Alabama Medicaid Income Limits 2026: New COLA & Eligibility Guide

Last Updated: 5 January, 2026 by Akash Biswas

Alabama Medicaid offers free or low-cost health coverage to eligible residents, with eligibility determined by income, family size, and specific circumstances.

In 2026, a single adult would not qualify unless pregnant or disabled, while a family of four could still get coverage for children if the income is below $44,367.

Alabama is one of the states that has not expanded Medicaid, and with the “One Big Beautiful Bill” now shaping new work requirements and stricter SNAP rules, understanding the income cutoffs is more important than ever.

Key Takeaways (2026)

• Single adults (under 65): Not eligible unless pregnant, disabled, blind, or elderly
• SSI-related Medicaid (elderly/disabled): Income limit increased to $994/month (individual)
• Nursing home Medicaid: New cap is $2,982/month
• Children: Covered at much higher income levels (up to 317% FPL through ALL Kids)
• Pregnant women: Eligible up to 146% FPL
• Parents: Eligibility remains extremely limited (about 18% FPL)
• Important: FPL-based limits will rise again in Spring 2026

What Is Alabama Medicaid?

Medicaid is a joint federal–state health insurance program created in 1965 to ensure that low-income families, children, seniors, and people with disabilities can access medical care.

In Alabama, the program is administered by the Alabama Medicaid. 

Alabama Medicaid Income Limits 2026 by Household Size

Important Note: These figures are based on 2025 Federal Poverty Level guidelines. The 2026 FPL guidelines are expected to be released by HHS in mid-January 2026 and typically take effect for Medicaid in March or April 2026, which will increase these limits slightly.

The table shows how the federal poverty levels increase with each household size. Alabama uses these figures to set its Medicaid rules, but because the state has not expanded, the 138% column is not applied to most adults. Instead, Alabama prioritizes coverage for children, pregnant women, and very low-income parents.

What this means in real life:

A single parent with two children (3-person household) could make around $26,000 and still get help for their children through Medicaid or CHIP.

A pregnant woman in a 4-person household could qualify even with income slightly above the 100% FPL mark, because Alabama uses higher limits for pregnancy.

A childless adult with the same income would not qualify in Alabama, even though they would in most expansion states.

2026 Income Limits for Elderly & Disabled (SSI-Related)

Effective January 1, 2026, Alabama Medicaid increased income limits for elderly and disabled individuals by 2.8% due to the federal Cost-of-Living Adjustment (COLA):

Individual Income Limit (SSI): $994 per month (increased from $967)

Couple Income Limit (SSI): $1,491 per month (increased from $1,450)

Nursing Home / Institutional Cap: $2,982 per month (300% of SSI Federal Benefit Rate)

Asset/Resource Limit: $2,000 (Individual) / $3,000 (Couple) — unchanged

Spousal Impoverishment Standards (2026)

For married couples where one spouse enters a nursing home and the other stays home, the following federal maximums are effective January 1, 2026:

Community Spouse Resource Allowance (CSRA): $162,660 (maximum assets the healthy spouse can keep)

Monthly Maintenance Needs Allowance (MMMNA): $4,066.50 (maximum income allocated to the healthy spouse)

Why Income Limits Vary by Group in Alabama

Not every group of people is treated the same under Alabama Medicaid. Eligibility depends on both income and life circumstances:

Children: Covered at much higher income levels, often up to 200% FPL through Medicaid or CHIP. This ensures children can still get preventive care, immunizations, and doctor visits.

Pregnant women: Eligible up to about 146% FPL ($1,905/month for a single person). Alabama aims to reduce infant and maternal health risks by covering prenatal and delivery care.

Parents with dependent children: Qualify only at extremely low incomes, around 18% FPL ($235/month for a single person). This leaves many working parents unable to get coverage.

Adults without children: Not eligible under Alabama Medicaid, no matter their income. The only exception is if they are elderly, blind, or disabled.

Elderly and Disabled: Must meet SSI income standards ($994/month for individuals in 2026) and asset limits.

Example: A family of four earning $44,000 would qualify for Medicaid in an expansion state. In Alabama, the children might qualify under CHIP, but the parents almost certainly would not. This shows why knowing your group category is just as important as knowing your income. Agency and covers:

• Doctor visits and hospital care
• Prescription drugs
• Maternity and prenatal care
• Preventive services
• Nursing home and long-term care for seniors and disabled individuals

Unlike expansion states, Alabama does not cover childless adults based on income alone, regardless of how little they earn. Coverage instead focuses on children, pregnant women, seniors, and people with disabilities.

How Income Limits Are Decided in Alabama

Medicaid eligibility is built around the Federal Poverty Level (FPL), which is updated each year by the U.S. Department of Health & Human Services. The FPL represents the minimum amount of income a household needs for basic living costs like food, clothing, and shelter. Think of it as a financial yardstick.

Each state then uses those FPL figures to set its own Medicaid rules. In expansion states, adults can qualify if they earn up to 138% of the FPL. Alabama, however, did not expand Medicaid, which means the rules here are stricter. Adults without children cannot qualify at all, and even parents are only eligible if their income is well below the poverty line. Pregnant women and children, however, are given higher limits to ensure they can access care.

For example, in 2026, the poverty guideline for a single adult is $15,650 per year. In an expansion state, that person could qualify for Medicaid up to $21,597 per year (138% FPL). In Alabama, though, that same adult would not be eligible unless they were pregnant or disabled. This shows how much the state’s decision not to expand affects real families.

For elderly and disabled individuals, Alabama uses SSI standards rather than FPL percentages, with the 2.8% COLA adjustment bringing the individual limit to $994 per month as of January 2026.

How to Check If You’re Eligible in Alabama

If you want to know whether you qualify for Medicaid in Alabama in 2026, follow these steps:

Visit the Alabama Medicaid Agency website or start at Medicaid.gov.

Use the eligibility tools provided to enter your household size and income.

Gather documents:

• Pay stubs or tax returns (to show income)
• ID and Social Security number
• Proof of Alabama residency (like a lease or utility bill)
• Proof of pregnancy or disability (if relevant)

Submit your application: Online, by mail, or at a local Medicaid office.

Report any changes in income or household size, since they can affect your eligibility.

Tip: Some states automatically check income through tax records to simplify renewals. In Alabama, you may need to provide updated paperwork each year.

What If You Don’t Qualify? Alternatives to Consider

Not everyone meets Alabama’s Medicaid rules, but there are other ways to get coverage:

CHIP (ALL Kids program): Provides affordable health insurance for children whose families earn too much for Medicaid but still cannot afford private insurance. Children may qualify up to 317% FPL (approximately $4,135/month for a single child). It covers doctor visits, hospital care, dental, vision, and prescriptions.

ACA Marketplace: When you apply through HealthCare.gov, the system will check your Medicaid eligibility first. If you don’t qualify, it calculates subsidies to lower your premium costs. Many families in Alabama pay less than $50 a month, and some plans can be as low as $20.

Community Health Centers: For people in the “coverage gap,” federally funded health centers offer care on a sliding scale. Services may include primary care, women’s health, and chronic condition management.

These options ensure that even if Medicaid isn’t available to you, there are still safety nets to keep healthcare within reach.

Conclusion

Alabama Medicaid income limits for 2026 reflect both the 2.8% COLA increase for elderly and disabled individuals and the current Federal Poverty Level guidelines for families and children. Because Alabama did not expand Medicaid, many adults without children cannot qualify, and parents often need to earn well below the poverty line. However, children, pregnant women, seniors, and people with disabilities have broader eligibility.

If you believe you may qualify, don’t wait to apply. Visit the Alabama Medicaid Agency website, gather your documents, and submit your application. Even if you are not eligible, programs like ALL Kids, ACA marketplace subsidies, and community clinics can still help you and your family access affordable care.

Healthcare can feel complicated, but with the right information, you can take the next step confidently.