most Affordable in Alabama: Cigna
Cigna offers a range of plans with no monthly premium.
Many of its plans also have no copay for seeing doctors and no prescription deductible. Cigna also has 4.5 out of 5 stars, which means its members rate it highly. Cigna includes hearing, dental and vision services with some of its plans.
It offers HMO and PPO plans, so you can choose what works best for you.
3. Best for PPO: Aetna
Aetna offers a highly rated PPO plan with no monthly premium.
If you don’t want to worry about getting referrals, this might be the plan for you. It covers out-of-network doctors at a higher copay, which means you have the freedom to choose the best providers.
Some plans won’t cover out-of-network providers at all. Aetna also offers dental, hearing aid and vision coverage.
4. Best for Dual Eligibility: Humana
Humana offers a special needs plan for people who have Medicare and Medicaid.
It covers many preventive services with no copay. It also offers benefits not offered through Medicare or Medicaid, including hearing screenings and hearing aid fittings, dental services, vision services and transportation to medical appointments.
Care managers are also available through the plan to help you coordinate your care.
5. Best for Virtual Care: UnitedHealthcare
Tired of waiting for hours to see a doctor?
UnitedHealthcare offers virtual medical visits with its Medicare Advantage plans. There’s no copay for virtual medical care, and some plans offer virtual behavioral health benefits as well.
UnitedHealthcare is the official Medicare provider for AARP. Its plans include vision, dental and hearing coverage and fitness benefits.
Choosing the Right Plan for You
Medicare.gov offers plan comparison tools. You input your ZIP code and your prescriptions, and it shows you the plans based on your personal information. Look at the total costs for each plan, including the deductibles, copays and out-of-pocket maximums. The monthly premium matters too, but it’s only a starting point for comparison. Keep in mind additional benefits that you might use as well. If you have a hearing aid, look for a plan that covers hearing screenings and hearing aids.
Frequently Asked Questions
Medicare has 4 parts named Parts A, B, C, and D. Part A provides hospitalization coverage while Part B provides outpatient coverage, like doctor visits. Parts A and B make up Medicare’s core coverages. Part C is provides private-market Medicare plans, called Medicare Advantage Plans. Part C coverage often includes additional benefits. Medicare Part D provides coverage for prescription drugs. Get a Medicare Insurance Quote through the top providers here.
Because there are 4 parts to Medicare, there can be different cost structures. Most people won’t have to pay for Medicare Part A (hospitalization). Eligibility for premium-free Part A is based on your work history during which you paid Medicare taxes. Many people do pay a monthly premium for Medicare Part B, however, which covers outpatient medical services, like doctor visits. Deductibles also apply to services covered under Medicare Parts A and B, so you’ll pay a part of the annual cost.
Medicare Parts C and D are optional coverages and have premium costs of their own. Medicare Part C refers to Medicare Advantage Plans that offer additional coverage in exchange for a monthly premium. Part D, the prescription plan, reduces the cost of medications but also requires a monthly premium. Subsidies may be available for low income households to help reduce overall Medicare costs.
If you signed up for Social Security before age 65, you were enrolled in Medicare automatically but benefits will begin at age 65. In most cases, there are penalties for not enrolling at age 65, so it pays to sign up on time. Click here to get a medicare quote in minutes from the best providers.
If you have employer coverage, you may be able to delay Medicare coverage while your work plan is still in force. However, the size of the employer determines whether you’ll pay a penalty for not enrolling at age 65. Employees (and their spouses) of companies that offer group health insurance to 20 or more people are usually exempt from late sign-up penalties if they are covered by the employer’s plan.