Author: Dr. Patricia Chen

  • Medicare in Colorado: Plans, Costs & Coverage Guide (2026)

    Medicare in Colorado: Quick Facts

    Medicare Beneficiaries 920,000
    Medicare Advantage Plans Available 38
    Average MA Plan Premium $9.10/month average premium
    Average MA Star Rating 4.0 / 5.0 stars
    Part D Plans Available 24
    Average Medigap Plan G Premium $138/month
    Medicaid Expansion Status Expanded (138% FPL)
    Medicaid Nursing Home Income Limit $2,982/month

    Medicare Options in Colorado

    Colorado residents on Medicare have three primary coverage paths: Original Medicare (Parts A and B), Medicare Advantage (Part C), and Medicare Supplement (Medigap) insurance paired with a Part D prescription drug plan. With 920,000 Medicare beneficiaries, Colorado is a mid-sized Medicare markets, which means fewer plan options but often more personalized service.

    Medicare Advantage in Colorado

    Colorado has 38 Medicare Advantage plans available, with an average star rating of 4.0 out of 5.0. The average monthly premium across all MA plans in the state is $9.10/month average premium. Medicare Advantage plans in Colorado typically include prescription drug coverage, dental, vision, and hearing benefits not available through Original Medicare.

    2026 Medicare Advantage Star Ratings in Colorado

    CMS rates Medicare Advantage plans on a 1–5 star scale based on quality measures including preventive care, managing chronic conditions, member experience, and customer service. Plans rated 4 stars or higher receive bonus payments from CMS, which they typically pass on to members through lower premiums or enhanced benefits. The average MA plan star rating in Colorado is 4.0 stars.

    Star Rating What It Means Bonus Payments
    5 Stars Excellent — top-performing plan Yes — highest bonus
    4.5 Stars Above average quality Yes
    4 Stars Good quality Yes
    3.5 Stars Average quality No
    3 Stars or below Below average — consider switching No

    Medicare Part D in Colorado

    Colorado has 24 standalone Part D prescription drug plans available. In 2026, the maximum out-of-pocket cap for Part D drugs is $2,100 — a major change from prior years that eliminates catastrophic drug costs. The maximum Part D deductible is $615.

    2026 Part D Key Numbers for Colorado Residents

    2026 Part D Limit Amount
    Out-of-pocket maximum $2,100/year
    Maximum deductible $615/year
    National base beneficiary premium $38.99/month
    Late enrollment penalty (per month uncovered) 1% × $38.99
    Coverage gap (“donut hole”) Eliminated as of 2025

    Medicare Supplement (Medigap) in Colorado

    Medigap Plan G is the most popular Medicare Supplement plan in Colorado, with an average monthly premium of $138. Plan G covers the Part A deductible ($1676 in 2026), Part B coinsurance (20% of all covered services), skilled nursing facility coinsurance, and foreign travel emergency coverage. The only cost Plan G does not cover is the Part B deductible ($240 in 2026).

    Medigap Plan Comparison for Colorado

    Plan Part A Deductible Part B Coinsurance SNF Coinsurance Estimated Monthly Premium
    Plan G (most popular) Covered Covered Covered $138/month
    Plan N Covered Covered (with copays) Covered $113/month
    Plan F (pre-2020 enrollees only) Covered Covered Covered $159/month
    Plan K (high-deductible) 50% covered 50% covered 50% covered $62/month

    Medicaid in Colorado

    Colorado has fully expanded Medicaid under the Affordable Care Act, meaning adults earning up to 138% of the Federal Poverty Level ($22,025/year for an individual) qualify for Medicaid coverage.

    Medicaid Income Limits in Colorado (2026)

    Medicaid Program Income Limit (Single) Notes
    Nursing Home / Institutional Medicaid $2,982/month Nearly all income goes toward cost of care
    HCBS Waiver (home-based care) $2,982/month Recipient keeps income for living expenses
    Regular Medicaid (Aged, Blind, Disabled) $994/month For seniors and disabled individuals

    Medicare Savings Programs in Colorado

    Medicare Savings Programs (MSPs) help low-income Medicare beneficiaries pay their premiums, deductibles, and copays. Colorado residents may qualify for one of four programs based on income:

    Program Individual Income Limit Couple Income Limit Benefit
    QMB (Qualified Medicare Beneficiary) $1,255/month $1,704/month Pays Part A and B premiums, deductibles, and copays
    SLMB (Specified Low-Income MB) $1,478/month $1,992/month Pays Part B premium only
    QI (Qualifying Individual) $1,660/month $2,239/month Pays Part B premium only, limited slots
    QDWI (Qualified Disabled Working) $4,945/month $6,659/month Pays Part A premium for working disabled under 65

    SSDI Recipients and Medicare in Colorado

    Social Security Disability Insurance (SSDI) recipients in Colorado automatically become eligible for Medicare after a 24-month waiting period from their disability onset date. This means that if you were approved for SSDI in Colorado, your Medicare coverage begins in month 25 of your disability. During the 24-month waiting period, Colorado residents may qualify for Medicaid to bridge the coverage gap.

  • Medicare in California: Plans, Costs & Coverage Guide (2026)

    Medicare in California: Quick Facts

    Medicare Beneficiaries 6,800,000
    Medicare Advantage Plans Available 98
    Average MA Plan Premium $12.30/month average premium
    Average MA Star Rating 4.2 / 5.0 stars
    Part D Plans Available 28
    Average Medigap Plan G Premium $168/month
    Medicaid Expansion Status Expanded (138% FPL)
    Medicaid Nursing Home Income Limit No income limit

    Medicare Options in California

    California residents on Medicare have three primary coverage paths: Original Medicare (Parts A and B), Medicare Advantage (Part C), and Medicare Supplement (Medigap) insurance paired with a Part D prescription drug plan. With 6,800,000 Medicare beneficiaries, California is one of the larger Medicare markets, which means strong plan competition and generally lower premiums.

    Medicare Advantage in California

    California has 98 Medicare Advantage plans available, with an average star rating of 4.2 out of 5.0. The average monthly premium across all MA plans in the state is $12.30/month average premium. Medicare Advantage plans in California typically include prescription drug coverage, dental, vision, and hearing benefits not available through Original Medicare.

    2026 Medicare Advantage Star Ratings in California

    CMS rates Medicare Advantage plans on a 1–5 star scale based on quality measures including preventive care, managing chronic conditions, member experience, and customer service. Plans rated 4 stars or higher receive bonus payments from CMS, which they typically pass on to members through lower premiums or enhanced benefits. The average MA plan star rating in California is 4.2 stars.

    Star Rating What It Means Bonus Payments
    5 Stars Excellent — top-performing plan Yes — highest bonus
    4.5 Stars Above average quality Yes
    4 Stars Good quality Yes
    3.5 Stars Average quality No
    3 Stars or below Below average — consider switching No

    Medicare Part D in California

    California has 28 standalone Part D prescription drug plans available. In 2026, the maximum out-of-pocket cap for Part D drugs is $2,100 — a major change from prior years that eliminates catastrophic drug costs. The maximum Part D deductible is $615.

    2026 Part D Key Numbers for California Residents

    2026 Part D Limit Amount
    Out-of-pocket maximum $2,100/year
    Maximum deductible $615/year
    National base beneficiary premium $38.99/month
    Late enrollment penalty (per month uncovered) 1% × $38.99
    Coverage gap (“donut hole”) Eliminated as of 2025

    Medicare Supplement (Medigap) in California

    Medigap Plan G is the most popular Medicare Supplement plan in California, with an average monthly premium of $168. Plan G covers the Part A deductible ($1676 in 2026), Part B coinsurance (20% of all covered services), skilled nursing facility coinsurance, and foreign travel emergency coverage. The only cost Plan G does not cover is the Part B deductible ($240 in 2026).

    Medigap Plan Comparison for California

    Plan Part A Deductible Part B Coinsurance SNF Coinsurance Estimated Monthly Premium
    Plan G (most popular) Covered Covered Covered $168/month
    Plan N Covered Covered (with copays) Covered $138/month
    Plan F (pre-2020 enrollees only) Covered Covered Covered $193/month
    Plan K (high-deductible) 50% covered 50% covered 50% covered $76/month

    Medicaid in California

    California has fully expanded Medicaid under the Affordable Care Act, meaning adults earning up to 138% of the Federal Poverty Level ($22,025/year for an individual) qualify for Medicaid coverage.

    Medicaid Income Limits in California (2026)

    Medicaid Program Income Limit (Single) Notes
    Nursing Home / Institutional Medicaid No income limit Nearly all income goes toward cost of care
    HCBS Waiver (home-based care) No income limit Recipient keeps income for living expenses
    Regular Medicaid (Aged, Blind, Disabled) $1,836/month For seniors and disabled individuals

    Medicare Savings Programs in California

    Medicare Savings Programs (MSPs) help low-income Medicare beneficiaries pay their premiums, deductibles, and copays. California residents may qualify for one of four programs based on income:

    Program Individual Income Limit Couple Income Limit Benefit
    QMB (Qualified Medicare Beneficiary) $1,255/month $1,704/month Pays Part A and B premiums, deductibles, and copays
    SLMB (Specified Low-Income MB) $1,478/month $1,992/month Pays Part B premium only
    QI (Qualifying Individual) $1,660/month $2,239/month Pays Part B premium only, limited slots
    QDWI (Qualified Disabled Working) $4,945/month $6,659/month Pays Part A premium for working disabled under 65

    SSDI Recipients and Medicare in California

    Social Security Disability Insurance (SSDI) recipients in California automatically become eligible for Medicare after a 24-month waiting period from their disability onset date. This means that if you were approved for SSDI in California, your Medicare coverage begins in month 25 of your disability. During the 24-month waiting period, California residents may qualify for Medicaid to bridge the coverage gap.

  • Medicare in Arkansas: Plans, Costs & Coverage Guide (2026)

    Medicare in Arkansas: Quick Facts

    Medicare Beneficiaries 680,000
    Medicare Advantage Plans Available 31
    Average MA Plan Premium $6.40/month average premium
    Average MA Star Rating 3.7 / 5.0 stars
    Part D Plans Available 23
    Average Medigap Plan G Premium $118/month
    Medicaid Expansion Status Expanded (138% FPL)
    Medicaid Nursing Home Income Limit $2,982/month

    Medicare Options in Arkansas

    Arkansas residents on Medicare have three primary coverage paths: Original Medicare (Parts A and B), Medicare Advantage (Part C), and Medicare Supplement (Medigap) insurance paired with a Part D prescription drug plan. With 680,000 Medicare beneficiaries, Arkansas is a mid-sized Medicare markets, which means fewer plan options but often more personalized service.

    Medicare Advantage in Arkansas

    Arkansas has 31 Medicare Advantage plans available, with an average star rating of 3.7 out of 5.0. The average monthly premium across all MA plans in the state is $6.40/month average premium. Medicare Advantage plans in Arkansas typically include prescription drug coverage, dental, vision, and hearing benefits not available through Original Medicare.

    2026 Medicare Advantage Star Ratings in Arkansas

    CMS rates Medicare Advantage plans on a 1–5 star scale based on quality measures including preventive care, managing chronic conditions, member experience, and customer service. Plans rated 4 stars or higher receive bonus payments from CMS, which they typically pass on to members through lower premiums or enhanced benefits. The average MA plan star rating in Arkansas is 3.7 stars.

    Star Rating What It Means Bonus Payments
    5 Stars Excellent — top-performing plan Yes — highest bonus
    4.5 Stars Above average quality Yes
    4 Stars Good quality Yes
    3.5 Stars Average quality No
    3 Stars or below Below average — consider switching No

    Medicare Part D in Arkansas

    Arkansas has 23 standalone Part D prescription drug plans available. In 2026, the maximum out-of-pocket cap for Part D drugs is $2,100 — a major change from prior years that eliminates catastrophic drug costs. The maximum Part D deductible is $615.

    2026 Part D Key Numbers for Arkansas Residents

    2026 Part D Limit Amount
    Out-of-pocket maximum $2,100/year
    Maximum deductible $615/year
    National base beneficiary premium $38.99/month
    Late enrollment penalty (per month uncovered) 1% × $38.99
    Coverage gap (“donut hole”) Eliminated as of 2025

    Medicare Supplement (Medigap) in Arkansas

    Medigap Plan G is the most popular Medicare Supplement plan in Arkansas, with an average monthly premium of $118. Plan G covers the Part A deductible ($1676 in 2026), Part B coinsurance (20% of all covered services), skilled nursing facility coinsurance, and foreign travel emergency coverage. The only cost Plan G does not cover is the Part B deductible ($240 in 2026).

    Medigap Plan Comparison for Arkansas

    Plan Part A Deductible Part B Coinsurance SNF Coinsurance Estimated Monthly Premium
    Plan G (most popular) Covered Covered Covered $118/month
    Plan N Covered Covered (with copays) Covered $97/month
    Plan F (pre-2020 enrollees only) Covered Covered Covered $136/month
    Plan K (high-deductible) 50% covered 50% covered 50% covered $53/month

    Medicaid in Arkansas

    Arkansas has fully expanded Medicaid under the Affordable Care Act, meaning adults earning up to 138% of the Federal Poverty Level ($22,025/year for an individual) qualify for Medicaid coverage.

    Medicaid Income Limits in Arkansas (2026)

    Medicaid Program Income Limit (Single) Notes
    Nursing Home / Institutional Medicaid $2,982/month Nearly all income goes toward cost of care
    HCBS Waiver (home-based care) $2,982/month Recipient keeps income for living expenses
    Regular Medicaid (Aged, Blind, Disabled) $1,064/month For seniors and disabled individuals

    Medicare Savings Programs in Arkansas

    Medicare Savings Programs (MSPs) help low-income Medicare beneficiaries pay their premiums, deductibles, and copays. Arkansas residents may qualify for one of four programs based on income:

    Program Individual Income Limit Couple Income Limit Benefit
    QMB (Qualified Medicare Beneficiary) $1,255/month $1,704/month Pays Part A and B premiums, deductibles, and copays
    SLMB (Specified Low-Income MB) $1,478/month $1,992/month Pays Part B premium only
    QI (Qualifying Individual) $1,660/month $2,239/month Pays Part B premium only, limited slots
    QDWI (Qualified Disabled Working) $4,945/month $6,659/month Pays Part A premium for working disabled under 65

    SSDI Recipients and Medicare in Arkansas

    Social Security Disability Insurance (SSDI) recipients in Arkansas automatically become eligible for Medicare after a 24-month waiting period from their disability onset date. This means that if you were approved for SSDI in Arkansas, your Medicare coverage begins in month 25 of your disability. During the 24-month waiting period, Arkansas residents may qualify for Medicaid to bridge the coverage gap.

  • Medicare in Arizona: Plans, Costs & Coverage Guide (2026)

    Medicare in Arizona: Quick Facts

    Medicare Beneficiaries 1,320,000
    Medicare Advantage Plans Available 52
    Average MA Plan Premium $8.20/month average premium
    Average MA Star Rating 4.1 / 5.0 stars
    Part D Plans Available 26
    Average Medigap Plan G Premium $128/month
    Medicaid Expansion Status Expanded (138% FPL)
    Medicaid Nursing Home Income Limit $2,982/month

    Medicare Options in Arizona

    Arizona residents on Medicare have three primary coverage paths: Original Medicare (Parts A and B), Medicare Advantage (Part C), and Medicare Supplement (Medigap) insurance paired with a Part D prescription drug plan. With 1,320,000 Medicare beneficiaries, Arizona is one of the larger Medicare markets, which means strong plan competition and generally lower premiums.

    Medicare Advantage in Arizona

    Arizona has 52 Medicare Advantage plans available, with an average star rating of 4.1 out of 5.0. The average monthly premium across all MA plans in the state is $8.20/month average premium. Medicare Advantage plans in Arizona typically include prescription drug coverage, dental, vision, and hearing benefits not available through Original Medicare.

    2026 Medicare Advantage Star Ratings in Arizona

    CMS rates Medicare Advantage plans on a 1–5 star scale based on quality measures including preventive care, managing chronic conditions, member experience, and customer service. Plans rated 4 stars or higher receive bonus payments from CMS, which they typically pass on to members through lower premiums or enhanced benefits. The average MA plan star rating in Arizona is 4.1 stars.

    Star Rating What It Means Bonus Payments
    5 Stars Excellent — top-performing plan Yes — highest bonus
    4.5 Stars Above average quality Yes
    4 Stars Good quality Yes
    3.5 Stars Average quality No
    3 Stars or below Below average — consider switching No

    Medicare Part D in Arizona

    Arizona has 26 standalone Part D prescription drug plans available. In 2026, the maximum out-of-pocket cap for Part D drugs is $2,100 — a major change from prior years that eliminates catastrophic drug costs. The maximum Part D deductible is $615.

    2026 Part D Key Numbers for Arizona Residents

    2026 Part D Limit Amount
    Out-of-pocket maximum $2,100/year
    Maximum deductible $615/year
    National base beneficiary premium $38.99/month
    Late enrollment penalty (per month uncovered) 1% × $38.99
    Coverage gap (“donut hole”) Eliminated as of 2025

    Medicare Supplement (Medigap) in Arizona

    Medigap Plan G is the most popular Medicare Supplement plan in Arizona, with an average monthly premium of $128. Plan G covers the Part A deductible ($1676 in 2026), Part B coinsurance (20% of all covered services), skilled nursing facility coinsurance, and foreign travel emergency coverage. The only cost Plan G does not cover is the Part B deductible ($240 in 2026).

    Medigap Plan Comparison for Arizona

    Plan Part A Deductible Part B Coinsurance SNF Coinsurance Estimated Monthly Premium
    Plan G (most popular) Covered Covered Covered $128/month
    Plan N Covered Covered (with copays) Covered $105/month
    Plan F (pre-2020 enrollees only) Covered Covered Covered $147/month
    Plan K (high-deductible) 50% covered 50% covered 50% covered $58/month

    Medicaid in Arizona

    Arizona has fully expanded Medicaid under the Affordable Care Act, meaning adults earning up to 138% of the Federal Poverty Level ($22,025/year for an individual) qualify for Medicaid coverage.

    Medicaid Income Limits in Arizona (2026)

    Medicaid Program Income Limit (Single) Notes
    Nursing Home / Institutional Medicaid $2,982/month Nearly all income goes toward cost of care
    HCBS Waiver (home-based care) $2,982/month Recipient keeps income for living expenses
    Regular Medicaid (Aged, Blind, Disabled) $1,330/month For seniors and disabled individuals

    Medicare Savings Programs in Arizona

    Medicare Savings Programs (MSPs) help low-income Medicare beneficiaries pay their premiums, deductibles, and copays. Arizona residents may qualify for one of four programs based on income:

    Program Individual Income Limit Couple Income Limit Benefit
    QMB (Qualified Medicare Beneficiary) $1,255/month $1,704/month Pays Part A and B premiums, deductibles, and copays
    SLMB (Specified Low-Income MB) $1,478/month $1,992/month Pays Part B premium only
    QI (Qualifying Individual) $1,660/month $2,239/month Pays Part B premium only, limited slots
    QDWI (Qualified Disabled Working) $4,945/month $6,659/month Pays Part A premium for working disabled under 65

    SSDI Recipients and Medicare in Arizona

    Social Security Disability Insurance (SSDI) recipients in Arizona automatically become eligible for Medicare after a 24-month waiting period from their disability onset date. This means that if you were approved for SSDI in Arizona, your Medicare coverage begins in month 25 of your disability. During the 24-month waiting period, Arizona residents may qualify for Medicaid to bridge the coverage gap.

  • Medicare in Alaska: Plans, Costs & Coverage Guide (2026)

    Medicare in Alaska: Quick Facts

    Medicare Beneficiaries 95,000
    Medicare Advantage Plans Available 4
    Average MA Plan Premium $0/month (many $0-premium plans available)
    Average MA Star Rating 3.5 / 5.0 stars
    Part D Plans Available 18
    Average Medigap Plan G Premium $198/month
    Medicaid Expansion Status Expanded (138% FPL)
    Medicaid Nursing Home Income Limit $2,982/month

    Medicare Options in Alaska

    Alaska residents on Medicare have three primary coverage paths: Original Medicare (Parts A and B), Medicare Advantage (Part C), and Medicare Supplement (Medigap) insurance paired with a Part D prescription drug plan. With 95,000 Medicare beneficiaries, Alaska is a mid-sized Medicare markets, which means fewer plan options but often more personalized service.

    Medicare Advantage in Alaska

    Alaska has 4 Medicare Advantage plans available, with an average star rating of 3.5 out of 5.0. The average monthly premium across all MA plans in the state is $0/month (many $0-premium plans available). Medicare Advantage plans in Alaska typically include prescription drug coverage, dental, vision, and hearing benefits not available through Original Medicare.

    2026 Medicare Advantage Star Ratings in Alaska

    CMS rates Medicare Advantage plans on a 1–5 star scale based on quality measures including preventive care, managing chronic conditions, member experience, and customer service. Plans rated 4 stars or higher receive bonus payments from CMS, which they typically pass on to members through lower premiums or enhanced benefits. The average MA plan star rating in Alaska is 3.5 stars.

    Star Rating What It Means Bonus Payments
    5 Stars Excellent — top-performing plan Yes — highest bonus
    4.5 Stars Above average quality Yes
    4 Stars Good quality Yes
    3.5 Stars Average quality No
    3 Stars or below Below average — consider switching No

    Medicare Part D in Alaska

    Alaska has 18 standalone Part D prescription drug plans available. In 2026, the maximum out-of-pocket cap for Part D drugs is $2,100 — a major change from prior years that eliminates catastrophic drug costs. The maximum Part D deductible is $615.

    2026 Part D Key Numbers for Alaska Residents

    2026 Part D Limit Amount
    Out-of-pocket maximum $2,100/year
    Maximum deductible $615/year
    National base beneficiary premium $38.99/month
    Late enrollment penalty (per month uncovered) 1% × $38.99
    Coverage gap (“donut hole”) Eliminated as of 2025

    Medicare Supplement (Medigap) in Alaska

    Medigap Plan G is the most popular Medicare Supplement plan in Alaska, with an average monthly premium of $198. Plan G covers the Part A deductible ($1676 in 2026), Part B coinsurance (20% of all covered services), skilled nursing facility coinsurance, and foreign travel emergency coverage. The only cost Plan G does not cover is the Part B deductible ($240 in 2026).

    Medigap Plan Comparison for Alaska

    Plan Part A Deductible Part B Coinsurance SNF Coinsurance Estimated Monthly Premium
    Plan G (most popular) Covered Covered Covered $198/month
    Plan N Covered Covered (with copays) Covered $162/month
    Plan F (pre-2020 enrollees only) Covered Covered Covered $228/month
    Plan K (high-deductible) 50% covered 50% covered 50% covered $89/month

    Medicaid in Alaska

    Alaska has fully expanded Medicaid under the Affordable Care Act, meaning adults earning up to 138% of the Federal Poverty Level ($22,025/year for an individual) qualify for Medicaid coverage.

    Medicaid Income Limits in Alaska (2026)

    Medicaid Program Income Limit (Single) Notes
    Nursing Home / Institutional Medicaid $2,982/month Nearly all income goes toward cost of care
    HCBS Waiver (home-based care) $2,982/month Recipient keeps income for living expenses
    Regular Medicaid (Aged, Blind, Disabled) $1,845/month For seniors and disabled individuals

    Medicare Savings Programs in Alaska

    Medicare Savings Programs (MSPs) help low-income Medicare beneficiaries pay their premiums, deductibles, and copays. Alaska residents may qualify for one of four programs based on income:

    Program Individual Income Limit Couple Income Limit Benefit
    QMB (Qualified Medicare Beneficiary) $1,255/month $1,704/month Pays Part A and B premiums, deductibles, and copays
    SLMB (Specified Low-Income MB) $1,478/month $1,992/month Pays Part B premium only
    QI (Qualifying Individual) $1,660/month $2,239/month Pays Part B premium only, limited slots
    QDWI (Qualified Disabled Working) $4,945/month $6,659/month Pays Part A premium for working disabled under 65

    SSDI Recipients and Medicare in Alaska

    Social Security Disability Insurance (SSDI) recipients in Alaska automatically become eligible for Medicare after a 24-month waiting period from their disability onset date. This means that if you were approved for SSDI in Alaska, your Medicare coverage begins in month 25 of your disability. During the 24-month waiting period, Alaska residents may qualify for Medicaid to bridge the coverage gap.

  • Medicare in Alabama: Plans, Costs & Coverage Guide (2026)

    Medicare in Alabama: Quick Facts

    Medicare Beneficiaries 1,050,000
    Medicare Advantage Plans Available 28
    Average MA Plan Premium $18.50/month average premium
    Average MA Star Rating 3.8 / 5.0 stars
    Part D Plans Available 22
    Average Medigap Plan G Premium $142/month
    Medicaid Expansion Status Not Expanded
    Medicaid Nursing Home Income Limit $2,982/month

    Medicare Options in Alabama

    Alabama residents on Medicare have three primary coverage paths: Original Medicare (Parts A and B), Medicare Advantage (Part C), and Medicare Supplement (Medigap) insurance paired with a Part D prescription drug plan. With 1,050,000 Medicare beneficiaries, Alabama is one of the larger Medicare markets, which means strong plan competition and generally lower premiums.

    Medicare Advantage in Alabama

    Alabama has 28 Medicare Advantage plans available, with an average star rating of 3.8 out of 5.0. The average monthly premium across all MA plans in the state is $18.50/month average premium. Medicare Advantage plans in Alabama typically include prescription drug coverage, dental, vision, and hearing benefits not available through Original Medicare.

    2026 Medicare Advantage Star Ratings in Alabama

    CMS rates Medicare Advantage plans on a 1–5 star scale based on quality measures including preventive care, managing chronic conditions, member experience, and customer service. Plans rated 4 stars or higher receive bonus payments from CMS, which they typically pass on to members through lower premiums or enhanced benefits. The average MA plan star rating in Alabama is 3.8 stars.

    Star Rating What It Means Bonus Payments
    5 Stars Excellent — top-performing plan Yes — highest bonus
    4.5 Stars Above average quality Yes
    4 Stars Good quality Yes
    3.5 Stars Average quality No
    3 Stars or below Below average — consider switching No

    Medicare Part D in Alabama

    Alabama has 22 standalone Part D prescription drug plans available. In 2026, the maximum out-of-pocket cap for Part D drugs is $2,100 — a major change from prior years that eliminates catastrophic drug costs. The maximum Part D deductible is $615.

    2026 Part D Key Numbers for Alabama Residents

    2026 Part D Limit Amount
    Out-of-pocket maximum $2,100/year
    Maximum deductible $615/year
    National base beneficiary premium $38.99/month
    Late enrollment penalty (per month uncovered) 1% × $38.99
    Coverage gap (“donut hole”) Eliminated as of 2025

    Medicare Supplement (Medigap) in Alabama

    Medigap Plan G is the most popular Medicare Supplement plan in Alabama, with an average monthly premium of $142. Plan G covers the Part A deductible ($1676 in 2026), Part B coinsurance (20% of all covered services), skilled nursing facility coinsurance, and foreign travel emergency coverage. The only cost Plan G does not cover is the Part B deductible ($240 in 2026).

    Medigap Plan Comparison for Alabama

    Plan Part A Deductible Part B Coinsurance SNF Coinsurance Estimated Monthly Premium
    Plan G (most popular) Covered Covered Covered $142/month
    Plan N Covered Covered (with copays) Covered $116/month
    Plan F (pre-2020 enrollees only) Covered Covered Covered $163/month
    Plan K (high-deductible) 50% covered 50% covered 50% covered $64/month

    Medicaid in Alabama

    Alabama has not expanded Medicaid, meaning most adults without dependent children do not qualify for Medicaid regardless of income. Only parents earning up to 18% FPL ($4,918/year for a family of three) may qualify.

    Medicaid Income Limits in Alabama (2026)

    Medicaid Program Income Limit (Single) Notes
    Nursing Home / Institutional Medicaid $2,982/month Nearly all income goes toward cost of care
    HCBS Waiver (home-based care) $2,982/month Recipient keeps income for living expenses
    Regular Medicaid (Aged, Blind, Disabled) $1,014/month For seniors and disabled individuals

    Medicare Savings Programs in Alabama

    Medicare Savings Programs (MSPs) help low-income Medicare beneficiaries pay their premiums, deductibles, and copays. Alabama residents may qualify for one of four programs based on income:

    Program Individual Income Limit Couple Income Limit Benefit
    QMB (Qualified Medicare Beneficiary) $1,255/month $1,704/month Pays Part A and B premiums, deductibles, and copays
    SLMB (Specified Low-Income MB) $1,478/month $1,992/month Pays Part B premium only
    QI (Qualifying Individual) $1,660/month $2,239/month Pays Part B premium only, limited slots
    QDWI (Qualified Disabled Working) $4,945/month $6,659/month Pays Part A premium for working disabled under 65

    SSDI Recipients and Medicare in Alabama

    Social Security Disability Insurance (SSDI) recipients in Alabama automatically become eligible for Medicare after a 24-month waiting period from their disability onset date. This means that if you were approved for SSDI in Alabama, your Medicare coverage begins in month 25 of your disability. During the 24-month waiting period, Alabama residents may qualify for Medicaid to bridge the coverage gap.