Alabama medicaid form tool printable 2025

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Alabama recognizes two standard claim forms (UB-04 and CMS-1500) and three Medicaid non-standard claim forms (Pharmacy, Dental, and one Medicare/Medicaid-related claim form). The providers provider type determines which claim type to bill, as illustrated in the table below.
What documents and information do you need for your Medicaid application? Your name and date of birth. Your Social Security number. Your monthly payment amounts for rent, mortgage, or utilities. Proof of citizenship or immigration status. Proof of income, like paystubs or W-2s.
Income Asset Limits for Eligibility 2025 Alabama Medicaid Long-Term Care Eligibility for Seniors Type of MedicaidSingle Institutional / Nursing Home Medicaid $2,901 / month* $2,000 Medicaid Waivers / Home and Community Based Services $2,901 / month $2,000 Regular Medicaid / Medicaid for Elderly and Disabled $987 / month $2,0001 more row Dec 4, 2024
Yes. Alabama Medicaid has three programs for people who have Medicare coverage: The Qualified Medicare Beneficiary (QMB) program, the Specified Low-Income Medicare Beneficiary (SLMB) program, and the Qualifying Individual (QI-1) program. The services you get depend on how much income you have.
To qualify for Medicaid, applicants must meet income, age or other requirements; provide proof of income and other information, fill out forms correctly and turn in a completed application to the correct office or worker. For more help, applicants should contact 1-800-362-1504.
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