Who Qualifies For Medicaid In Mississippi

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How Many People Are On Medicaid

Medicaid changes in Mississippi

According to the Centers for Medicare & Medicaid Services, as of November 2020, here are the number of people enrolled in Medicaid and Chip in the entire United States:

  • 78,521,263 individuals were enrolled in Medicaid and CHIP
  • 72,204,587 individuals were enrolled in Medicaid
  • 6,695,834 individuals were enrolled in CHIP

Effective Date Of Coverage

Once an individual is determined eligible for Medicaid, coverage is effective either on the date of application or the first day of the month of application. Benefits also may be covered retroactively for up to three months prior to the month of application, if the individual would have been eligible during that period had he or she applied. Coverage generally stops at the end of the month in which a person no longer meets the requirements for eligibility.

Where Can I Apply For Medicaid In Mississippi

Medicaid is administered by the Department of Medicaid in Mississippi. You can use this website to apply online for Medicaid ABD or a Medicare Savings Program.

Josh Schultz has a strong background in Medicare and the Affordable Care Act. He coordinated a Medicare ombudsman contract at the Medicare Rights Center in New York City, and represented clients in extensive Medicare claims and appeals. In addition to advocacy work, Josh helped implement federal and state health insurance exchanges at the technology firm hCentive. He has also held consulting rules, including at Sachs Policy Group, where he worked with hospital, insurer and technology clients.

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Where Can Medicare Beneficiaries Get Help In Mississippi

Mississippi State Health Insurance Assistance Program

Medicare counseling is available by contacting the Mississippi State Health Insurance Assistance Program at 1-844-822-4622.

The Mississippi SHIP can help beneficiaries enroll in Medicare, compare and change Medicare Advantage and Part D plans, and answer questions about state Medigap protections. SHIP counselors may also be able to offer referrals to local agencies for services like home care and long-term care. The SHIPs website has more information on the services it offers.

Elder Law Attorneys

Elder law attorneys can help individuals plan for Medicaid long-term care benefits. You can use this National Academy of Elder Law Attorneys search feature to find an elder attorney locally.

Mississippi Area Agencies on Aging

Medicare beneficiaries in Mississippi can also receive information and assistance from an Area Agency on Aging . These organizations can counsel about services available to help with aging or living with a disability, and with planning for long-term care needs. This is a list of AAAs in Mississippi.

Learn About Chip In Mississippi

Mississippi Medicaid director staying in new administration

Childrens Health Insurance Program in Mississippi was signed into law in 1997 and is mainly for children younger than 18 years of age. The purpose of MS CHIP is to provide health coverage to children who do not qualify for Medicaid. This means that if adults in a family do not have Medicaid eligibility children in the family can still apply for CHIP. Medicaid for children and CHIP are separate programs even though CHIP and Medicaid enrollment often follow similar rules and guidelines. Many parents interested in enrolling their children affordable health care coverage may not know how to apply for CHIP or who is eligible. To find out what is CHIP Medicaid and what is covered by Medicaid in Mississippi, read the information below.

What is Mississippis Childrens Health Insurance Program?

The MS Childrens Health Insurance Program is state-provided health care coverage for children, not a form of private insurance. Like enrolling in Medicaid, Mississippi CHIP beneficiaries will have access to a network of medical providers. CHIP enrollees are able to pick any doctor or health provider that is in network with CHIP coverage. While Medicaid for children covers approved medical treatments, CHIP recipients will have to pay small premiums to keep their coverage. Even services partially covered by Medicaid may have additional costs in the form of copays.

Is CHIP Considered Medicaid in Mississippi?
Who qualifies for CHIP in Mississippi?
How to Apply for CHIP in Mississippi

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Ssi Eligibility And Eligibility For Certain Former Ssi Recipients

You may qualify for SSI /Medicaid, or you may be able to remain eligible for Medicaid after your SSI payments stop if you meet certain eligibility guidelines.

SSI EligibilityIf you qualify for Supplemental Security Income , you automatically receive Medicaid. SSI makes monthly payments to individuals with low income and few resources that are either age 65 or over or blind or disabled. Blindness and disability are determined using Social Security rules. An application for SSI is filed with the Social Security Administration.

If you have unpaid medical bills in any of the 3 months prior to the month you apply for SSI, you can apply for Medicaid to cover these month by filing an application with the Division of Medicaid.

For more information, see the Medicaid Eligibility Guide for SSI Recipients and Certain Former SSI Recipients brochure.

Medicaid Eligibility for Certain Former SSI RecipientsCertain former SSI recipients may continue to receive Medicaid. You must be eligible in one of the groups briefly described below:

Missing Out On Billions In Federal Funding

As the ACA was written, it called for Medicaid expansion in every state for residents with incomes up to 133% of poverty . But in 2012, the Supreme Court ruled that states could not be penalized for opting out of expansion, and Mississippi is one of 12 states that have not yet expanded Medicaid.

In states that expand Medicaid, the federal government paid the full cost of expansion through 2016. After that, states gradually began to pay a share of the expansion cost, but the federal government will always pay at least 90% . As a result, states that reject Medicaid expansion are leaving billions of dollars on the table.

From 2013 through 2022, Mississippi has given up $14.5 billion in federal funding that would otherwise have been available to the state to help provide medical care for low-income residents.

And since residents in states not expanding Medicaid still have to pay federal taxes, Mississippi residents have been subsidizing Medicaid expansion in other states. Over a decade, people in Mississippi are paying $1.7 billion in federal taxes that are used to pay for Medicaid expansion in other states.

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Expansion Under The Affordable Care Act

The Affordable Care Act provided for the expansion of Medicaid to cover childless adults whose income is 138 percent of the federal poverty level or below. The provision for expanding Medicaid went into effect nationwide in 2014. As of November 2018, a total of 36 states and Washington, D.C., had expanded or voted to expand Medicaid.

Mississippi had not expanded Medicaid under the Affordable Care Act as of June 2017. GovernorPhil Bryant expressed opposition to Medicaid expansion in 2014, stating that for the state “to enter into an expansion program would be a fool’s errand” in case the ACA was repealed.

Support

Arguing in support of the expansion of Medicaid eligibility in an April 2013 article, the Center for American Progress states that the expansion helps increase the number of people with health insurance and benefits states economically. The organization argues that by providing health insurance to those who would otherwise be uninsured, Medicaid expansion allows low-income families to spend more money on food and housing:

âMedicaid coverage translates into financial flexibility for families and individuals, allowing limited dollars to be spent on basic needs, including breakfast for the majority of the month or a new pair of shoes for a job interview.â
âCenter for American Progress

Opposition

Apply For Medicaid In Mississippi

Petitioning starts for plan to expand Mississippi Medicaid

You can enroll through HealthCare.gov or you can fill out a PDF of the Mississippi Medicaid Application Form. You can also enroll by phone at 800-318-2596.

Eligibility: Parents with dependent children are eligible with household incomes up to 22% of FPL. Children are eligible for Medicaid or CHIP with household incomes up to 209% of FPL, and pregnant women are eligible with household incomes up to 194% of FPL.

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Unitedhealthcare Senior Care Options Plan

UnitedHealthcare SCO is a Coordinated Care plan with a Medicare contract and a contract with the Commonwealth of Massachusetts Medicaid program. Enrollment in the plan depends on the plans contract renewal with Medicare. This plan is a voluntary program that is available to anyone 65 and older who qualifies for MassHealth Standard and Original Medicare. If you have MassHealth Standard, but you do not qualify for Original Medicare, you may still be eligible to enroll in our MassHealth Senior Care Option plan and receive all of your MassHealth benefits through our SCO program.

Estate Recovery And Liens

Under Medicaid law, following the death of the Medicaid recipient a state must attempt to recover from his or her estate whatever benefits it paid for the recipients care. However, no recovery can take place until the death of the recipients spouse, or as long as there is a child of the deceased who is under 21 or who is blind or disabled.

While states must attempt to recover funds from the Medicaid recipients probate estate, meaning property that is held in the beneficiarys name only, they have the option of seeking recovery against property in which the recipient had an interest but which passes outside of probate. This includes jointly held assets, assets in a living trust, or life estates. Given the rules for Medicaid eligibility, the only probate property of substantial value that a Medicaid recipient is likely to own at death is his or her home. However, Mississippi has not yet broadened its estate recovery to include non-probate assets at this date, and therefore may not make a claim against the Medicaid recipients home if it is not in his or her probate estate.

Whether or not a lien is placed on the house, the liens purpose should only be for recovery of Medicaid expenses if the house is sold during the beneficiarys life. The lien should be removed upon the beneficiarys death. However, check with an elder law specialist in your state to see how your local agency applies this federal rule.

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Medicaid Certified Home Care Agency In Mississippi

To get reimbursements against Mississippi Medicaid claims, the caregiver agency needs to be certified as HHA . The regulations can be different for different states, and the service providers need to check their compliance by going through the information provided by the Bureau of Licensing and Certification or states Department of Human Services.

Governing Body: Mississippi Division of Medicaid

Is Transferring Assets Against The Law

Mississippi Medicaid Income Limits

You may have heard that transferring assets, or helping someone to transfer assets, to achieve Medicaid eligibility is a crime. Is this true? The short answer is that for a brief period it was, and its possible, although unlikely under current law, that it will be in the future.

As part of a 1996 Kennedy-Kassebaum health care bill, Congress made it a crime to transfer assets for purposes of achieving Medicaid eligibility. Congress repealed the law as part of the 1997 Balanced Budget bill, but replaced it with a statute that made it a crime to advise or counsel someone for a fee regarding transferring assets for purposes of obtaining Medicaid. This meant that although transferring assets was again legal, explaining the law to clients could have been a criminal act.

In 1998, Attorney General Janet Reno determined that the law was unconstitutional because it violated the First Amendment protection of free speech, and she told Congress that the Justice Department would not enforce the law. Around the same time, a U.S. District Court judge in New York said that the law could not be enforced for the same reason. Accordingly, the law remains on the books, but it will not be enforced. Since it is possible that these rulings may change, you should contact your elder law attorney before filing a Medicaid application. This will enable the attorney to advise you about the current status of the law and to avoid criminal liability for the attorney or anyone else involved in your case.

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Unitedhealthcare Dual Complete Plans

Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract and a contract with the State Medicaid Program. Enrollment in the plan depends on the plans contract renewal with Medicare. This plan is available to anyone who has both Medical Assistance from the State and Medicare. This information is not a complete description of benefits. Call TTY 711 for more information. Limitations, co-payments, and restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year.

Income Limits In Mississippi For Medicaid

In Mississippi the individual receiving Medicaid cannot have income over $2,250. If their income is over that amount, they will need to do some Medicaid Planning to create eligibility. One strategy that works well is a Miller Trust . If an individual is married, the spouse’s income does not typically count towards the income cap, but it is important to maximize income protection via the Monthly Needs Allowance rules. The maximum amount of income the Medicaid office allows a community spouse to keep in Mississippi is $3,090. All of an individual’s monthly income must go towards their cost of care, which can include medical bills, prescriptions and other health care costs, aside from $44 which is for a personal needs allowance. The income limits are based as a percentage of the Supplemental Security Income defined by the Social Security Administration’s Federal Poverty Levels and change every year.

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Mississippi Long Term Care

Mississippi is an income cap state, meaning that in order to be eligible for Medicaid long term care benefits there is a hard income limit. Non income cap states allow applicants to spend down money for their care, whereas income cap states require the amount to be no higher than their limit at time of application.

Retroactive benefits: Medicaid applicants may be eligible to receive benefits for up to three months prior to the month of application. To qualify, the person must meet all eligibility requirements during the first three months and have received qualifying medical services in each of the three preceding months.

Mississippi Medicaid Asset Limits 2019

Mississippi Moment: Medicaid Expansion

Individuals in Mississippi are allowed to keep $4,000 when they apply to Medicaid for long term care. If they are over this amount, they must spend down on care. It is important to note, that individuals are not allowed to give gifts of any amount for a period of 5 years prior to applying to Medicaid. If an individual’s assets are more than $4,000, they should learn about Medicaid Planning strategies. This asset limit only applies to assets that are considered countable assets. Some examples of countable assets include savings accounts, bank accounts, retirement accounts and a second home. If you have multiple assets and are looking to access Medicaid, it may make sense to speak with a Medicaid Planner or Elder Law attorney in Mississippi.

Couples that both require Medicaid for long term care in Mississippi are allowed to keep $6,000 in assets. If there is one spouse that requires care, and one that does not, the spouse that does not receive care is referred to as the Community Spouse. The Community spouse is allowed to keep up to $123,600 in countable assets which is known as the Community Spouse Resource Allowance.

The maximum amount of home equity allowed when applying to Medicaid is $572,000. Despite the fact the home is not a countable asset, Medicaid, can look for repayment in probate court from the proceeds of a sale after it stops paying for care. It is important to understand if your home may be subject to the Medicaid repayment process.

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Elderly & Disabled Waiver

Similar to the Assisted Living Waiver, the Elderly & Disabled Waiver provides care for aged, blind and disabled persons who are unable to care for themselves independently. However, this waiver is intended to help those who live at home and require home health services and those who need institutional care.

Mississippi Medicaid Income Limit

The Mississippi Medicaid Income Limit is calculated as a percentage of the Federal Poverty Line.

To qualify, you must meet the Mississippi Medicaid Income limits listed below.

Here is the Federal Poverty Level for 2021.

2021 Federal Poverty Levels for the 48 Contiguous States & D.C.
Household Size

Additionally, to be eligible for Medicaid, you cannot make more than the income guidelines outlined below:

  • Children up to age 1 with family income up to 194 percent of FPL
  • Any child age 1-5 with a family income up to 143 percent of FPL
  • Children ages 6- 18 with family income up to 133 percent of FPL
  • CHIP for children with family income up to 209 percent of FPL
  • Pregnant women with family income up to 194 percent of FPL
  • Parents of minor children with family income up to 21 percent of FPL
  • Individuals who are elderly, blind, and disabled with family income up to 74% of the FPL

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What Is Mississippi Medicaid

Mississippi Medicaid is operated jointly by the Mississippi Division of Medicaid and the federal government. It helps low-income populations throughout the state access quality health care services from qualified providers. Instead of providing reimbursements to the program’s beneficiaries, Mississippi Medicaid pays health care providers directly for the services they provide.

While traditional Medicaid covers services like primary care and hospitalization, there are several waivers in Mississippi that amend the program’s coverage inclusions, allowing seniors to access additional supports for long-term care in the home or in senior care facilities.

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