Alabama Medicaid for Grandchildren and ALL Kids: How to Enroll Without Custody

You Don't Need Custody to Get a Child Health Coverage

The most common reason grandparents in Alabama delay getting a grandchild on Medicaid is the belief that a court custody order comes first. It doesn't. Physical care and residence of the child in your home is sufficient. Any relative or even a non-relative caretaker can apply.

Alabama provides child health coverage through two programs:

• Medicaid for Children covers kids ages 0 through 18 in households with Modified Adjusted Gross Income (MAGI) at or below 141% of the Federal Poverty Level.
• ALL Kids (Alabama's CHIP program) covers the same age range from 141% up to 312% FPL.

Both programs have no asset or resource test. Your savings, home, car, or retirement accounts don't count.

The Income Rule That Changes Everything

When a relative caregiver has not legally adopted the child and does not claim the child as a tax dependent, the child's Medicaid eligibility is evaluated as a household of one. Only the child's own income counts — not the grandparent's Social Security, pension, or wages.

Most children in kinship care have zero income. A child with no personal income generally meets the Medicaid income test, subject to the other eligibility requirements.

If you do claim the child as a tax dependent, your income enters the calculation. For families below 312% FPL, this still typically qualifies the child for ALL Kids even with the caregiver's income counted.

Caretaker Relative Medicaid for the Grandparent

Alabama also offers Medicaid for adult caretaker relatives raising dependent children. The catch: the income threshold is just 13% FPL, one of the lowest adult eligibility caps in the country. Most working-age or retirement-age caregivers won't qualify, but those with very low income should know the option exists.

How to Apply

Three routes:

1. Online through the Alabama Medicaid Gateway or InsureAlabama.org
2. On paper at your county DHR office or a public health clinic
3. Automatically — if you apply for SNAP or Family Assistance through MyDHR, the system cross-screens the child for Medicaid and ALL Kids without a separate application

The processing timeline is 45 calendar days for Medicaid and ALL Kids applications.

12-Month Continuous Eligibility and Renewals

Once approved, the child gets 12 months of continuous coverage. Minor income fluctuations during the year don't cause a coverage gap.

At renewal, Alabama first tries an automatic ex parte verification using electronic data — wage databases, Social Security records, and state employment files. If the data confirms eligibility, coverage renews without any paperwork. If electronic verification is inconclusive, DHR mails a pre-populated renewal form. You have 30 days to return it with income documentation.

Getting the Application Right

The biggest risk for kinship caregivers is having the child's household defined incorrectly — lumping the grandparent's income into the child's eligibility when it shouldn't be there. The Financial Help for Grandparents and Relatives Raising a Child in Alabama guide walks through the exact household composition rules for each program, so you know which income counts where before you file.

See more Alabama guides →