Mississippi Health Insurance: Find Affordable Plans

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.

• 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 an affordable health insurance plan directly from an insurer.
• Open enrollment: The Open enrollment period for the Mississippi Health Insurance Marketplace starts on November 1 and ends on January 15 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 (SEP). Qualifying life events that trigger an SEP include getting married, having a child, changing your job, or moving.
• 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.

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:

• Ambetter of Magnolia Inc.
• Molina Healthcare of Mississippi Inc.
• UnitedHealthcare
• Vantage Health Plan of Mississippi

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 three types of insurance plans that you can select.

• Health Maintenance Organization (HMO) plans offer a network of doctors that you can visit. You’ll need to get a referral whenever you need to see a specialist.
• Preferred Provider Organization (PPO) plans provide much more freedom to see any doctor or specialist you want, but you’re required to pay higher premiums for this freedom.
• Point of Service (POS) plans rest in the middle because they offer a network of doctors you can receive care from at a discount, but you’re able to see doctors outside of the network as long as you pay a higher copayment.

Insurance for families in Mississippi

When shopping for family insurance plans, you’ll 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? 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 doesn’t require referrals.

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. If you’re looking for cheap health insurance, 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:

• 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 $401.
• 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 $462.
• 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 $548.

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.

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

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 aged 65 and older

Eligibility for the Medicaid program depends on annual household income and your family size. In 2023, Mississippi’s annual income limits before taxes are $18,075 for a single person and $24,353 for a couple. You can only qualify for Medicaid in Mississippi if you’re a state resident and a United States 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

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 federal poverty level (FPL), and unearned income can’t exceed 135%.

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 $499 per month. Part B premiums depend on your income. The Medicare Part A deductible for inpatient hospital stays is $1,600 in 2023. Medicare Part B enrollees pay a standard monthly premium of $226 for 2023.
• 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. As of 2023, there are 69 Medicare Advantage Plans available in the state, however, you can only select a plan that’s available in your county.

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

Eligibility

To qualify for Medicare, you must be at least 65 years old or have a qualifying disability. In most cases, a qualifying disability is a condition that makes you eligible for at least 24 months of payments from the Social Security Disability Insurance program or Railroad Retirement Board. You may be able to qualify sooner if you have end-stage renal disease or amyotrophic lateral sclerosis (Lou Gehrig’s disease).

Enrollment

If you start receiving your Social Security or Railroad Retirement Board benefits at least four months before you turn 65, you’ll be automatically enrolled in Medicare. Otherwise, you must fill out an application online or contact your local Social Security office. You can enroll in Medicare during the following periods:

• Initial enrollment: Your initial enrollment period starts three months before your 65th birthday and ends three months after your 65th birthday. If you’ve never had Medicare, you can enroll during this period. If you started receiving Medicare when you were younger, you can also make changes to your plan.
• General enrollment: Choose this enrollment period if you missed your initial enrollment period. The Medicare general enrollment period is January 1 to March 31. You can choose Original Medicare, Medicare Advantage, Medigap, or Part D.
• Medicare Advantage open enrollment: You can make changes to your Medicare Part C, also known as Medicare Advantage, from January 1 to March 31.
• Open enrollment: You can join, switch plans, or drop your coverage from October 15 to December 7 each year.
• Special enrollment periods: You may qualify for a special enrollment period if you lose your coverage or have changes to your eligibility outside the regular enrollment periods.

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.

• HealthCare.gov | Last accessed December 22, 2022
• HealthCare.gov | Advanced Premium Tax Credit | Last accessed December 22, 2022
• HealthCare.gov | Calculate yearly income | Last accessed December 22, 2022
• HealthCare.gov | Cost Sharing Reduction (CSR) | Last accessed December 22, 2022
• HealthCare.gov | Deductible | Last accessed December 22, 2022
• HealthCare.gov | Disability | Last accessed December 22, 2022
• HealthCare.gov | Enroll in or change 2021 plans — only with a Special Enrollment Period | Last accessed December 22, 2022
• HealthCare.gov | Mississippi Rate Review Submissions | Last accessed December 22, 2022
• HealthCare.gov | New, lower costs are here | Last accessed December 22, 2022
• HealthCare.gov | Preferred Provider Organization (PPO) | Last accessed December 22, 2022
• HealthCare.gov | Point of Service (POS) Plans | Last accessed December 22, 2022
• Healthcare.gov | 2021 Special Enrollment Period Access Extended to December 15 on HealthCare.gov for Marketplace Coverage | Last accessed December 22, 2022
• HealthCare.gov | 4 steps to getting covered in the Health Insurance Marketplace | Last accessed December 22, 2022
• KFF | Health Insurance Coverage of the Total Population | Last accessed December 22, 2022
• Medicare.gov | How do Medicare Advantage Plans work? | Last accessed December 22, 2022
• Medicare.gov | What’s Medicare Supplement Insurance (Medigap)? | Last accessed December 22, 2022
• Mississippi Department of Human Services | Adults and Seniors | Last accessed December 22, 2022
• Mississippi Division of Medicaid | Apply | Last accessed December 22, 2022
• Mississippi Division of Medicaid | Office Locations | Last accessed December 22, 2022
• Mississippi Division of Medicaid | Medicaid Eligibility Guide for a Disabled Child Living At-Home | Last accessed December 22, 2022
• Mississippi Division of Medicaid | An Eligibility Guide for Persons Working and Disabled | Last accessed December 22, 2022
• Mississippi Insurance Department | Health Insurance | Last accessed December 22, 2022
• Mississippi Insurance Department | Health Insurance 101 and Autism | Last accessed December 22, 2022
• Mississippi Insurance Department | Medicare | Last accessed December 22, 2022
• Mississippi Insurance Department | Mississippi Health Maintenance Organization (HMO) Service Areas | Last accessed December 22, 2022
• NAIC.org | SHORT-TERM LIMITED-DURATION HEALTH PLANS | Last accessed December 22, 2022
• SHIP | State Health Insurance Assistance Program (SHIP) | Last accessed December 22, 2022
• usa.gov | Continuation of Health Coverage COBRA | Last accessed December 22, 2022