Alabama Medicaid is one of the most restrictive Medicaid programs in the United States. Alabama has not adopted the Affordable Care Act's Medicaid expansion, which means adults ages 19-64 without dependent children have virtually no path to Alabama Medicaid coverage regardless of income. The program instead focuses coverage on children, pregnant women, parents and caretaker relatives with dependent children, and aged, blind, or disabled adults who meet SSI-related income and asset tests. The 2026 Federal Poverty Level, set at $15,960 for a single person in the 48 contiguous states and $33,000 for a family of four, is the anchor for every threshold on this page. Alabama's key MAGI Medicaid threshold is 146% FPL for children and pregnant women, a rate that has not kept pace with the 138% FPL threshold that expansion states use for all adults.
Alabama Medicaid eligibility splits into three main categories under MAGI rules, plus the asset-tested aged, blind, and disabled group. Children under 19 qualify up to 146% of the Federal Poverty Level (approximately $48,180 per year for a family of four in 2026). Pregnant women qualify at the same 146% FPL threshold, with coverage including prenatal care, labor and delivery, and a full 12 months of postpartum coverage under federal continuous-eligibility rules. Parents and caretaker relatives with dependent children qualify at a much lower threshold, approximately 18% FPL with the 5% MAGI disregard applied, which amounts to roughly $5,940 per year for a family of four. Adults without dependent children ages 19-64 fall into the Alabama coverage gap: they earn too little to qualify for ACA marketplace subsidies (which require at least 100% FPL starting in 2026) but have no Alabama Medicaid path. An estimated 90,000 to 154,800 Alabamians fall into this gap, depending on the source.
The household-size table below shows the 2026 Alabama Medicaid income limits for children, pregnant women, and parents. If household income is above the Alabama Medicaid limit for children but below 317% FPL, the child may qualify for ALL Kids, Alabama's CHIP program (approximately $104,610 per year for a family of four in 2026). If household income exceeds both Alabama Medicaid and ALL Kids limits, marketplace plans through Healthcare.gov may offer subsidized coverage. Adults in the Alabama coverage gap who earn between 0% and 100% FPL have no subsidized coverage option under current law, though Alabama Arise and Cover Alabama Coalition continue to advocate for expansion. For seniors and dual-eligible adults, see the Medicare Savings Programs section below.
Alabama Medicaid income limits by household size (2026)
The 2026 Alabama Medicaid income guidelines below are based on the 2026 Federal Poverty Level for the 48 contiguous states. Adult column = parent/caretaker limit (~18% FPL with 5% disregard; adults without dependent children show 0 because they are not covered). Children column = 146% FPL for children under 19. Pregnancy column = 146% FPL for pregnant women (same as children in Alabama). Add roughly $5,680 of annual income per additional household member.
2026 Alabama Medicaid income guidelines by household size| Household size | Adults (annual) | Adults (monthly) | Children (annual) | Children (monthly) | Pregnancy (annual) | Pregnancy (monthly) |
|---|
| 1 person | — | — | $23,302 | $1,942 | $23,302 | $1,942 |
| 2 people | $3,895 | $325 | $31,594 | $2,633 | $31,594 | $2,633 |
| 3 people | $4,918 | $410 | $39,887 | $3,324 | $39,887 | $3,324 |
| 4 people | $5,940 | $495 | $48,180 | $4,015 | $48,180 | $4,015 |
| 5 people | $6,962 | $580 | $56,473 | $4,706 | $56,473 | $4,706 |
| 6 people | $7,985 | $665 | $64,766 | $5,397 | $64,766 | $5,397 |
| 7 people | $9,007 | $751 | $73,058 | $6,088 | $73,058 | $6,088 |
| 8 people | $10,030 | $836 | $81,351 | $6,779 | $81,351 | $6,779 |
| Each additional person | $1,022 | $85 | $8,293 | $691 | $8,293 | $691 |
All figures rounded to nearest dollar using 2026 HHS poverty guidelines. Adults without dependent children ages 19-64 do not qualify for Alabama Medicaid regardless of income (Alabama is a non-expansion state). The parent/caretaker 18% FPL figure includes the federal 5% MAGI disregard; the net limit before disregard is approximately 13% FPL. ALL Kids (CHIP) covers children from 146% FPL up to 317% FPL with small premiums and copays.
Source: HHS ASPE 2026 Poverty Guidelines + Alabama Medicaid Agency Income Limits 2026 (effective March 2026)
Alabama Medicaid eligibility requirements (non-income)
Beyond income, Alabama Medicaid applicants must meet non-income requirements that vary by population category. Children, pregnant women, and parent/caretaker groups use MAGI rules (no asset test). Aged, blind, and disabled adults use SSI-related income and asset tests. The items below cover the requirements that apply across all population groups.
- Alabama residency: the applicant must currently live in Alabama. There is no minimum length-of-residence requirement for Medicaid; you qualify from the day you establish Alabama residency.
- U.S. citizenship or qualifying immigration status: U.S. citizens, lawful permanent residents (subject to the federal 5-year bar in most cases), refugees, asylees, and certain other immigration categories qualify. Undocumented adults do not qualify for full Alabama Medicaid but may receive emergency Medicaid for life-threatening conditions.
- Social Security Number: required for all applicants seeking full Alabama Medicaid coverage. Emergency Medicaid applicants are not required to provide an SSN.
- Household composition under MAGI rules: for the parent/caretaker category, the applicant must be the parent or caretaker relative of a child under 18 who lives with them. Children and pregnant women are evaluated separately without the dependent-child requirement.
- Asset test: NOT applied for MAGI Medicaid populations (children, pregnant women, and parents/caretakers). The asset test IS applied for aged, blind, and disabled adults. General asset limits are $2,000 for a single individual or $3,000 for a couple, with the home, one vehicle, personal household goods, and certain burial accounts excluded.
- Age requirements by category: children must be under age 19. Pregnant women must be currently pregnant (coverage continues 12 months postpartum). Aged adults must be 65 or older. Disabled adults must have a qualifying disability as determined by the Alabama Medicaid Agency or the Social Security Administration.
- Other health coverage: applicants are not required to be uninsured. Alabama Medicaid serves as the payer of last resort when other insurance is present. However, employer-sponsored insurance that meets minimum value standards may make CHIP (ALL Kids) ineligible for the child.
What income counts for Alabama Medicaid
Alabama Medicaid uses Modified Adjusted Gross Income (MAGI) rules for children, pregnant women, and parents/caretakers. MAGI is based on the household's projected annual income as it would appear on a federal income tax return. The Alabama Medicaid Agency applies the standard federal 5% MAGI disregard for MAGI-eligible populations, which is why the posted income limits are approximately 5 percentage points above the base FPL percentage (the 146% FPL posted limit includes this disregard). Aged, blind, and disabled populations use SSI countable-income rules instead of MAGI.
Income sources included
- Wages, salaries, tips, and overtime pay (gross, before payroll taxes are deducted)
- Net self-employment and 1099 income (after allowable business expenses, including gig-work earnings from platforms like DoorDash, Uber, or Amazon Flex)
- Social Security retirement and Social Security Disability Insurance (SSDI) benefits (note: SSI, Supplemental Security Income, is excluded and handled separately)
- Unemployment compensation received during the benefit year
- Pensions, annuities, and taxable retirement-account distributions (401(k), IRA, 403(b))
- Rental income (net of allowable rental expenses), interest income, dividends, and net capital gains
- Alimony received under divorce decrees finalized before January 1, 2019 (post-2018 decrees do not count as MAGI income under TCJA rules)
Income sources excluded
- Supplemental Security Income (SSI) payments from the Social Security Administration
- Child support received (it is excluded from MAGI calculations for all MAGI Medicaid categories)
- Federal and state tax refunds, including refundable credits like the Earned Income Tax Credit (EITC) and Child Tax Credit
- Veterans Affairs disability compensation, VA pensions, and education benefits (GI Bill, MGIB)
- SNAP (food stamps) benefits, TANF cash assistance, and other federal means-tested program payments
- Workers' compensation payments for job-related illness or injury
- Loans (personal loans, student loans, mortgage proceeds), gifts, and one-time inheritances
- Federal Pell Grants and need-based student financial aid used for tuition, fees, or required course materials
How to apply for Alabama Medicaid in Alabama
Alabama Medicaid applications for children, pregnant women, and low-income families are processed through Insure Alabama, the online portal operated by the Alabama Department of Public Health. The same Insure Alabama portal handles both SOBRA Medicaid and ALL Kids (CHIP) applications. Seniors and disabled adults (the Elderly and Disabled category) use a separate portal at expedite.medicaid.alabama.gov. Applications can also be submitted by paper at any local Alabama Medicaid District Office or by calling the Recipient Call Center at 1-800-362-1504.
- 1. Gather your documents before starting: photo ID, Social Security Numbers for all household members seeking coverage, proof of Alabama residency, proof of citizenship or immigration status, and income documentation (pay stubs, tax returns, or self-employment records).
- 2. For children and pregnant women, go to insurealabama.adph.state.al.us and create an account, or call 1-888-373-KIDS (5437) Monday through Friday 7:30 a.m. to 5:00 p.m. CST. For aged and disabled adults, go to expedite.medicaid.alabama.gov.
- 3. Complete the online application: list every household member, report all income sources (wages, self-employment, SSDI, pensions), and enter the household's Alabama address. The system will screen for both Medicaid and ALL Kids eligibility automatically.
- 4. Upload supporting documents when prompted: pay stubs, tax records, proof of pregnancy (from a physician or clinic), and citizenship or immigration documents. Missing documents are the leading reason for denial or delayed processing.
- 5. Sign and submit the application electronically. The Alabama Medicaid Agency will send a confirmation notice with your case number. Save this number for follow-up inquiries.
- 6. Respond promptly to any requests for additional information from the Alabama Medicaid Agency. You typically have 10 days to provide missing documents. Failure to respond within this window is one of the most common denial reasons.
- 7. Wait for the eligibility determination notice. Standard Alabama Medicaid applications are processed in 30-45 days. Pregnancy applications may be expedited. If approved, coverage can be retroactively applied to the first day of the month you applied.
Official portal: insurealabama.adph.state.al.us
Documents needed
- Photo ID for the head of household (Alabama driver's license, state-issued ID, U.S. passport, or military ID)
- Social Security Numbers for every household member applying for Alabama Medicaid or ALL Kids coverage
- Proof of Alabama residency (utility bill, bank statement, lease agreement, or mortgage statement with Alabama address)
- Proof of U.S. citizenship or qualifying immigration status (birth certificate, U.S. passport, Certificate of Naturalization, permanent resident card, or asylee/refugee documentation)
- Last 30 days of pay stubs (all jobs, all household members) or 12 months of self-employment records and most recent federal tax return (Schedule C for self-employed)
- Proof of pregnancy from a licensed physician or nurse practitioner (required for pregnant-women Medicaid category)
- Bank statements and resource documentation for aged, blind, or disabled applicants (required for the asset test in these categories)
Processing timeline: Standard Alabama Medicaid applications are processed within 30-45 days of submission. Pregnancy applications may be processed more quickly given the time-sensitive nature of prenatal care. Applications for the aged, blind, and disabled category can take 60-90 days because the Alabama Medicaid Agency must conduct a medical determination of disability. If approved, coverage is typically retroactive to the first day of the month the application was submitted.
Common reasons applications get denied
- Income above the population-specific threshold (the most common reason; adults without dependent children are denied at any income level because Alabama has not expanded Medicaid).
- Missing or incomplete documents (pay stubs, proof of pregnancy, immigration documents) not submitted within the 10-day response window after an information request.
- Alabama residency cannot be verified (no utility bill, bank statement, or lease in the applicant's name at an Alabama address).
- Federal 5-year bar for certain categories of newly-arrived lawful permanent residents (exempt categories include children under 21, pregnant women, and refugees regardless of entry date).
- Asset test failure for aged, blind, or disabled applicants who have countable resources above $2,000 for an individual or $3,000 for a couple.
If your child's family income is over the Alabama Medicaid limit
Alabama ALL Kids is the state's Children's Health Insurance Program (CHIP), covering children under age 19 in households earning between 146% and 317% of the Federal Poverty Level. For a family of four in 2026, the ALL Kids upper income limit is approximately $104,610 per year (317% FPL). ALL Kids charges small monthly premiums (ranging from $5 to $35 per month depending on family income) plus low copays for most services. ALL Kids covers doctor visits, prescriptions, dental care, vision, mental health services, and hospitalizations. Families apply through the same Insure Alabama portal at insurealabama.adph.state.al.us or by calling 1-888-373-KIDS (5437). The Alabama Medicaid Agency routes your child's application to either Medicaid or ALL Kids automatically based on the household income you report.
Compare CHIP and Medicaid income limits across all 50 states
If you are 65 or older with limited income in Alabama: Medicare Savings Programs
Alabama administers three Medicare Savings Programs (MSPs) for Medicare beneficiaries with limited income and resources. The Qualified Medicare Beneficiary (QMB) program covers income up to 100% FPL plus the standard $20 disregard ($1,350 per month for an individual in 2026) and pays Medicare Parts A and B premiums, deductibles, and coinsurance. The Specified Low-Income Medicare Beneficiary (SLMB) program covers income from 100% to 120% FPL plus $20 ($1,616 per month) and pays the Medicare Part B premium only. The Qualifying Individual (QI) program covers income from 120% to 135% FPL plus $20 ($1,816 per month) and also pays Part B premiums. Alabama has eliminated the MSP asset test, so there is no resource limit for QMB, SLMB, or QI in Alabama. Enrolling in any MSP also qualifies you for the federal Extra Help program (Low-Income Subsidy) that reduces Medicare Part D prescription drug costs. Apply through the Alabama Medicaid Agency's MSP application at medicaid.alabama.gov or call 1-800-362-1504.
Read the Medicare eligibility guide
Frequently Asked Questions
What is the Alabama Medicaid income limit for a family of 4 in 2026?
For a family of four in 2026, the Alabama Medicaid income limit depends on which family member is applying. Children under 19 and pregnant women qualify if family income is below $48,180 per year (146% of the Federal Poverty Level), or about $4,015 per month. A parent or caretaker relative in the same household qualifies only if income is below approximately $5,940 per year (18% FPL), or about $495 per month. Adults without dependent children do not qualify for Alabama Medicaid at any income level under current rules.
Is Alabama a Medicaid expansion state?
No. Alabama has not expanded Medicaid under the Affordable Care Act. Alabama remains one of only 10 states that have not adopted ACA Medicaid expansion as of 2026. Expansion would extend Medicaid to adults earning up to 138% of the Federal Poverty Level ($22,025 per year for an individual in 2026), but Alabama's current rules cover most adults only if they are pregnant, disabled, 65 or older, or are a parent/caretaker at approximately 18% FPL. An estimated 90,000 to 154,800 Alabamians fall into the resulting coverage gap.
Can I get Alabama Medicaid as an adult without children?
Generally no, unless you are pregnant, have a qualifying disability, or are 65 years old or older with limited income and resources. Adults ages 19-64 without dependent children are excluded from Alabama Medicaid under current non-expansion rules, regardless of how low their income is. If your income is between 100% and 400% of the Federal Poverty Level, you likely qualify for subsidized ACA marketplace coverage through Healthcare.gov, even in Alabama.
Where do I apply for Alabama Medicaid?
Children and pregnant women apply through Insure Alabama at insurealabama.adph.state.al.us or by calling 1-888-373-KIDS (5437), Monday through Friday, 7:30 a.m. to 5:00 p.m. CST. Aged, blind, and disabled adults apply through the Alabama Medicaid Agency portal at expedite.medicaid.alabama.gov. You can also download a paper application from the Alabama Medicaid Agency website at medicaid.alabama.gov, or visit a local Alabama Medicaid District Office for in-person help.
How long does an Alabama Medicaid application take?
Standard Alabama Medicaid applications are processed in 30-45 days. If you are pregnant, the agency may process your application faster given the time-sensitive need for prenatal care. Applications for the aged, blind, and disabled Medicaid category can take 60-90 days because the Alabama Medicaid Agency must complete a medical determination of disability. If approved, coverage is usually retroactive to the first day of the month you submitted your application.
What counts as income for Alabama Medicaid?
Alabama Medicaid uses Modified Adjusted Gross Income (MAGI) for most applicants. MAGI includes wages, salaries, tips, net self-employment income, Social Security Disability Insurance (SSDI), unemployment compensation, pensions, rental income, dividends, and capital gains. MAGI does not include Supplemental Security Income (SSI), child support received, federal tax refunds, SNAP benefits, veterans disability benefits, workers' compensation, or loans. The Alabama Medicaid Agency applies a standard 5% disregard that effectively raises the income threshold slightly above the base FPL percentage.
What documents do I need to apply for Alabama Medicaid?
You will need a photo ID for the head of household, Social Security Numbers for all household members seeking coverage, proof of Alabama residency (utility bill, lease, or bank statement), proof of U.S. citizenship or qualifying immigration status (birth certificate, passport, or green card), and income documentation (last 30 days of pay stubs or most recent tax return for self-employed). Pregnant women also need a statement from a physician confirming pregnancy. Aged, blind, and disabled applicants need bank statements and asset documentation.
What happens if I am denied Alabama Medicaid?
If your Alabama Medicaid application is denied, you will receive a written notice explaining the reason and your appeal rights. You have the right to request a fair hearing within 30 days of the denial notice. During a fair hearing, an impartial Alabama Medicaid hearing officer reviews your case. You can request a hearing by calling 1-800-362-1504 or by writing to the Alabama Medicaid Agency. If your income is above the Medicaid limit, you may qualify for ALL Kids (CHIP) for children, or for subsidized ACA marketplace coverage through Healthcare.gov.
Does Alabama Medicaid cover dental and vision for adults?
Alabama Medicaid coverage for adults is very limited compared to states that expanded Medicaid. Adult dental coverage through Alabama Medicaid is restricted to emergency extractions and limited restorative care for eligible adults (mainly the aged, blind, and disabled). Routine adult dental and vision coverage is not standard. Children and pregnant women enrolled in Alabama Medicaid receive comprehensive benefits including dental, vision, and preventive care. ALL Kids (CHIP) also covers dental and vision for enrolled children.
