Alabama Seniors: Medicare Is Now Covering This — Most Haven’t Claimed It Yet
Every year, Medicare quietly expands what it covers — and every year, millions of seniors miss out simply because they didn’t know to ask. In 2026, there are several newly covered benefits that Alabama seniors are eligible for that most haven’t claimed yet.
If you’re 65 or older and enrolled in Medicare Parts A and B, or if you have a Medicare Advantage plan, this guide is for you. We’ll walk through what’s new, what you may already be entitled to but aren’t receiving, and the single most important call you can make this month.
WHAT MEDICARE ADDED IN 2025 AND 2026
The Inflation Reduction Act and subsequent CMS rulemakings have changed Medicare coverage in meaningful ways over the past two years. Here are the most significant changes affecting Alabama seniors:
Prescription drug costs are now capped. Starting in 2025, Medicare Part D beneficiaries have a $2,000 out-of-pocket cap on prescription drugs per year. Before this change, there was no limit — some seniors were paying $5,000 to $10,000 annually for medications. If your pharmacy hasn’t adjusted your costs to reflect this cap, ask your Part D plan provider directly.
Mental health coverage has expanded. Medicare now covers mental health services at the same rate as other medical services. This includes individual therapy, group therapy, and psychiatric services. There is no longer a higher cost-sharing requirement for mental health compared to physical health visits. In Alabama, where rural mental health services are severely underserved, this matters.
Caregiver training is now covered. If a family member or friend helps you with daily care and needs training to do it safely, Medicare Part B now covers caregiver training sessions provided by a qualified healthcare provider. This is brand new and almost entirely unknown.
Dental, vision, and hearing through Medicare Advantage. Original Medicare (Parts A and B) still does not cover routine dental, vision, or hearing. However, most Medicare Advantage plans now include these benefits. If you are on original Medicare and paying out of pocket for dental or glasses, you may be able to switch to an Advantage plan that covers these at no additional premium.
WHAT ALABAMA SENIORS ARE MISSING THAT ALREADY EXISTS
Beyond the new additions, there are long-standing Medicare benefits that Alabama seniors consistently underuse.
The Annual Wellness Visit is 100% covered with no copay. This is not the same as a regular physical exam — it’s a dedicated Medicare benefit for creating a personalized prevention plan, reviewing your medications, and screening for cognitive decline. You are entitled to one per year. Studies show that fewer than 20% of eligible Medicare beneficiaries use this benefit annually.
Chronic Care Management is a covered program for people with two or more chronic conditions — diabetes and high blood pressure, for example. Your doctor can bill Medicare for monthly care coordination on your behalf. If you have multiple conditions and your doctor hasn’t mentioned this program, ask specifically: “Do I qualify for Chronic Care Management under Medicare?”
In my experience speaking with Alabama seniors about Medicare, the most common situation is that they are paying out of pocket for things that Medicare would cover — simply because they never asked their doctor to bill for it properly.
Diabetes prevention and management programs are covered. If you’re at risk for diabetes or already managing it, Medicare covers the Diabetes Prevention Program and diabetes self-management training. Both are available through certified providers in Alabama, including several hospital systems in Birmingham, Huntington, and Mobile.
THE LOW INCOME SUBSIDY — AND WHO QUALIFIES IN ALABAMA
Alabama has one of the highest rates of Medicare beneficiaries who qualify for the Low Income Subsidy (LIS, also called Extra Help) but don’t receive it.
Extra Help is a federal program that helps people with limited income pay for Medicare Part D costs. If you qualify, your monthly premium, deductible, and co-pays for prescription drugs can drop dramatically — sometimes to zero.
To qualify in 2026, your income must be below approximately $22,590 per year (single) or $30,660 (married couple), and your assets must be below $16,660 (single) or $33,240 (married). These limits are higher than most people expect.
You apply through the Social Security Administration at ssa.gov/extrahelp or by calling 1-800-772-1213. The Alabama State Health Insurance Assistance Program (SHIP) — reachable at 1-800-243-5463 — can help you apply for free. They are not selling anything; it’s a federally funded counseling service.
HOW TO FIND OUT IF YOUR PLAN IS STILL THE BEST OPTION
Medicare Advantage plans change their coverage and costs every year. A plan that was the best option for you in 2023 may not be the best option in 2026. Alabama’s Medicare Advantage market has changed significantly, with several new plans entering the state and others reducing their dental and vision benefits.
The Medicare Plan Finder at medicare.gov/plan-compare allows you to enter your zip code and medications and compare every plan available in your area side by side. This tool is free, unbiased, and run by the federal government — it’s the best starting point.
The Alabama SHIP program also offers free one-on-one plan comparison help by phone or in person. They cover every county in the state.
The Open Enrollment period runs from October 15 to December 7 each year. Outside that window, you can still make changes if you qualify for a Special Enrollment Period.
THE MOST IMPORTANT CALL YOU CAN MAKE THIS MONTH
If you’re an Alabama senior on Medicare and you haven’t reviewed your plan or checked for new benefits in the past 12 months, the single most valuable thing you can do is call the Alabama SHIP program at 1-800-243-5463.
This call is free. The counselors are trained and certified. They don’t work for an insurance company. Their only job is to help you understand what you’re entitled to and make sure you’re getting it.
SOURCES:
– CMS 2026 Medicare coverage updates: cms.gov
– Alabama SHIP (State Health Insurance Assistance Program): 1-800-243-5463
– Medicare Plan Finder: medicare.gov/plan-compare
– Social Security Extra Help program: ssa.gov/extrahelp
– Medicare Annual Wellness Visit: medicare.gov/coverage/yearly-wellness-visits