Alabama is the birthplace of the Confederate flag, the first Mardi Gras celebration, and the first NASA ship to land humans on the moon. The state has a very rich history, and it is undoubtedly a staple of Southern culture. When it comes to health insurance, this Southern entity is covered by several reputable companies such as Celtic, Blue Cross Blue Shield, Humana, and UnitedHealthcare. If you are not already insured through one of these companies (or if you are and feel like doing some comparison shopping) and you live in Alabama, compare rates in your area by filling out a quote below.

 

Health Status

Though many residents have health insurance, 16% of the population remains uninsured, which includes 744,100 individuals. In Alabama, as with the rest of the country, a variety of health concerns are prevalent among residents. One of the more notable health problems in the state is overweight/obesity, which affects a staggering 70% of adults (and a somewhat average 31% of children). Residents of Alabama are also eating less fruits and vegetables per day than much of the country, despite the fact that certain farmer’s markets accept EBT, WIP and FMNP benefits.

Compared to the rest of the states, the population of excessive drinkers is significantly less. However, the death rate due to heart disease is higher than most of the U.S., at 233.1 per 100,000. Stroke and other cerebrovascular diseases also caused a slightly higher number of deaths in Alabama than most of the country, with 55.4 deaths per 100,000 population. There are also high numbers of smokers and diabetics.

Not to worry, Alabama, according to UnitedHealth, your outlook is bright – with statistics indicating that your state’s health is likely to make positive changes in the future. A plus of living in Alabama is that the state funding for public health care services has increased, therefore those who are uninsured, medically needy, or have low income have access to better health care. Also, though there are still Alabama residents without insurance, the past 10 years has seen a 3% increase in the total insured population.

 

Health Insurance Plans

As mentioned above, the carriers available in Alabama are some of the best in the nation, and top-sellers at East Coast Health Insurance for various reasons. Depending on your budget and life situation, there are health plans for almost anyone. If you have a serious health condition or a low income, it is best to consider a federally funded program, as many insurance companies can reject you for coverage (until 2014 under the Affordable Care Act). The companies we work with in Alabama have various plans, and the following is a brief outline of the options offered. For more detailed pricing and availability information, fill out a quote.

Blue Cross Blue Shield of Alabama

  • Total Blue & Classic Blue are copay plans that offer the same type of payment method for medical services as a group health policy, with a predictable copay for most visits. These plans also have the option of adding dental  coverage, and offer discounted services through in-network providers. Various services such as preventive care, inpatient hospital care, emergency room services, lab work, and doctor’s office visits are available for a copay before your deductible has been met. Even more coverage is available after meeting your deductible
  • BlueChoice Plus & Blue Choice Essential are high-deductible PPO plans, qualified for use with a health savings account (HSA). These plans provide coverage through Blue Cross Blue Shield’s PPO network of providers for a lower rate than seeing an out-of-network provider, though you are still covered when seeing an out-of-network provider. Prescription drugs, hospital care, and other services are covered, and an HSA is an efficient way to pay for medical services or plan for future needs.
  • Blue Link is a short term coverage plan (up to six months) with a $1,000 deductible. When you meet your deductible, you will receive 80% coverage on services such as preventive care, physician’s office visits, and emergency room care. Coverage on some services is available before meeting the deductible, such as prescription drugs and hospital care.

Celtic

  • Celtic Basic plans are PPOs that allow for 80/20%  or 70/30% coverage, and the ability to choose in-network or out-of-network providers. These have a range of deductibles to choose from with a low monthly premium, and two $30 copay office visits per year. There is also a prescription drug option and healthy lifestyle benefits
  • CeltiCare Preferred plans are PPOs available in three types: Any Doc, Select PPO, and Managed Indemnity. Both Any Doc and Select PPO come with a range of deductibles, and no charge for in-network annual physical and GYN exams, as well as well baby care. Preventive care is covered at 100%, and copays for certain services are available before you meet your deductible. Managed Indemnity plans have comprehensive major medical coverage with no network requirements, a range of deductibles, and covers preventive care. There are also optional benefits such as prescription drug, supplemental accident, and term life insurance coverage.
  • CelticSaver HSA is a PPO plan with a high deductible that qualifies for a health savings account (HSA). These plans have a low monthly premium in exchange for a high deductible, and you have much freedom. You can choose your own providers, and you also can pay for medical expenses with tax-advantaged funds from your HSA.

HumanaOne

  • Value plans are high deductible PPO plans with 100% coverage after deductible on doctor’s office visits, inpatient hospital care, X-ray and lab work, and many other services. Prescriptions are available for a copay, and preventive care is covered at 100% before you meet your deductible.
  • Copay plans through HumanaOne are PPOs, available in 70%, 80%, or Enhanced 80, all of which have preventive care covered at 100%. As the name suggests, many services such as doctor’s office visits, specialists, and urgent care are available for a copay before you have paid your deductible in full. After you have done so, you have access to many services with 70% or 80% coverage, depending on the plan you choose. There are many deductibles to choose from with these plans, between $500 – $5,000 in-network for individuals, and $1,500 – $15,000 for families (Enhanced Copay 80). Out-of-network deductibles are double, but still covered.
  • HSA plans are high deductible plans qualified for opening an health savings account (HSA), which can be incredibly useful when you want control over your medical expenses. These plans offer 100% coverage of preventive care before deductible, and 100% coverage after deductible on most major medical services such as X-rays and lab work, emergency room, and inpatient and outpatient hospital care. You can set aside tax-advantaged HSA funds for future use or put it towards your deductible, or any other qualified health care services.

UnitedHealthOne

  •  High Deductible plans have incredibly low premiums and high deductibles (as low as $33/month in Montgomery with a Saver 80 $10,000). These are high deductible PPO plans with the ability to go in or out of network for coverage, receive discounts on prescriptions, and no charge for annual physical or GYN exams, and well baby care. Preventive care is covered 100% in-network with any of these plans, and you have a variety of options for deductibles. You can also add vision or supplemental accident coverage.
  • Copay plans are convenient and simple, with a designated cost for certain types of medical services, such as office visits and prescription drugs. Most other services are available for a coinsurance payment after meeting your deductible.
  • HSA plans are high deductible plans with the option of opening an health savings account (HSA). These plans have most services covered at either 100% or 70% after deductible, depending on which plan you choose. You also have the ability to pay for medical care with tax-free funds from your HSA. There are several deductibles to select from, and a variety of option benefits available such as prescription discount cards, and vision.

Public Health Options

Many public health programs are available in the State of Alabama. Visit the Alabama Department of Public Health to browse their programs, and find the one that is right for you. There are state-funded programs for family health, disease prevention and control, home health care services, emergency services, women’s health, minority health and many more.

  • Medicaid: for low-income, disabled, blind, elderly, pregnant, or medically needy individuals
  • ALL Kids: Children’s Health Insurance Program through Blue Cross Blue Shield of Alabama
  • Alabama Health Insurance Plan (AHIP): state-funded continuous coverage/high risk pool, also offered through Blue Cross Blue Shield of Alabama
  • Public Education Employees’ Health Insurance Plan (PEEHIP): state-funded health benefits to current and former employees of the Alabama public education system
  • SOBRA Medicaid: a state-funded program to assist in paying health care expenses for pregnant women and children ages 0 – 19. This also covers family planning services for women between age 19 – 44.

 

Health Insurance Laws

Pre-existing conditions are defined differently by each insurance company and each state, though many qualifying conditions overlap. In Alabama, the insurance company has the right to decide what is a pre-existing condition. At the time, the nation is still under legislation from the Affordable Care Act, which will require all adults with pre-existing conditions to be accepted for a health plan as of January 1, 2014. Until then, private insurers in the State of Alabama are allowed to turn you away for one of their plans, attach an elimination rider to your plan (never pay for care related to your pre-existing condition), not cover your condition for a 24-month exclusion period, or charge you higher premiums.

A high-risk pool for qualifying individuals was created by the Affordable Care Act, either run by the state or federal government. The Department of Health and Human Services (HHS) operates Alabama’s Pre-Existing Condition Insurance Plan (PCIP) for individuals with pre-existing conditions to get fair and affordable coverage until the 2014 law becomes effective. If you have been denied coverage from an insurer due to a pre-existing condition, you can compare rates through PCIP by filling out a quote.

Many regulations apply to Alabama the same as the rest of the country, such as  the availability of federally and state funded health care programs (see Public Health Options above), as well as guaranteed renewability. The guaranteed renewability provision under HIPAA ensures that once you have insurance, you are permitted to keep it. At the end of a term, insurers are required to allow you to renew your plan, and they cannot terminate your plan if you acquire an illness while insured. HIPAA laws apply in every state, in order to protect the insured individual and help keep their personal data safe within the context of permitted medical transactions only.

In Alabama, children with pre-existing conditions are required to be accepted for a private health insurance plan. As of March 2010, the Affordable Care Act passed a law that states insurance companies cannot turn away children under 19 for coverage, regardless of their condition. There are also many health plans through public programs available for children if they or their parent or caretaker are unable to afford a private health policy.