Health insurance in Tuscaloosa County, Alabama
2 insurers sell 25 marketplace plans here, and 8.6% 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.
Two insurers, and what that means
Two insurers sell here, offering 25 plans between them. If either leaves, Tuscaloosa County becomes a single-insurer county. It gained 1 since the previous plan year, up from 1.
How many people here have no coverage
8.6% of Tuscaloosa County's 181,574 under-65 residents have no health coverage — 15,539 people. That is close to the Alabama rate of 10.0%, and puts Tuscaloosa County in the middle half of the 1,817 counties on this site (1299th).
Some of those 15,539 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
16,899 Tuscaloosa County residents selected a marketplace plan for 2026: 93 per thousand under-65 residents, 868th of 1,817. That is above the 78 per thousand typical of published counties. 1,882 of them — 11% — were new rather than renewing.
Tuscaloosa County against Alabama
Tuscaloosa County is the 6th largest of the 8 Alabama counties we publish. Its uninsured rate runs 1.4 points lower than Alabama overall and with 2 it has the fewest insurers of any Alabama county. Marketplace use is close to the Alabama rate.
| Tuscaloosa County | Alabama | Published median | |
|---|---|---|---|
| Uninsured, under 65 | 8.6% | 10.0% | 9.9% |
| Insurers selling | 2 | 2–4 | 4 |
| Plans offered | 25 | — | 57 |
| Selections per 1,000 | 93 | 114 | 78 |
| New rather than renewing | 11% | 13% | 15% |
Counties of a similar size nearby
| County | Under 65 | Uninsured | Insurers | Plans |
|---|---|---|---|---|
| Montgomery County | 172,864 | 9.8% | 2 | 30 |
| Shelby County | 191,414 | 7.1% | 4 | 54 |
| Baldwin County | 201,674 | 9.5% | 3 | 43 |
Shelby County has 4 insurers against this county's 2 — a reminder that the county line, not the state line, is what decides your options.
Other Alabama counties · Where the subsidy stops · Enrollment dates