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Healthcare Advisor

Dr. Noor Ali is a licensed medical doctor and surgeon with an established national health insurance consulting practice serving clients in 34+ states.

You have health insurance options in Mississippi. If offered, you can opt in to your employer’s health care plan, purchase a plan from the Health Insurance Marketplace, enroll in Medicaid or Medicare, or purchase coverage directly from an insurer. This guide details your Mississippi health insurance options.

What to know about insurance in Mississippi

  • Marketplace plans: If you don’t have health benefits through an employer, or if it doesn’t meet your needs, you can enroll in a state marketplace plan or purchase a health insurance plan directly from an insurer.
  • Open Enrollment: The Open Enrollment Period for the Mississippi Health Insurance Marketplace starts on November 1st and ends on December 15th each year. These dates apply to coverage for the coming year. If you don’t sign up or make changes during open enrollment, you won’t be able to change your enrollment until the following November.
  • Special Enrollment: If you’re eligible, you can make changes to your health insurance during the year through a special enrollment period. Qualifying life events that trigger an SEP include getting married, having a child, changing your job, or moving.
  • Extended enrollment: In response to the COVID-19 emergency, the federal government announced a special enrollment period for 2021 from February 15th through August 15th. During this period, you can buy or change your health insurance without a qualifying life event.
  • Health Insurance Marketplace: You can enroll in an individual health insurance plan using the Health Insurance Marketplace. Marketplace plans qualify for the Advanced Premium Tax Credit (APTC) that subsidizes premiums based on your income.
  • Direct enrollment: If you don’t qualify for the tax credit, you can purchase health insurance directly from one of the companies selling policies in Mississippi.
  • Coverage types: Slightly more than 42% of Mississippi residents had employer-sponsored health insurance in 2019. Only 4.7% had individual health insurance, while 24.2% were on Medicaid. Another 14.2% were on Medicare, and 12.9% were uninsured.

How do I enroll in Mississippi's Health Insurance Marketplace?

Mississippi is one of 36 states using the Health Insurance Marketplace, and your first steps in finding coverage are to register on the HealthCare.gov website and create an account. To create an account, you will need to provide your name and contact telephone number, choose a password and set up several security questions. You’ll need the full names, dates of birth, and Social Security numbers of everyone your health insurance plan will cover. Each person must be qualified as your spouse, partner, or dependent. The application process requires you to supply information, including:

  • Your marital status
  • The name of your spouse or unmarried partner, provided they live with you or are the parent of your child
  • The number of dependents claimed on your tax return
  • Anyone under age 21 who lives with you and who you take care of
  • The mailing address of everyone listed on your application
  • Whether you and your spouse file taxes together or separately
  • Information about health plans you or any member of the household are eligible for
  • Your total estimated household income for the year; if you’re uncertain about this figure, you can use the income calculator

Once you’ve entered the required information, HealthCare.gov checks your eligibility for Medicaid and whether you qualify for APTC credits. The system will give you a list of available plans with information such as the:

  • Type of plan
  • Plan benefits
  • Monthly premiums
  • Out-of-pocket costs

There’s also a tool for comparing these plans side-by-side. Once you choose a plan, you can proceed through the enrollment process. The following companies sell family and group insurance in Mississippi:

  • All Savers Insurance Company
  • Ambetter of Magnolia Inc.
  • Blue Cross and Blue Shield of Mississippi
  • Golden Rule Insurance Company
  • Humana Insurance Company
  • Molina Healthcare of Mississippi Inc.
  • UnitedHealthcare Insurance Company

How do I enroll in Mississippi individual and families insurance?

The health insurance enrollment process is similar for individuals and families. For families, it’s helpful to evaluate whether individual plans for each family member are a better choice than a single policy. Points to consider include:

  • Each person’s medical needs, age, and income
  • Plan types
  • Coverage levels

Insurance for individuals in Mississippi

Individual insurance may turn out to be more affordable if you and your spouse or other family members have widely different medical needs. With good health, you could choose a policy with lower monthly premiums at the expense of higher annual deductibles. If you have a chronic condition or a disability, then a policy with more comprehensive benefits, higher monthly premiums, but lower annual deductibles may be a better choice.

There are several types of health insurance plans available:

  • Health Maintenance Organization (HMO) plans: A lower-cost option is an HMO plan. HMOs require that you get care from the insurer’s network of physicians, health care providers, and hospitals. HMO plans have low deductibles, but out-of-network care isn’t covered, and Mississippi HMOs have defined service areas.
  • Preferred Provider Organizations (PPOs): If you travel a lot, you might consider a PPO. PPO plans offer greater flexibility and the freedom to use out-of-network providers. Deductibles and premiums are higher, and you’ll pay more to see providers outside the plan’s network.
  • Point-of-Service (POS) plans: Another type is POS. POS plans combine features of HMO and PPO plans, where you pay less for medical services received from the insurer’s network of providers. However, you need to get referrals to see specialists.

Insurance for families in Mississippi

When shopping for family insurance plans, you will need to consider the health needs of each family member. Do you or your spouse suffer from a chronic illness that requires a higher level of medical expense? Or does one of your children have special health needs? It’s important to balance individual needs to ensure each person has adequate coverage while minimizing premiums, deductibles, and copays. Consider separate policies based on coverage needs.

You should evaluate the pros and cons of the different plan types available in Mississippi. An HMO plan may offer lower deductibles, but you need to use the insurer’s health provider network and get referrals for specialists. If someone in your family needs specialist care not available within the network, then a PPO plan may be a better option. With a PPO network, access to providers is nationwide, much more flexible, and does not require referrals.

How much does health insurance cost in Mississippi?

Health Insurance Marketplace plans are divided into four tiers: bronze, silver, gold, and platinum. Individual plans are assigned to specific tiers based on premiums, copays, and annual deductibles. Bronze plans cost less but have fewer benefits than gold plans. Each plan offers the same basic benefits, but the value and coverage level differ according to the tier.

Average Premiums in Mississippi 2018 2019 2020 2021
Most affordable bronze plan $464 $455 $422 $407
Most affordable silver plan $479 $456 $449 $458
Most affordable gold plan $648 $621 $575 $543

  • Bronze plans have the lowest premiums but the highest annual deductibles. Once your deductible is reached, the plan pays 60% of the medical costs, and you pay 40%. Some policies have copays. Bronze plans work well if you’re young, healthy, and don’t normally incur high medical expenses. The average monthly premium for a bronze plan in Mississippi is $407.
  • Silver plans have slightly higher premiums and lower deductibles. Your insurance kicks in sooner because you can meet your deductible earlier in the year, and your share of medical expenses is lower at 30% coinsurance. If you’re eligible for cost-sharing reductions, you must take a silver plan to benefit. Silver plans cover more routine medical expenses than bronze plans, and you can expect to pay an average monthly premium of $458.
  • While monthly premiums for gold plans are higher, your deductible will be much lower, and your share of medical expenses is only 20%. A gold plan is a good choice if you or a family member requires ongoing medical care and expensive prescription medications. Platinum plans can be ideal if you have a chronic illness or an ongoing medical condition that requires routine treatment. Premiums are higher, but deductibles are lower, and your share of medical expenses is only 10%. The average monthly premium for gold plans in Mississippi is $543.

All plans offer certain preventive care services, and most provide network discounts even before you meet your deductible. Average health insurance premiums in Mississippi have dropped steadily since 2018.

What kind of low-income health insurance is available in Mississippi?

Mississippi Medicaid provides medical insurance based on your medical needs and income. Families with children may qualify for the Children’s Health Insurance Program.

Medicaid in Mississippi

Medicaid in Mississippi helps pay for medical services if you have low income and belong to at least one of these categories:

  • Pregnant women
  • Responsible for a child aged 18 or younger
  • Blind individuals
  • Disabled individuals
  • Seniors 65 and older

Eligibility for the Medicaid program depends on annual household income and your family size. In 2021, Mississippi’s annual income limits before taxes are $17,131 for a single person and $23,169 for a couple. You can only qualify for Medicaid in Mississippi if you’re a state resident and a U.S. citizen or legal permanent resident. You can check your eligibility and apply for Medicaid through the Mississippi Division of Medicaid or HealthCare.gov. You can also apply in person at one of the 30 regional offices located throughout the state. Medicaid provides coverage for essential services, including:

  • Doctors’ visits
  • Preventive care
  • Wellness screenings
  • Hospital care
  • Nursing care
  • Diagnostics
  • Medical transportation

Children’s Health Insurance Program (CHIP)

The CHIP program covers children 19 and younger who are ineligible for Medicaid and have no health insurance. Eligibility is based on family income, which may not exceed 209% of the federal poverty level.

Disabled children and working disabled

Disabled children living at home who would otherwise need hospitalization or placement in a long-term care facility are covered, provided care costs are lower than the equivalent cost of full-time institutional care. Additionally, the child’s annual income must be below $2,000, and they can’t be medically stable. Suppose you’re a disabled working person who meets the Social Security definition of disability and works more than 40 hours per month. In that case, you can be covered by Medicaid provided your household meets certain income requirements. Earned income must not exceed 250% of the FPL, and unearned income can’t exceed 135%.

What are Mississippi’s Medicare options for seniors and people with disabilities?

There are several Medicare programs available for Mississippi seniors and adults with disabilities.

  • Original Medicare is one option. This program has two parts: Part A covers hospital inpatient, skilled nursing facility, and hospice care, along with some home health care services. Part B covers outpatient care, doctor visits, and preventive services. If you’ve been employed and paid Medicare taxes for 10 or more years, Part A coverage is free. If you don’t qualify, you pay a premium of up to $471 per month. Part B premiums depend on your income.
  • As an alternative to Original Medicare, you can enroll in a Medicare Advantage Plan, sometimes called Part C. These plans are offered by Medicare-approved insurance companies and cover Part A and B services. Many also include Part D prescription drug coverage and additional benefits.

If you enroll in Original Medicare (Part A and B), you can opt to add a Part D prescription drug plan or supplemental Medigap insurance to help pay out-of-pocket expenses not covered by Original Medicare.

Eligibility and Enrollment
Eligibility To be eligible for Medicare, you must be aged 65 or older and a U.S. citizen or a permanent resident for five years. You may be eligible at a younger age if you have a qualifying disability.
Enrollment You have an initial enrollment period of seven months. It begins three months before your 65th birthday and ends three months after your birthday month. If you or your spouse have employment-related health insurance, you may be eligible for a special enrollment period of eight months beginning on the date you retire. There’s also an annual general enrollment period from January 1 to March 31 when you can enroll and an open enrollment from October 15 to December 7 when you can change your plan.

Medicare Resources

You can get help and advice about Medicare from State Health Insurance Assistance Program (SHIP) counselors throughout Mississippi. The Mississippi Insurance Department provides information and assistance on insurance matters, including Medicare. You can also contact the Mississippi Department of Human Services (MDHS) for assistance.

Are there short-term health insurance plan options in Mississippi?

In Mississippi, you can purchase short-term or temporary health insurance coverage. These policies have a defined term, which is usually three to 12 months in length.

You might need short-term health insurance if you’re in between insurance policies due to a job change, missed open enrollment, or are waiting for Medicare coverage to start.

Short-term health insurance policies typically cost less than ACA-compliant health plans with minimum essential coverage, so look at the policy to ensure it has the coverage you need. Short-term policies typically exclude preexisting conditions and pregnancy.

Mississippi Insurance FAQs

Does Mississippi require health insurance?

Mississippi doesn’t require residents to have health insurance. The Affordable Care Act (ACA) requires insurance, but there is no longer a tax penalty if you don’t carry insurance.

Do I have to use the Health Insurance Marketplace in Mississippi?

No, you can purchase health coverage directly from insurance companies. However, if you’re eligible for and want to receive Advanced Premium Tax Credits, you must buy your insurance and enroll through the Health Insurance Marketplace. Eligibility for tax credits is dependent on annual household income.

What types of alternative health insurance plans (like cost-sharing plans) are available in Mississippi?

There are alternative health insurance options available for those who qualify in Mississippi, such as cost-sharing programs that pool funds to pay members’ health care expenses. These programs typically cost less than traditional health insurance plans. Cost-sharing programs are not obligated to pay health insurance claims as they are not legally defined as health insurance programs.

Do I need health insurance if I have an HSA/FSA?

There’s no requirement to purchase health insurance if you have a health savings account (HSA) or flexible savings account (FSA). However, the primary purpose of an HSA or FSA is to save pretax money to cover the deductibles associated with high-deductible health insurance policies. These accounts aren’t intended as a substitute for health insurance.

Do I need short-term disability coverage in Mississippi if I have health insurance?

Short-term disability coverage is intended to help you meet household expenses if you’re temporarily disabled. It doesn’t replace health insurance. Mississippi employers aren’t required to provide short-term disability insurance, but you can take out a policy if you want to have this coverage.

Do I need long-term disability coverage in Mississippi if I have health insurance?

Long-term disability insurance provides funds to sustain you and your family should you be unable to work due to a specified disability. These policies cover household expenses, food, and housing. Long-term disability insurance payments typically continue until you’re age 65. These policies don’t replace health insurance, and monthly payments are unlikely to be sufficient to cover all medical costs.

What does Mississippi CHIP cover?

The Mississippi Children’s Health Insurance Program (CHIP) provides health insurance for children from birth through age 19. Children who aren’t eligible for Medicaid can get CHIP insurance, provided your family’s monthly household income doesn’t exceed certain limits.

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