Frequently Asked Questions

Division of Medicaid Questions

Depending on a number of factors an individual may qualify for full Mississippi Medicaid health benefits, reduced coverage or limited benefits (full coverage with some service limits) in a covered group briefly described below.

Full Medicaid Benefits

The following covered groups of people qualify for full Mississippi Medicaid health benefits if eligible under the appropriate income limits and other qualifications.

·        Infants and Children: This category includes infants and children from birth up to age 19 based on age, income, family size. Household income, tax filing status and the relationships between household members must be considered in determining eligibility for each infant and child living in the home. You can find the MAGI income limit table at https://medicaid.ms.gov/medicaid-coverage/who-qualifies-for-coverage/income-limits-for-medicaid-and-chip-programs/.

 

·        Children’s Health Insurance Program (CHIP): This category includes uninsured children from birth up to age 19 based on based on age, insured status of each child, family size and family household income cannot exceed 209% of the federal poverty level (FPL). A child must be determined ineligible for Medicaid before eligibility for CHIP can be considered. Children with current health insurance coverage at the time of application are not eligible for CHIP. The child’s age and family income factor into when a child may qualify for CHIP. You can find the MAGI income limit table at https://medicaid.ms.gov/medicaid-coverage/who-qualifies-for-coverage/income-limits-for-medicaid-and-chip-programs/.

 

·        Parents/Caretakers of Minor Children: This category includes low-income parents, caretakers. Income limits are not based on the FPL. Parents or caretakers must have children under age 18 living in the home, who are deprived of the support of one or both parents due to the disability of a parent, the death or continued absence of a parent or have parent(s) who are unemployed or have very low income. Caretaker relatives must be within a certain degree of relationship to the children and have primary responsibility for children under age 18 in order to qualify. As a condition of eligibility, the adult must cooperate with child support enforcement requirements for each child deprived due to a parent’s continued absence from the home. You can find the MAGI income limit table at https://medicaid.ms.gov/medicaid-coverage/who-qualifies-for-coverage/income-limits-for-medicaid-and-chip-programs/.

 

·        Pregnant Women: This category includes pregnant women with income limit under 194% of the FPL, family size. Pregnant women receive benefits two months postpartum and are automatically put on the family planning waiver for one year. Any child born to Medicaid eligible mother automatically receives Medicaid benefits until the infant reaches the age of one. The number of individuals within the family is increased by the number of babies expected when determining family size for Medicaid. Pregnant minors (under age 19) can qualify regardless of family income. You can find the MAGI income limit table at https://medicaid.ms.gov/medicaid-coverage/who-qualifies-for-coverage/income-limits-for-medicaid-and-chip-programs/.

 

·        Disabled Child Living at Home: This category includes disabled children from birth up to age 19 who require a level of care typically provided in a hospital or long term care facility. Only the child’s income and resources are considered. The limit is the current institutional maximum income limit and the resource limit is $2,000. For more information, view the Guidelines for Medicaid Eligibility for Disabled Child Living At Home brochure, found at https://medicaid.ms.gov/medicaid-coverage/who-qualifies-for-coverage/. The child must be disabled and in need of an institutional level of care.

 

·        Working Disabled: This category includes the working disabled whose income does not exceed 250% of the federal poverty level and unearned income does not exceed 135% of the federal poverty level. For more information, view the Guidelines for Persons Working and Disabled brochure, found at https://medicaid.ms.gov/medicaid-coverage/who-qualifies-for-coverage/. There are no age restrictions, but individuals age 65 or over must be disabled. The working disabled individual must work at least 40 hours per month. Those who earn more than 150% of the federal poverty level must pay a monthly premium to purchase Medicaid coverage.

 

·        Aged, Blind or Disabled Receiving Supplemental Security Income (SSI): This category includes the aged, blind or disabled age 65 or older; if under age 65 must be blind or disabled (eligibility for this covered group is certified by the Social Security Administration). Income limits change annually and are determined by the Social Security Administration. For more information, view the Guidelines for the Aged, Blind and Disabled Receiving SSI or Former SSI Recipients brochure, found at https://medicaid.ms.gov/medicaid-coverage/who-qualifies-for-coverage/. SSI recipients are automatically eligible for Medicaid.

 

·        Aged, Blind or Disabled Former Supplemental Security Income (SSI) Recipients: Certain Former SSI Recipients who lose SSI due to a qualifying event that allows Medicaid to continue. This category includes certain disabled adult children, widow(er)s within a certain age limit who do not have Medicare and certain individuals who lose SSI due to a cost of living increase in their Social Security benefits. For more information, view the Guidelines for the Aged, Blind and Disabled Receiving SSI or Former SSI Recipients brochure, found at https://medicaid.ms.gov/medicaid-coverage/who-qualifies-for-coverage/.

 

·        Long Term Care for Aged, Blind or Disabled Residing in Nursing Homes or Participating in a Home and Community Based Services (HCBS) Waiver: This category includes individuals aged 65 or over or under age 65 who are blind or disabled. The individual must be determined to be in need of a level of care that is provided by the nursing facility or HCBS waiver program. Monthly income that does not exceed 300% of the SSI Federal Benefit Rate. Individuals whose income exceeds the institutional limit may qualify based on an Income Trust that obligates all income to the facility or to the Division of Medicaid. For HCBS waiver participants, income over the Medicaid limit is payable to the Division of Medicaid under the terms of an Income Trust. For more information, view the Guidelines for Medicaid Eligibility for Aged, Blind and Disabled Living in Nursing Homes brochure, found at https://medicaid.ms.gov/medicaid-coverage/who-qualifies-for-coverage/. Placement in a facility or HCBS waiver program must be medically necessary and the individual must be income and resource eligible and must not have transferred assets within a five year look back period and any subsequent months in order to qualify for Medicaid.

 

·        Emergency Services for Immigrants (who do not otherwise qualify for Medicaid): This category includes non-qualified or undocumented immigrants. An immigrant must qualify for a covered group on all factors other than citizenship and immigration status. The income (and resource) limit for the covered group applies. The age limit for the applicable covered group applies. Immigrants who have had an emergency medical service and who are determined eligible for a covered group, are covered solely for the date of service of the emergency.

 

Reduced Coverage / Medicare Cost Sharing or Premium Payment

·        Qualified Medicare Beneficiaries: This category includes individuals of any age covered by Medicare. Income cannot exceed 100% of the federal poverty level. For more information, view the Guidelines for Medicare Cost-Sharing Programs brochure, found at https://medicaid.ms.gov/medicaid-coverage/who-qualifies-for-coverage/. Individuals must be eligible for Medicare Part A hospital insurance.

 

·        Specified Low-Income Medicare Beneficiaries: This category includes individuals of any age covered by Medicare. Income cannot exceed 135% of the federal poverty level. For more information, view the Guidelines for Medicare Cost-Sharing Programs brochure, found at https://medicaid.ms.gov/medicaid-coverage/who-qualifies-for-coverage/. Individuals must have Medicare Part A (hospital insurance).

 

·        Qualified Individuals: This category includes individuals of any age covered by Medicare. Income cannot exceed 135% of the federal poverty level. For more information, view the Guidelines for Medicare Cost-Sharing Programs brochure, found at https://medicaid.ms.gov/medicaid-coverage/who-qualifies-for-coverage/. Individuals must have Medicare Part A (hospital insurance).

 

Limited Benefits

·        Family Planning Waiver: This category includes women and men age 13-44 with a family income at or below 194% FPL. This Waiver will cover women and men who have not had any type of procedure that would prevent them from reproducing, and does not have any other type of health insurance.

 

·        Healthier Mississippi Waiver: This category includes individuals 65 or older or who are blind or disabled who are not Medicare eligible. Monthly income cannot exceed 135% of the federal poverty level. For more information, view the Healthier Mississippi Waiver brochure, found at https://medicaid.ms.gov/medicaid-coverage/who-qualifies-for-coverage/. This waiver covers individuals who are not eligible for Medicare. Once Medicare starts, eligibility for the Healthier MS Waiver ends.

There are multiple ways you can apply for Mississippi Medicaid health benefits: You can apply online, by completing and submitting a Mississippi Medicaid Application Form (PDF), you can apply via fax or postal mail, you can apply in person, or you can apply by phone. See below for details about each method of applying.

The Mississippi Division of Medicaid and the federally facilitated marketplace (FFM) has one single application for all insurance affordability programs. Application for any of the insurance affordability programs may be filed online through the Division of Medicaid or the FFM at Healthcare.gov. You can download the Mississippi Medicaid Application form at https://medicaid.ms.gov/medicaid-coverage/how-to-apply/.

To fill out this application, you will need:

·       Social Security Numbers or document numbers for legal immigrants who need insurance.

·       Dates of birth for each person applying.

·       Employer and income information for each person in the family with income. Use income from the most recent month’s pay stubs or W-2 forms or any document that shows exactly what each person receives as income.

·       Policy numbers for any current health insurance.

·       Information about any job-related health insurance available to your family.

Important Information to Successfully Submit Your Application Form:

Apply by completing and submitting a Mississippi Medicaid Application Form (PDF). To fill out the Mississippi Medicaid Application, please follow the steps below:

o   Download the Mississippi Medicaid Application form (PDF) to your computer

o   Open the form and fill out the application with as much information as you can.

o   Digitally sign the application and date your application.

o   Select the Submit button at the bottom of the form.

Note: If you open and fill out the application in your browser, the processing of your application may be delayed.           

An application form can be printed at either website, completed and submitted to the Division of Medicaid by one of the following ways:

·       Fax the Office of Eligibility at the Division of Medicaid: 601-576-4164

·       Mail to: 550 High Street, Suite 1000, Jackson, MS 39201 or the regional office that serves your county of residence

You may request to have a paper application mailed to you. An original signature is not required for a faxed application.

You can apply in person at one of the 30 regional offices that serves your county of residence. You can find an office map and office locations at https://medicaid.ms.gov/about/office-locations/.

If you want an application mailed to you or if you need telephone assistance:

·       Call the Office of Eligibility toll-free at: 800-421-2408

·       Contact the regional office that serves your county of residence

For Mississippi Medicaid applications:

·       Applications are reviewed by state staff.

·       Eligibility assessment and determination is approved or denied.

·       If determined applicant is not eligible for Mississippi Medicaid, applications are automatically referred to the FFM.

The Division of Medicaid and the FFM will verify as much data as possible from electronic sources in order to verify what is reported on your application. You will only be asked to provide verification of needed eligibility information, if eligibility factors cannot be verified through an available electronic source or if the information you give conflicts with data from electronic sources.

View the income limits for Medicaid and CHIP programs. There is no resource test for any insurance affordability program, including Medicaid and CHIP.

If you are applying for aged, blind or disabled Mississippi Medicaid benefits and services, an in-person interview may be required. If so, you will be contacted by staff at the regional office that serves your county of residence.

Apply by filling out the Mississippi Medicaid Aged, Blind and Disabled Application Form (PDF), which can be found at https://medicaid.ms.gov/medicaid-coverage/how-to-apply/, and submitting the application to the regional office that serves your county of residence or if the applicant is in a nursing home, the regional office that serves the county where the nursing facility is located. Mail or bring in the application at the time of the in-person interview if one is required.  It is advised that you do not email forms or submit online forms with protected health information or personally identifiable information, to protect your confidentiality in accordance with the Health Insurance Portability and Accountability Act of 1996.

Apply for family planning benefits by completing and submitting the Mississippi Medicaid Family Planning Services Application Form (PDF), which can be found at https://medicaid.ms.gov/medicaid-coverage/how-to-apply/.

For assistance, call the Office of Eligibility toll-free at 800-421-2408. Submit the application as follows:

Mail: MS Division of Medicaid ATTN: Office of Eligibility

550 High Street, Suite 1000

Jackson, MS 39201-1399

Fax: 601-576-4164

In-Person: at any Medicaid regional office

Yes. A voter registration form is available for download at” https://medicaid.ms.gov/medicaid-coverage/how-to-apply/

Click on the form and complete prior to visiting a Medicaid regional office.

          Voter registration form

After you submit an application for Mississippi Medicaid health benefits, the regional office that serves your county of residence will be in contact with you by phone or you may get a letter regarding your eligibility determination. If something is incorrect, missing or needs clarification a regional office staff member will contact you.    

If you are approved to receive health benefits, a letter and a blue Medicaid identification card will be mailed to you. Mississippi Medicaid has a large network of health care providers available for medical services. When you make an appointment be sure the provider you choose accepts Mississippi Medicaid.

You may be eligible for health benefits through a coordinated care program called Mississippi Coordinated Access Network (MississippiCAN). Those who are automatically qualified for this program will have the option of choosing between one of three Coordinated Care Organizations (CCO), Magnolia Health, Molina Healthcare and United Healthcare Community Plan. Mandatory populations are not eligible for dis-enrollment.

Those individuals who qualify for this program in an optional population have the choice to either enroll in a CCO or choose to stay in the traditional Medicaid “fee-for-service” program.

If you are eligible for Mississippi Medicaid health benefits and your case is approved, it will be reviewed on an annual basis. Near your renewal date you will receive a letter to review your personal information and have the opportunity to make changes. If anything needs to be updated, indicate the changes on the form and mail it back or notify your case worker.

An eligibility hearing is an administrative process that you may ask for if you do not agree with a decision that has been made about your Medicaid eligibility. Beneficiaries/applicants are entitled to a fair hearing if they disagree with actions taken by the Division of Medicaid to deny, terminate or reduce services.

For more information regarding hearings, visit the Eligibility Hearing webpage at https://medicaid.ms.gov/medicaid-coverage/after-you-apply/eligibility-hearings/.

The Office of Appeals is responsible for coordinating, scheduling, and facilitating appeals for Medicaid beneficiaries. Cases are heard by an impartial hearing officer employed by or on contract with the agency. If you have questions regarding fair hearings for Medicaid eligibility decisions, contact the Mississippi Division of Medicaid:

Toll-free: 800-421-2408

Phone: 601-359-6050

Or contact the regional office that serves your county of residence.

If you have questions regarding fair hearings for Medicaid eligibility decisions that are part of a Supplemental Security Income (SSI) decision for the low income aged, blind or disabled, contact the Social Security Administration (SSA):

Toll-free: 800-772-1213

Social Security Administration website: http://www.ssa.gov

Yes. Once Medicaid eligibility has been approved, each eligible member will get a plastic Medicaid identification (ID) card in the mail. The standard Medicaid ID card is blue, printed with the Medicaid logo and the beneficiary’s name and ID number. Medicaid ID cards for members on the family planning waiver are yellow.

Always remember to take your Medicaid ID card every time you go to get health services. Remember that not all doctors, dentists and other providers accept Medicaid. You should always ask the provider if he or she accepts Mississippi Medicaid health benefits before you get services.

If you have questions regarding ID cards or if you need a replacement ID card, contact Conduent toll-free at: (800) 884-3222.

Medicaid beneficiaries are encouraged to get a free annual health screening from your doctor or clinic. This physical examination will not be used to determine your eligibility for Medicaid. You do not have to pay for this health screening and it does not count as one of your office visits!

 For individuals who can get full Mississippi Medicaid health benefits, the following are covered services:

          office visits

          family planning services

          inpatient hospital care

          outpatient hospital care

          prescription drugs

          eyeglasses

          long term care services

          inpatient psychiatric care

For more details regarding limits and maximum services available, please visit www.medicaid.ms.gov.

Medicaid will help eligible persons travel to medical appointments when there are no other means of getting to and/or from the appointment and the services are medically necessary, covered by Medicaid, rendered by a Medicaid approved provider and the eligible person has not exceeded any service limits associated with the covered service. To find out how to get help with transportation to your appointment, call toll-free at 1-866-331-6004.

When a person accepts a Medicaid card, that person (or his or her representative) must report all changes in either income or resources that could affect his or her eligibility. These changes should be reported to the regional office that serves your county of residence by phone, in writing by mail or visiting the regional office in person. All changes MUST be reported within 10 days after the change happens (or within 10 days after the beneficiary realizes the change has taken place.) Failure to report a change may result in the beneficiary receiving the wrong Medicaid benefits.

          Report eligibility changes or updates

Yes. See additional information you are required to report below:

Third Party Insurance

Persons who apply for, as well as those who already have Medicaid, must report any and all types of health insurance or third party coverage policies you may have. “Third party” includes any type of policy which would pay for medical services such as: health insurance, workers compensation, employer liability, indemnity policies, major medical policies, CHAMPUS, and lawsuit settlements. In order to be eligible for Medicaid, state law requires as a condition of eligibility that a Medicaid beneficiary sign over all third party rights to medical payments from any source  to the Division of Medicaid. Medicaid beneficiaries should identify all third party policies in addition to Medicaid coverage whenever any medical service is provided. This will allow the provider to file and obtain those benefits before filing the Medicaid claim.

Estate Recovery

Effective July 1, 1994, Medicaid will seek recovery from the estate of deceased Medicaid recipients who are age 55 or older and in a nursing facility, or enrolled in a Home and Community Based Services waiver program at the time of death. Recovery will be made from any real or personal property in the estate of the recipient up to the value of payments made by Medicaid for nursing facility, hospital and drug services. Estate recovery will not apply to recipients who have a surviving spouse, dependent or disabled child. For more information read the Federal Law on Medicaid Estate Recovery and Mississippi Medicaid Estate Recovery Law.

You can contact the Mississippi Division of Medicaid (DOM) multiple ways as listed below, including by phone, postal mail, and fax. If you choose to contact DOM in writing, you are advised to submit information by postal mail or fax to protect the confidentiality of your protected health information or personally identifiable information.

To contact the appropriate area by phone, first review the division/topics of interest menu below. The main call center switchboard will then route your call to the appropriate area.

          Toll-free: 800-421-2408

          DOM main switchboard phone: 601-359-6050

          DOM general fax: 601-359-6294

          Provider Beneficiary Relations fax: 601-359-4185

          Mailing address: 550 High Street, Suite 1000, Jackson, MS 39201

If you speak another language, assistance services, free of charge, are available to you. Call 1-800-421-2408 (Deaf and Hard of Hearing VP: 1-228-206-6062). For more information, read our Notice of Non-Discrimination.

Mississippi Department of Human Services Questions

Those who qualify for SNAP include, persons who:

  • work for low wages.
  • are unemployed or work part-time.
  • receive TANF, SSI or other assistance payments.
  • are elderly or disabled and live on a small income.

Click here to see if you may be eligible for SNAP benefits. 

Use of a SNAP pre-screening tool, available through the Food and Nutrition Service (FNS), does not determine a household’s eligibility for SNAP, but can be used to give you an idea of how eligibility is determined. Access the SNAP pre-screening tool.

Applications for SNAP benefits are available online in English, En Español – Spanish, or Ti?ng Vi?t – Vietnamese or you may request an application by phone, in person, by fax, or by mail from your county office.

  • Complete as much of your application as you can. Your name, address, and signature are necessary on the application for it to be accepted on the same day it is turned in, even if there is no interview on that day. Only one adult household member or authorized representative may sign the application for SNAP benefits under penalty of perjury.
  • When your application has been turned in, the local county office will set up an interview to review your application.

At the time of your interview, bring verification of your income and expenses. If you cannot get all the information together by your interview date, come for the interview because you will have additional time to provide this information. If you need assistance in obtaining this information, please discuss this with your caseworker at the time of the interview. The following are examples of what to bring:

  • Proof of identity (driver’s license, etc.)
  • Social Security Numbers for all household members.
  • If employed, proof of income (wage stubs, earning statements, etc.) for the four weeks prior to your interview or last filed tax return if self-employed.
  • Proof of residency (utility bills, rent/mortgage payments, lot rent, taxes)

To learn more download our SNAP Brochure.

Download the SNAP Rights & Responsibilities brochure here  English, En Español – Spanish, or Ti?ng Vi?t – Vietnamese

You may be asked to provide additional information based on your circumstances.

After the interview and collection of needed information for eligibility determination, the worker will send your household a notice.  If your household does not qualify for SNAP, a notice will be provided giving the reasons for ineligibility.  If your household is determined to be eligible, the notice will provide the monthly benefit amount and length of the certification period.

  • As soon as all necessary information is provided and verified for eligibility, you will be able to receive your SNAP benefits within 30 days of your dated application.

This checklist gives examples of the information that may have to be verified to determine your eligibility for SNAP and/or TANF. Use this checklist to help you gather the items needed for your interview.

  • Identity of person making application and authorized representative, if applicable
  • Divorce decree marriage license, death certificate for spouse
  • Proof of relationship of children to you (TANF only)
  • Alien Status for any non-U.S. citizen
  • Checking or savings account, or union or bank statement
  • Names, addresses, Social Security numbers, and places of employment of the absent parent(s) of your children
  • Trust funds
  • Medical expenses for anyone age 60 or older or disabled
  • Stocks and/or savings bonds
  • Social Security number for all individuals
  • Proof of where you live
  • Property owned, sold, or transferred
  • Pregnancy
  • Dependent care (child/disabled or aged dependent care)
  • Rent and Utility expenses
  • Income

If you have any current medical documentation to verify a current medical condition, please bring it to your appointment.  At the time of your interview, you may be asked to furnish additional information and/or verification, depending on your circumstances.

Failure to keep your SNAP or TANF application appointment will cause your SNAP or TANF application to be denied.

You must bring or send verification for each of the items needed to determine your eligibility.

Items to be Verified

Bring or Send One or More of the Following:

Identity

  • Driver’s license
  • Work or school ID
  • Work badge
  • Health insurance ID
  • ID for another assistance program
  • Voter registration card
  • Birth certificates
  • Draft cards or military ID
  • Medicare Card
  • United States Passport
  • Proof Of Where You Live
  • Rent or lease receipts from landlord
  • Utility bills
  • Mortgage payment book
  • Tax receipts
  • Documents showing home address

Alien Status

  • INS 1-151 Alien Registration Receipt Card
  • 1-551 Re-entry Permit; 1-94 Arrival-Departure Record

Social Security Numbers

  • Social Security Card for each member
  • Official document containing the Social Security Number
  • Social Security Award Letter

Income

  • Check Stubs
  • Statement from employer
  • Benefit award letter from Social Security
  • SSI
  • Veterans Administration
  • Unemployment Compensation
  • Business records for self-employed
  • Lay off or termination notice
  • IRS 1040 Form – for self-employment

Trust Funds

  • Wills
  • Court orders
  • Deeds or other documents by which the trust was established

Medical Expenses

  • Medical bills from hospitals or clinics
  • Pharmacy printouts
  • Health insurance premium receipt or stub
  • Payment agreement with doctor, and/or hospital

Pregnancy

  • Statement from a licensed physician or medical personnel in a public health or outpatient clinic

Residency

  • Rent or lease receipt from landlord
  • Utility bills (gas, electric, water etc.)
  • Telephone bill
  • Property tax statement
  • Home owner’s insurance policy
  • Mortgage payment books

Dependent Care

  • Child care or day care receipts or statement from provider

Property Owned

  • Sold or Transferred
  • Deeds
  • Sale or transfer papers

Proof Of Relationship

  • Birth certificates
  • Marriage licenses
  • Insurance policies
  • Wills