Alabama Medicaid is a health insurance program for certain low-income and needy people paid with federal, state, and county dollars. It is the most extensive program providing medical and health-related services to Alabama's poorest people – including children, the aged, blind, and/or disabled, and people who are eligible to receive federally assisted income maintenance payments.

Here is a partial list of the goods and services that Alabama Medicaid pays for. For a complete list of covered services, see the Covered Services Handbook.

• Dental Services for recipients under age 21: Medicaid pays for dental services as long as the recipient is eligible for full Medicaid. Most children are only eligible after their 19th birthday if they become eligible for another category.
• Dental Services for pregnant recipients: Medicaid pays for dental services until 60 days after the pregnancy ends. 
• Doctor Services: Medicaid pays for 14 doctor visits per calendar year. Medicaid also pays for 16 days of doctor’s care when the recipient is in a hospital. 
• Eye Care Services for recipients age 21 and older: Medicaid pays for one complete eye exam and one pair of glasses every two calendar years. 
• Eye Care Services for recipients under age 21: Eye exams and eyeglasses are covered once every calendar year or more often if medical necessity is documented. Most children are only eligible after their 19th birthday if they become eligible for another category. 
• Family Planning Services: Family planning services are available to women of childbearing age and men of any age. Medicaid pays for women age 21 and older to have their tubes tied and pays for vasectomies for men age 21 and older. Family planning services do not count against regular doctor’s office visits. 
• Hearing Services for recipients under age 21: Medicaid pays for a hearing screening once every calendar year and for hearing aids. 
• Home Health Services: Medicaid provides certain medical services in the recipient’s home if they have an illness, disability, or injury that keeps them from leaving home without special equipment or the help of another person. 
• Hospice Services: Medicaid pays for hospice care for terminally ill recipients with a life expectancy of six months or less. There is no limit on hospice days when Medicaid approves beforehand. Covered hospice services include nursing care, medical social services, doctors’ services, short-term inpatient hospital care, medical appliances and supplies, medicines, home health aide and homemaker services, therapies, counseling services, and nursing home room and board. 
• Hospital Services - Inpatient Hospital Care: Medicaid inpatient days are unlimited if hospital care is medically necessary. Coverage is for a semiprivate hospital room (2 or more beds in a room). In certain hospitals, nursing home care services are provided to Medicaid patients waiting to enter a nursing home (called Post Hospital Extended Care (PEC). 
• Hospital Services - Outpatient Care: Medicaid covers emergency and non-emergency outpatient hospital visits that are medically necessary. There are no restrictions on outpatient hospital visits for lab work, x-ray services, radiation treatment, or chemotherapy. Medicaid covers up to three outpatient surgical procedures per calendar year, provided they are performed in an Ambulatory Surgical Center.
• Hospital Services - Psychiatric:  Medicaid pays for medically necessary services in a psychiatric hospital for recipients under age 21 and adults over 65. 
• Laboratory and X-ray Services: Medicaid pays for laboratory and X-ray services when these services are medically necessary. 
• Maternity Services: Medicaid pays for prenatal (before the baby is born) care, delivery, and postpartum care. Medicaid also pays for prenatal vitamins. 
• Mental Health Services: Medicaid pays for the treatment of people diagnosed with mental illness or substance use disorder. The services from a mental health center do not count against regular doctor’s office visits or other Medicaid-covered services. 
• Nurse Midwife Services: Medicaid covers nurse midwife services for maternity care, delivery, routine gynecology services, and family planning services. 
• Nursing Home Care Services: Medicaid pays for nursing home room and board, medicines prescribed by a doctor, and 14 visits from a doctor per calendar year while the recipient is in a nursing home. Medicaid also pays for long-term care for people who have an intellectual disability. 
• Out-of-State Services: Medicaid pays for some medical services if certain conditions are met. 
• Prescription Drugs: Medicaid pays for most drugs ordered by doctors. Some drugs must be approved by Medicaid ahead of time. For some recipients, Medicaid limits the number of brand-name drugs each month. You can ask your doctor or pharmacist which drugs are paid for by Medicaid. 
• Renal Dialysis Services: Medicaid pays for 156 outpatient dialysis treatments per calendar year for recipients with kidney failure. Medicaid also pays for certain drugs and supplies. 
• Transplant Services: Medicaid pays for some organ transplants. 
• Transportation Services - Ambulance Services: Medicaid pays for ambulance services only when medically necessary. 
• Transportation Services - Non-Emergency Transportation Services: Medicaid helps cover the cost of transportation to and from medically necessary appointments for recipients who have no other means of transportation. Call 1-800-362-1504 for free to find out how to get help paying for a ride. 
• Well-Child Checkup Program (EPSDT Screening Program): The Well-Child Checkup Program is for all Medicaid-eligible recipients under 21 years of age with full benefits. More doctor visits, extra hospital days, and medically necessary services may be available if a medical problem is found during an EPSDT screening. Most children are only eligible after their 19th birthday if they become eligible for another category. Recipients who receive family planning services only or non-citizens who receive emergency services only do not qualify for the Well-Child Checkup Program since they do not have full Medicaid.

The eligibility requirements for Medicaid in Alabama vary depending on the specific program and the applicant's circumstances. Here is a summary of the key eligibility criteria:

General Eligibility

• The applicant must be a resident of Alabama.
• The applicant must be a U.S. citizen, legal alien, or permanent resident.
• The applicant must need health care/insurance assistance.
• The applicant's income must fall within the established limits, which vary based on household size.

Income Limits

• The income limits may differ for single applicants depending on the specific Medicaid program. For example, in 2024, a single Nursing Home Medicaid applicant must have an income under $2,829 monthly and assets under $2,000.
• These limits are higher for married couples or those with dependents. For instance, for Institutional/Nursing Home Medicaid, the income limit for a married couple (both applying) is $5,658 per month, with an asset limit of $4,000.

Specific Groups

• Medicaid in Alabama covers various groups, including children under 19, pregnant women, the elderly, and blind or disabled individuals.
• Coverage varies for low-income adults, with certain restrictions in place.

Program Variations

• Alabama Medicaid includes different programs like Institutional/Nursing Home Medicaid, Medicaid Waivers/Home and Community-Based Services, and Regular Medicaid/Medicaid for the Elderly and Disabled, each with its own specific criteria.

To fully understand Medicaid eligibility in Alabama and determine if you or your family members qualify, we recommend consulting the official Medicaid resources or seeking assistance from a Medicaid planning professional.

To apply for Medicaid, you can file a paper application or apply online.

You'll receive a letter in the mail when it's time to renew your Medicaid. You must fill out and return the renewal form provided. If you do not respond or are no longer eligible, your Medicaid coverage will be discontinued. 

Keep your contact information updated with Alabama Medicaid to ensure you receive your renewal information. If you have questions about the renewal process or no longer qualify for Medicaid, other options are available, such as the Federal Marketplace or Federally Qualified Health Centers. 

For more detailed information or to renew online, visit the Alabama Medicaid website or contact the Medicaid Recipient Call Center at 1-800-362-1504.