Learn About Coverage For Medicaid in Mississippi

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UPDATE: In 2020, most of the requirements for Medicaid are expected to remain the same.

If you are wondering, “What services are covered by Medicaid in Mississippi?” note that insured services and equipment will vary from state to state. The types of Medicaid insurance services provided by Mississippi Medicaid will be different from those provided in other parts of the country.

Furthermore, the question of, “How much does Medicaid cost?” varies similarly across the nation and within each state. For instance, while Medicaid coverage in MS will come with a monthly premium for some beneficiaries, others will not have to pay anything for medical services.

In July of 2016, Mississippi Medicaid covered nearly 700 thousand Mississippi residents. If you live in Mississippi and do not make enough money to afford health care coverage sold on the private market, you may qualify for Mississippi Medicaid.

For more information on Medicaid cost estimates in Mississippi, and for details on what services Medicaid covers and what services it does not, review the sections provided below:

What Services are Covered by Medicaid in Mississippi?

You might expect all types of Medicaid insurance to cover the same services and equipment. In fact, the Federal Government requires that every version of Medicaid coverage must envelop a set of mandatory services.

However, every state has its own version of Medicaid. When you go beyond the mandatory services, each state is free to develop its own mix of covered services.

Because the coverage can vary significantly from one state to another, you need to ask the question, “What services are covered by Medicaid in my state of residence?” to find out if the state medical assistance program suits your needs.

Mississippi Medicaid coverage pays for a wide variety of services and equipment for eligible beneficiaries. These services include:

  • Inpatient hospital care
  • Family planning services
  • Office visits
  • Long term healthcare
  • Inpatient psychiatric care
  • Eyeglasses
  • Prescription drugs

Other services may be covered as well if your Medicaid physician determines that they are medically necessary. If your Medicaid denies a procedure or piece of equipment during the Medicaid application process, you can always appeal the decision.

Your appeal rights are spelled out in the paperwork you received when you signed up. The process is pretty much the same in every state.

If a needed service is not covered, a person who is eligible for Medicaid will need to file an appeal. You will need a prescription from your doctor; you may need some additional supporting documentation explaining why you need the service, how the service will benefit you, and what, if any alternative treatments are available.

Depending on how busy the Medicaid department is, an appeal can take 3-6 months or more. It is always good to plan ahead for your medical whenever possible.

Children may be eligible for additional services that adults will not qualify for, such as dental services. These services may include regular exams, teeth cleaning, X-rays or even oral surgery, in extreme cases.

What Does Medicaid Not Cover in Mississippi?

While Medicaid coverage in Mississippi insures beneficiaries for a number of helpful services, there are certain procedures and pieces of equipment that Mississippi Medicaid will not cover.

The Mississippi Medicaid program establishes covered services based on medical necessity. Therefore, any service that is not medically necessary will not be covered in Mississippi.

The following services are not covered:

  • Cosmetic surgery
  • Home remedies
  • Unapproved organ transplants
  • Autopsies
  • Reports required for legal and insurance reasons
  • Services provided by members of your family
  • Procedures that are not medically necessary

You can still have these and other non-covered procedures done, but you will need to pay for these services out of your pocket.

How Much Does Medicaid Cost in Mississippi?

For those wondering, “How much is Medicaid in Mississippi?” note that many Medicaid beneficiaries pay nothing at all for their coverage due to the fact that they earn low incomes. Medicaid in Mississippi may cover 100% of your healthcare costs if your individual income is less than $1,416 per month.

Otherwise, Medicaid cost estimates are based on the household income and medical needs. For a couple, this threshold is $1,910 per month.

In every case, your income has to be less than the income limits set by law in Mississippi. In addition, you have to possess Medicaid hospital insurance.

If your income is above this threshold, you may still meet Medicaid eligibility requirements, but you will have to pay a portion of the cost of your coverage. The next logical question is, “How much will my Medicaid coverage cost?”

Unfortunately, there is no absolute answer to this question. The amount you pay can change based on your income, the size of your household and the exact level of coverage you have.

If paying for your Medicaid coverage ever becomes a financial burden, be sure to let your caseworker know right away; you may qualify for additional financial assistance, especially if your income, health or living situation has changed.

Even if there are no assistance programs available for you, you may be able to work out an extended payment plan. If you need medical insurance, but you cannot afford it, Medicaid could be a good option for you.

The information about Medicaid above relays that the coverage and costs may vary, depending on what state you live in, but the basic services you and your family depend on will always be included in your plan. If you cannot pay the cost of healthcare on your own, Medicaid may be the answer you are looking for.