Alabama Medicare Advantage plan enrollment by the numbers

With more than 358,000 enrollees, Alabama has the 16th-highest number of Medicare Advantage beneficiaries in the country.¹

There are several types of Medicare Advantage plans. In the state of Alabama, there are 36 different Medicare Advantage plans available as of 2018.² Not every plan is available in each county, so it's important to find out which ones are offered where you live.

A little more than half of Alabama Medicare Advantage beneficiaries belong to an PPO plan (as you can see in the chart below), while nearly as many participate in an HMO. The major types of Medicare Advantage plans include:

HMO

A Health Maintenance Organization usually requires patients to use health care providers and pharmacies that are part of the plan’s network (except in the case of emergencies) while also typically requiring a referral from a primary care doctor in order to see a specialist.

PPO

Medicare Advantage beneficiaries in a Preferred Provider Organization are able to see providers outside of their plan’s network, often at a higher cost. Beneficiaries in this type of plan typically pay less out of pocket if they choose to receive medical services from providers within their plan’s network. PPO plans typically do not require patients to acquire a referral before visiting with a specialist.

PFFS

A Private Fee-For-Service plan determines how much it will pay to health care providers and how much the patient will pay when care is received. With a PFFS plan, you can typically receive care from any doctor, hospital or health care provider that accepts your plan’s terms. Not all providers will accept these terms, however.

SNP

A Special Needs Plan is a type of Medicare Advantage plan limited to people with certain chronic conditions and  other specific characteristics. Typically, you must receive care from health care providers and hospitals within your SNP network, except for in cases when you need emergency or urgent care and when someone who has End-Stage Renal Disease (ESRD) needs out-of-area kidney dialysis.

Medicare Cost Plans, Medical Savings Accounts (MSA) and HMO Point-of-Service (HMO POS) plans are 3 additional types of Medicare Advantage plans. These plans make up less than 1 percent of all MA plans sold in Alabama.

Total number of Medicare Advantage enrollees in Alabama: 358,325 as of 2017¹

AL Medicare Advantage enrollees by plan type:

Data reflects Medicare Advantage enrollment in the state of Alabama as of 2017, as obtained from the Kaiser Family Foundation Medicare Advantage 2017 Spotlight: Enrollment Market Update¹

Alabama State Health Insurance Assistance Program (SHIP)

The state of Alabama staffs a group of SHIP volunteers who provide counseling and educational materials to older adults living in Alabama. This program can help Medicare beneficiaries better understand their Medicare coverage, rights and costs in order to get the most out of their benefits. You can contact Alabama’s SHIP program at 800-243-5463.

You can also explore more information about the insurance industry in Alabama by visiting the state’s Department of Insurance website.

¹Kaiser Family Foundation. Medicare Advantage 2017 Spotlight: Enrollment Market Update. Retrieved from https://www.kff.org/report-section/medicare-advantage-2017-spotlight-enrollment-market-update-appendices.

²Kaiser Family Foundation. State Health Facts: Medicare Advantage Plans. Retrieved from https://www.kff.org/medicare/state-indicator/plans/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D.