Key Takeaways
- Alabama requires a 6-month open enrollment period for Medicare Supplement starting at age 65
- Alabama does NOT have a Birthday Rule like California
- ALDOI regulates Medicare Supplement rates (exception to non-regulation of health rates)
- Medicare Supplement plans must be standardized (Plans A through N)
- Guaranteed issue rights apply in specific situations
Alabama Medicare Supplement (Medigap) Regulations
Alabama follows federal Medicare Supplement standards with state-specific rate regulation by ALDOI.
Open Enrollment Period
Alabama provides a 6-month open enrollment period for Medicare Supplement:
When It Begins
The 6-month period starts:
- First day of the month you are 65 or older AND
- Enrolled in Medicare Part B
Protections During Open Enrollment
- Guaranteed issue - Must be accepted regardless of health
- No pre-existing condition exclusions during this period
- Standard rates - Cannot be charged more for health conditions
- Any plan available - Can choose any Medigap plan A through N
No Birthday Rule
Important: Unlike California and a few other states, Alabama does NOT have a Birthday Rule. Outside of open enrollment or guaranteed issue situations, insurers may use health underwriting.
Rate Regulation
Unlike most health insurance, ALDOI does regulate Medicare Supplement rates:
- Rate increases must be filed with ALDOI
- Rates are reviewed for reasonableness
- This is an exception to the general non-regulation of health rates
- Provides additional consumer protection for seniors
Standardized Plans
Alabama requires Medigap plans to be standardized per federal requirements:
| Plan | Benefits |
|---|---|
| Plan A | Basic benefits only |
| Plan B | Basic + Part A deductible |
| Plan C | Comprehensive (pre-2020 only) |
| Plan D | Similar to C, no Part B excess |
| Plan F | Most comprehensive (pre-2020 only) |
| Plan G | Like F without Part B deductible |
| Plan K | 50% cost sharing, out-of-pocket max |
| Plan L | 75% cost sharing, out-of-pocket max |
| Plan M | 50% Part A deductible |
| Plan N | Cost sharing, copays for visits |
Note: Plans C and F are only available to those eligible for Medicare before January 1, 2020.
Guaranteed Issue Rights
Beyond open enrollment, Alabama provides guaranteed issue rights in specific situations:
Triggering Events
| Event | Guaranteed Issue Right |
|---|---|
| Losing employer coverage | Can purchase Medigap within 63 days |
| Leaving Medicare Advantage | Can return to Medigap within 63 days |
| Medicare Advantage plan leaves area | Can purchase Medigap |
| Medigap insurer becomes insolvent | Can switch to comparable plan |
| Losing Medicaid | Can purchase Medigap |
Trial Right
If you leave Medigap for Medicare Advantage:
- Have 12 months to decide
- Can return to previous Medigap plan
- Or any plan from same insurer with equal or lesser benefits
- Guaranteed issue, no health questions
Pre-Existing Conditions
During Open Enrollment
- No pre-existing condition waiting periods
- Must accept all applicants
- Standard rates apply
Outside Open Enrollment
- May impose up to 6-month waiting period
- Only for conditions treated within 6 months before effective date
- Credit given for prior creditable coverage
Does Alabama have a Birthday Rule for Medicare Supplement like California?
Does ALDOI regulate Medicare Supplement rates?