The unincorporated communities west and north of Mobile city — Tillman's Corner, Eight Mile, and the broader West Mobile area — are home to a large suburban population that often flies below the radar of statewide coverage discussions. Together these communities represent tens of thousands of residents working in retail, healthcare, port-related services, and light manufacturing. For this population, January 2024 represented a landmark shift: Alabama became one of the last states in the country to expand Medicaid, and working families across Mobile County who had previously been locked out of coverage suddenly had a pathway in.
Before January 2024, Alabama was one of eleven holdout states that had not expanded Medicaid eligibility under the ACA. Adults without dependent children could not qualify for Medicaid regardless of how low their income was, and if they earned below 100% of the federal poverty level, they also couldn't receive ACA marketplace subsidies. This created a coverage gap that trapped hundreds of thousands of Alabamians — including a significant share of Mobile County's working-age adults.
The 2024 expansion changed that. Alabama Medicaid now covers adults earning up to 138% of the federal poverty level — approximately $20,782 for a single person and $35,630 for a family of three in 2026. This means that a retail worker at Tillman's Corner earning $18,000 per year now qualifies for Medicaid coverage for the first time. A healthcare aide in West Mobile earning $22,000 with two children now has a clear Medicaid pathway rather than facing an unaffordable marketplace premium. If you or a family member were uninsured before 2024 and work in one of these communities, you should check your current eligibility — enrollment is open year-round through the Alabama Medicaid Agency at myalhipp.com.
Alabama's expansion extends Medicaid to all adults — with or without children — whose household income is at or below 138% FPL. This covers a wide range of Mobile County residents in the suburban communities:
Medicaid coverage through the expansion is comprehensive — it includes primary care, hospital, mental health, substance abuse treatment, dental (for adults, which varies by waiver), and prescription drugs. Premiums are zero for expansion adults at the lowest income tiers, and cost-sharing is minimal. This is a dramatically better benefit package than most Bronze ACA marketplace plans.
For residents earning above 138% FPL — where Alabama Medicaid eligibility ends — the ACA marketplace picks up. Mobile County is served primarily by Blue Cross Blue Shield of Alabama (BCBS AL), which holds a dominant market position statewide and offers the broadest provider network in the county. Ambetter AL (operated by Centene/Celtic Insurance) also participates in the Mobile County marketplace with competitive premium pricing, particularly at the Silver tier.
Premium tax credits are available for households earning 138%–400% FPL (and modestly above 400% FPL under the Inflation Reduction Act extensions). At 138–200% FPL, ACA Silver plans with cost-sharing reductions can have deductibles as low as $300–$500 — making them genuinely usable coverage even for households that need care. For working families in Tillman's Corner and West Mobile who earn in this range, the Silver plan is almost always the right choice over Bronze.
Mobile County is served by two major hospital systems, and the distinction matters when choosing a marketplace plan. Infirmary Health operates Mobile Infirmary Medical Center (downtown Mobile), the region's largest private hospital, as well as Infirmary West (closer to West Mobile and Tillman's Corner) and Thomas Hospital in Fairhope across the bay. For residents of Tillman's Corner and West Mobile, Infirmary West is often the closest hospital, making Infirmary Health network coverage particularly important.
USA Health (University of South Alabama Health System) operates USA Medical Center and affiliated specialist clinics, anchored in academic and specialty medicine. USA Health is a major destination for complex cases, cancer care, and high-acuity services. Some marketplace plans have stronger contracts with one system versus the other, so checking whether both are in-network — or which one serves as the primary facility for your specific plan — is essential before enrollment. Out-of-network emergency costs in Alabama can be significant even with insurance.
Even with the Medicaid expansion, some Mobile County residents — particularly those with incomes just above the Medicaid threshold or in households with complex eligibility situations — may benefit from the federally qualified health center (FQHC) network. The Mobile County Health Department operates primary care and public health services, and community health centers in the area provide sliding-fee services for uninsured and underinsured patients. These centers remain important resources for newly eligible Medicaid patients who haven't yet enrolled and for anyone navigating coverage transitions.