Health insurance in Madison County, Alabama
4 insurers sell 52 marketplace plans here, and 8.3% of under-65 residents have no coverage at all.
Source: CMS Marketplace Open Enrollment Public Use Files and US Census Small Area Health Insurance Estimates, 2026 release.
Who sells here, and how much choice that gives
4 insurers sell marketplace plans in Madison County, offering 52 plans between them, roughly 13 each. It gained 1 since the previous plan year, up from 3.
How many people here have no coverage
8.3% of Madison County's 344,068 under-65 residents have no health coverage — 28,464 people. That is below the Alabama rate of 10.0%, and puts Madison County in the middle half of the 1,817 counties on this site (1349th).
Some of those 28,464 are in the Alabama coverage gap: under $15,960 a year, too little for a subsidy and no expanded Medicaid to fall back on.
How much the marketplace is used
35,835 Madison County residents selected a marketplace plan for 2026: 104 per thousand under-65 residents, 736th of 1,817. That is above the 78 per thousand typical of published counties. 4,691 of them — 13% — were new rather than renewing.
Madison County against Alabama
Madison County is the 2nd largest of the 8 Alabama counties we publish. Its uninsured rate runs 1.7 points lower than Alabama overall and with 4 insurers it is as well served as anywhere in Alabama. Marketplace use is close to the Alabama rate.
| Madison County | Alabama | Published median | |
|---|---|---|---|
| Uninsured, under 65 | 8.3% | 10.0% | 9.9% |
| Insurers selling | 4 | 2–4 | 4 |
| Plans offered | 52 | — | 57 |
| Selections per 1,000 | 104 | 114 | 78 |
| New rather than renewing | 13% | 13% | 15% |
Counties of a similar size nearby
| County | Under 65 | Uninsured | Insurers | Plans |
|---|---|---|---|---|
| Mobile County | 325,164 | 9.8% | 3 | 43 |
| Baldwin County | 201,674 | 9.5% | 3 | 43 |
| Shelby County | 191,414 | 7.1% | 4 | 54 |
| Tuscaloosa County | 181,574 | 8.6% | 2 | 25 |
| Jefferson County | 522,923 | 10.4% | 4 | 54 |
All of them have fewer insurers than this county's 4, which makes it the stronger market locally.
Other Alabama counties · Where the subsidy stops · Enrollment dates