Frequently Asked Questions

About Medicaid

Medicaid began in Alabama on January 1, 1970. For nearly 50 years, millions of Alabamians have received medical services through Medicaid. Below are some questions people often ask about Medicaid. Click on the questions to see the answers.

Who does Medicaid cover?

Medicaid primarily covers low income children, disabled adults, nursing home residents and low income people who also have Medicare.

Does Alabama Medicaid cover all low income people?

No. Alabama Medicaid is a very limited program. The requirements vary from program to program. In many cases, Medicaid must consider resources (assets) as well as income. Some women are covered only if they are pregnant. Most Medicaid eligibles, however, are children.

Who decides if a person qualifies for Medicaid?

Medicaid eligibility is determined by several different agencies. The federal Social Security Administration certifies aged, blind or disabled people who have very low income and qualify for cash assistance through the Supplemental Security Income (SSI) program. The Alabama Department of Human Resources certifies foster children and children who receive state or federal adoption assistance. Medicaid certifies the remaining groups.

Is Medicaid the same in every state?

No. Each state Medicaid program decides what people and services will be covered. This usually depends on how much the state can afford. The federal government provides matching funds as long as the federal minimum requirements are met. One service may be covered in one state, but not in Alabama.

How many people are on Alabama Medicaid?

Over 1 million Alabama residents qualified for Medicaid at least one month of the year in FY 2020. This means about 1 of every 4 Alabamians had some form of Medicaid coverage at some point during the year.

What is the difference between Medicaid and Medicare?

Medicare is a federal program to provide medical insurance, primarily, for people age 65 or older. Medicaid is a federal and state program that provides medical assistance to low income people and persons with disabilities.

Who can be an Alabama Medicaid provider?

Any physician or dentist who is licensed in the State of Alabama may become a Medicaid provider. All providers must apply to provide services to Medicaid recipients. Some provider types have additional requirements that must be met in order to enroll as a Medicaid provider. All providers must not be disqualified or sanctioned due to fraud or abuse of the program.

How does Medicaid fit into the Alabama healthcare system?

Alabama Medicaid makes payments to hospitals, physicians, laboratories, nursing homes, pharmacies and other health care service providers on behalf of thousands of Medicaid-eligible Alabama citizens. All of these funds substantially support equipment, personnel and services that benefit all patients, regardless of payment source. Many providers, especially those in rural areas, depend on Medicaid dollars to cover the overhead costs of serving all patients. Maintaining a stable Medicaid program ensures that doctors, hospitals, nursing homes and other providers will be available to all citizens.

How is Alabama Medicaid funded?

Medicaid is funded jointly by the state and federal government. Medicaid's matching rate is approximately 70 percent federal, 30 percent state. This matching rate is based on state per capita income and changes each year.

How much of Alabama Medicaid's budget goes to pay for medical care?

Approximately 97 cents of every dollar goes directly to providing care and services to Alabama Medicaid recipients. Medicaid's administrative budget is typically about 2 to 3 percent of the overall budget.

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