Alabama is one of the most Medicare Advantage-heavy states in the country. About 63% of the state's 1.1 million Medicare beneficiaries were enrolled in an MA plan in 2026, well above the 54% national average. That high penetration is driven by competitive $0-premium options from national carriers like Humana and UnitedHealthcare and from regional players like VIVA Health, the only Alabama-based MA plan, affiliated with UAB Health System.
Alabama has not expanded Medicaid under the ACA, which means the state's low-income Medicare population relies more heavily on Medicare Savings Programs (MSPs) and Dual Special Needs Plans (D-SNPs) than in expansion states. D-SNPs in Alabama are offered by UnitedHealthcare, Humana, Aetna, and Devoted Health, and they typically carry $0 premiums and reduced cost-sharing for people who qualify for both Medicare and Medicaid. About 27% of Alabama MA enrollees are in Special Needs Plans, one of the higher SNP concentrations in the Southeast.
This guide covers the 2026 Alabama Medicare Advantage market: how many plans, which carriers, what to look for when shopping, and the key enrollment dates. Plan availability varies by county, from around 60 plans in urban Jefferson and Mobile counties to fewer options in rural Black Belt counties. Annual Election Period is October 15 to December 7, 2026, with coverage starting January 1, 2027.
2026 Medicare Advantage Market Overview in Alabama
In 2026, Alabama has 98 Medicare Advantage plans available, with 710,000 beneficiaries enrolled (63% MA penetration). The average monthly premium is $12 and the statewide average Star Rating is 3.5.
Top Medicare Advantage carriers in Alabama (2026)| Carrier | Plans | Avg Star Rating | Avg Premium |
|---|
| Blue Cross and Blue Shield of Alabama | 4 | 3.5 | $163/mo |
| Humana | 18 | 3.5 | $10/mo |
| UnitedHealthcare | 12 | 3.8 | $14/mo |
| Aetna | 8 | 3.5 | $4/mo |
| VIVA Health | 4 | 4.0 | $48/mo |
| HealthSpring | 5 | 3.8 | $5/mo |
| Devoted Health | 6 | 3.5 | $0/mo |
Source: CMS 2026 MA Landscape State-by-State Fact Sheet; Healthline 2026 Alabama Medicare Plans; KFF Medicare Advantage in the States 2024-2025; NerdWallet Alabama Medicare Advantage 2026
Plan Types in Alabama: HMO vs PPO vs SNP
Medicare Advantage plan-type breakdown in Alabama| Plan Type | Plans Available | Avg Premium | Best For |
|---|
| HMO / HMO-POS | 52 | $8/mo | Lower premiums, willingness to use network providers with referrals |
| PPO | 30 | $24/mo | Flexibility to see out-of-network providers at higher cost |
| Special Needs Plan (SNP) | 16 | $0/mo | Dual-eligible (Medicare and Medicaid), chronic conditions, or institutional care |
HMO and HMO-POS plans account for roughly half of Alabama's MA market. PPO plans are growing due to network flexibility. PFFS and MSA plan types are not widely offered in Alabama. SNP enrollment is high relative to other states: about 27% of Alabama MA enrollees are in a Special Needs Plan.
Source: CMS 2026 MA Landscape Fact Sheet; medicareadvantage.com Alabama 2026; KFF Medicare Advantage state data
County-Level Variance in Alabama
Plan availability in Alabama varies significantly by county. Urban counties in the Birmingham metro and Gulf Coast have 55-60 plans to choose from. Rural Black Belt counties in south-central Alabama typically have fewer options. Premiums are also higher in rural areas, partly because fewer carriers compete for those markets.
Plan count and average premium by county in Alabama| County | Plans Available | Avg Premium |
|---|
| Jefferson County (Birmingham metro) | 59 | $32/mo |
| Mobile County | 60 | $32/mo |
| Madison County (Huntsville metro) | 59 | $34/mo |
| Wilcox County | 41 | $44/mo |
Plan counts and premiums are from CMS Medicare Plan Finder and MedicareAdvantage.com Q4 2025 data. Use the plan finder at medicare.gov with your specific ZIP code for the most accurate results.
Source: CMS Medicare Plan Finder Q4 2025; MedicareAdvantage.com Alabama county data 2026
What to Look For in a Medicare Advantage Plan in Alabama
Shopping for a Medicare Advantage plan in Alabama means more than comparing premiums. Here are the factors that matter most in 2026:
- Provider network. Confirm your primary care physician, specialists, and preferred hospital are in-network before enrolling. HMO plans (the majority of Alabama MA plans) require in-network care for all non-emergency services. VIVA Health's network centers on UAB Health System; UnitedHealthcare and Humana networks extend statewide.
- Prescription drug coverage. Most MA plans in Alabama include Part D drug coverage (MA-PD). Check that your medications are on the plan's formulary at an affordable tier. The 2026 Part D out-of-pocket cap is $2,100 for all MA-PD plans, and the insulin cost-sharing cap is $35/month.
- Star Ratings. CMS rates plans 1-5 stars on quality of care, member experience, and chronic disease management. VIVA Health and HealthSpring's HMO plans score 4.0 stars in Alabama, above the state average. Higher-rated plans tend to offer richer supplemental benefits funded by CMS quality bonuses.
- Supplemental benefits (dental, vision, hearing, fitness). MA plans vary widely on extras. Look for dental coverage with annual maximum of at least $1,000, vision allowances for eyeglasses, hearing aid benefits, and fitness memberships like SilverSneakers. These can save several hundred dollars a year.
- Maximum out-of-pocket (MOOP). MA plans cap your annual in-network spending. The 2026 federal MOOP ceiling for in-network MA is $9,250 (down from $9,350 in 2025). Many Alabama plans set the MOOP lower, around $5,500 to $7,000. Original Medicare has no annual spending cap.
- D-SNP eligibility. If you qualify for both Medicare and Alabama Medicaid (including Medicare Savings Programs), a Dual Special Needs Plan may give you significantly better cost-sharing than a standard MA plan. Alabama has not expanded Medicaid, so full dual eligibility is limited to older adults, disabled individuals, and very low-income households that meet existing Medicaid rules.
Key Medicare Dates in Alabama
Medicare Advantage enrollment has several windows. Missing the right window can mean waiting a full year or paying late-enrollment penalties.
- Annual Election Period (AEP): October 15 to December 7, 2026 — Switch between Original Medicare and MA, change MA plans, or change your Part D plan. Coverage from any change starts January 1, 2027.
- Medicare Advantage Open Enrollment Period (MA OEP): January 1 to March 31, 2026 — If you are already enrolled in an MA plan, you can switch to a different MA plan or return to Original Medicare. One switch allowed per OEP.
- Initial Enrollment Period (IEP): 7-month window around your 65th birthday — Starts 3 months before your birthday month, includes the birth month, and runs 3 months after. Enroll in Medicare Parts A and B first, then choose MA or Original Medicare plus a standalone Part D plan.
- Special Enrollment Periods (SEPs): Varies by qualifying event — Triggered by moving out of a plan's service area, losing employer coverage, qualifying for Medicaid (dual eligible), a plan losing its contract, or other CMS-recognized life events. Typically a 2-month window from the triggering event.
Notable Extras in Alabama Plans
Alabama's Medicare Advantage market has several features that set it apart from other states:
- Non-expansion Medicaid and D-SNP access: Alabama has not expanded Medicaid under the ACA. Full dual eligibility (Medicare plus Medicaid) is limited to low-income seniors, people with disabilities, and a narrow set of families meeting the state's traditional Medicaid rules. If you qualify as dual eligible or for a Medicare Savings Program (QMB, SLMB, QI), a D-SNP plan from UnitedHealthcare, Humana, Aetna, or Devoted Health can dramatically reduce your cost-sharing compared to a standard MA plan.
- VIVA Health: the local Alabama plan: VIVA Health is the only Medicare Advantage plan headquartered in Alabama, affiliated with UAB Health System in Birmingham. VIVA Medicare HMO plans have earned a 4-star CMS rating and have received national recognition for quality. If you live in central or north Alabama and prefer a locally managed plan that integrates with UAB hospitals, VIVA is worth comparing against national carriers.
- HealthSpring rebrand (formerly Cigna): Cigna sold its Medicare business to Health Care Service Corp. (HCSC) in March 2025. For the 2026 plan year, Cigna Healthcare Medicare plans in Alabama are now marketed under the HealthSpring brand. If you were enrolled in a Cigna Medicare Advantage plan in 2025, you were automatically moved to the HealthSpring equivalent plan. Benefits and networks should be similar, but review your Evidence of Coverage to confirm.
- WellCare exited the Alabama Medicare Advantage market in 2025: WellCare (Centene) discontinued its Medicare Advantage plans in Alabama effective January 1, 2025, as part of a six-state exit (Alabama, Massachusetts, New Hampshire, New Mexico, Rhode Island, and Vermont). Affected enrollees had to select a replacement plan during the 2024 AEP. If you were previously enrolled with WellCare in Alabama, confirm you have a current plan in place for 2026. WellCare continues to offer standalone Part D prescription drug plans in Alabama.
Medicare Advantage vs Original Medicare in Alabama
Original Medicare (Parts A and B) covers hospital stays and outpatient care but has no annual out-of-pocket cap, no dental, no vision, and no hearing coverage. The 2026 Part B premium is $202.90/month and the Part A inpatient deductible is $1,736 per benefit period. There is no limit to how much you can spend in a given year under Original Medicare.
Medicare Advantage plans cover everything Original Medicare covers and typically add dental, vision, hearing, and Part D drug coverage. They also impose a maximum out-of-pocket (MOOP) on in-network spending. In Alabama, most MA plans set the MOOP between $5,500 and $7,500. Once you hit the MOOP, the plan pays 100% for covered in-network services for the rest of the year. This protection is especially valuable for beneficiaries with serious or chronic conditions.
Medicare Advantage vs Original Medicare in Alabama detail| Feature | Original Medicare | Medicare Advantage (AL avg) |
|---|
| Monthly premium | $202.90 (Part B) | $12/mo avg (some $0) |
| Annual out-of-pocket cap | None | $5,500 to $9,250 |
| Dental / Vision / Hearing | Not covered | Included in most plans |
| Part D drug coverage | Separate plan needed | Included in most MA-PD plans |
| Network restrictions | Any provider accepting Medicare | In-network required (HMO); flexible (PPO) |
| Prior authorization | Less common | More frequent for certain services |
MA-PD plans include Part D drug coverage. Some MA-only plans require a separate Part D plan. Confirm before enrolling.
How CMS Star Ratings Work in Alabama
CMS rates every Medicare Advantage plan on a 1-to-5 star scale each fall, based on clinical quality measures, member satisfaction surveys, and administrative performance. Plans rated 4 stars or higher receive bonus payments from CMS, which carriers typically reinvest into richer benefits, lower premiums, or lower cost-sharing. In Alabama, CMS data shows that approximately 72% of MA-PD plans earned 4 stars or higher in 2024, slightly above the national average.
In Alabama for 2026, VIVA Health and HealthSpring's HMO plans lead on quality with 4.0-star ratings. Humana and UnitedHealthcare plans average around 3.5 to 3.75 stars statewide. BCBS Alabama and Aetna PPO plans average 3.5 stars. Statewide, county-level averages from Medicare Plan Finder show weighted ratings around 3.3 to 3.5 stars, reflecting the concentration of lower-rated PPO plans in the statewide mix.
When comparing plans, treat Star Ratings as one signal among several — compare them alongside the Medigap vs Medicare Advantage tradeoff if you're considering the Original Medicare route. A 4-star HMO with a narrow network may not work as well for you as a 3.5-star PPO that includes your specialist. Always check the specific measures CMS uses at medicare.gov before deciding.
Special Needs Plans in Alabama: Who Qualifies
Alabama has one of the highest concentrations of Special Needs Plan (SNP) enrollment in the Southeast, with about 27% of MA enrollees in an SNP. Three types of SNPs operate in Alabama: Dual Special Needs Plans (D-SNPs) for people who qualify for both Medicare and Medicaid; Chronic Special Needs Plans (C-SNPs) for people with specific serious conditions like diabetes, congestive heart failure, or chronic lung disease; and Institutional Special Needs Plans (I-SNPs) for people living in long-term care facilities.
Because Alabama has not expanded Medicaid, D-SNP eligibility is narrower here than in expansion states. You qualify as dual eligible if you receive full Medicaid benefits (Medicaid pays your Medicare premium and cost-sharing) or if you qualify for a Medicare Savings Program (QMB, SLMB, or QI), which helps pay Part B premiums or Medicare cost-sharing. Check with the Alabama Medicaid Agency or the Alabama Department of Senior Services SHIP counselors to confirm eligibility before enrolling in a D-SNP.
Frequently Asked Questions
How many Medicare Advantage plans are available in Alabama for 2026?
There are 98 Medicare Advantage plans available statewide in Alabama for 2026, up from 93 in 2025. Plan availability varies by county: Jefferson and Mobile counties have around 59-60 plans, while rural Black Belt counties have fewer choices. Use the plan finder at medicare.gov with your ZIP code for the exact plans in your area.
What is the average Medicare Advantage premium in Alabama for 2026?
The average monthly Medicare Advantage premium in Alabama is approximately $12 for 2026, below the national MA average of $14. Many plans in Alabama are available at $0 monthly premium, though these often have higher cost-sharing or more limited networks. Premium figures are from CMS 2026 landscape data and may vary by county and plan type.
Which Medicare Advantage carriers operate in Alabama in 2026?
Major carriers in Alabama for 2026 include Blue Cross and Blue Shield of Alabama, Humana, UnitedHealthcare, Aetna, VIVA Health (UAB-affiliated), HealthSpring (formerly Cigna, now under HCSC), and Devoted Health. WellCare (Centene) exited the Alabama Medicare Advantage market for 2026 after discontinuing its plans, affecting approximately 37,000 enrollees.
What is VIVA Health and how is it different from national Medicare Advantage plans?
VIVA Health is the only Medicare Advantage plan headquartered in Alabama, affiliated with UAB Health System in Birmingham. It offers HMO plans in most Alabama counties with a 4-star CMS rating, which is above the state average. VIVA's network centers on UAB's hospitals and affiliated providers. It tends to have higher premiums than national carriers ($48/mo average), but the integrated UAB network can mean better care coordination if you use UAB facilities.
Does Alabama have Dual Special Needs Plans (D-SNPs) for people on both Medicare and Medicaid?
Yes. UnitedHealthcare, Humana, Aetna, and Devoted Health all offer D-SNP plans in Alabama for 2026. Because Alabama has not expanded Medicaid under the ACA, full dual eligibility is limited to low-income seniors and people with disabilities who meet Alabama's traditional Medicaid rules. However, people who qualify for Medicare Savings Programs (QMB, SLMB, QI) are also considered dually eligible and can enroll in D-SNPs. These plans typically have $0 premiums and reduced copays.
What happened to Cigna Medicare Advantage plans in Alabama?
Cigna sold its Medicare business, including its Medicare Advantage plans, to Health Care Service Corp. (HCSC) in March 2025. For 2026, Cigna's Alabama Medicare Advantage plans are now offered under the HealthSpring brand. If you were enrolled in a Cigna MA plan in 2025, you were transitioned to the equivalent HealthSpring plan. Review your updated Evidence of Coverage to confirm your 2026 benefits and network.
When is the Medicare Advantage Annual Election Period (AEP) for 2026?
The 2026 Annual Election Period (AEP) runs October 15 to December 7, 2026. Coverage from any plan change made during AEP starts January 1, 2027. During AEP you can switch from Original Medicare to a Medicare Advantage plan, switch from one MA plan to another, change your Part D plan, or return to Original Medicare. If you are already in a Medicare Advantage plan, you also have the Medicare Advantage Open Enrollment Period from January 1 to March 31, 2026, which allows one plan switch.
What is the maximum out-of-pocket limit for Medicare Advantage plans in Alabama in 2026?
The federal ceiling for in-network Medicare Advantage maximum out-of-pocket (MOOP) is $9,250 for 2026, down $100 from $9,350 in 2025. Most Alabama MA plans set their MOOP lower, typically between $5,500 and $7,500 for in-network care. Once you reach the MOOP, the plan covers 100% of covered in-network services for the rest of the calendar year. Original Medicare has no MOOP, which is one key reason many Alabama beneficiaries choose MA.
