As one of Mississippi’s 2.9 million residents, you have several options if you’re looking to buy or replace health insurance for yourself or your family.1
If you don’t get coverage through your employer, you might get a qualified insurance plan through the Health Insurance Marketplace, which in Mississippi operates through healthcare.gov. All the plans offered here must follow the requirements of the Affordable Care Act (ACA), also known as Obamacare.
And, if you qualify, there are government-run programs such as Medicare, Medicaid and the Children’s Health Insurance Program (CHIP) that can help. Depending on the size of your household and how much you earn, you might even qualify for one of the programs that insure you inexpensively.
Mississippi hasn’t chosen to expand Medicaid, but implementing the original ACA dropped the percentage of uninsured people in the state, which was 17% in 2013. From 2016 to 2018, that number stood at 12% of residents.2
Here are answers to some questions Mississippians frequently ask when looking to make the best health insurance decisions.
WHAT YOU NEED TO KNOW:
In Mississippi, the Open Enrollment Period to sign up, renew or change your health insurance plan runs from November 1 to December 15.
You can enroll online for an Affordable Care Act (ACA) plan through Mississippi’s Access.MS website or the federal government’s healthcare.gov site.
Your application will automatically let you know if you qualify for other coverage or subsidies to help you pay for insurance.
The average monthly premium in 2020 for an ACA plan for a 40-year-old ranges from $422 to $575, but you may qualify for help with premiums and out-of-pocket costs.
When Is Mississippi’s 2021 Open Enrollment Period?
Mississippi’s 2021 Open Enrollment Period (OEP) takes place from November 1, 2020 to December 15, 2020. You can enroll in a plan during the OEP and if you’re currently enrolled through the Mississippi Health Insurance Marketplace, you can also renew, change or update your plan for the following year.3
In 2020, more than 99,000 Mississippi residents enrolled in an ACA policy, nearly 12% more than the number of enrollees the year before.4
If you miss the OEP, you won’t be able to apply until next year’s OEP. However, you can sign up for health insurance at any time of the year if you’re eligible for a Special Enrollment Period because of a qualifying life event, such as moving or losing your job. That will trigger a short window during which you can get insurance.5
You Should Know
Your monthly premium could be much less if you qualify for tax credits or cost-sharing subsidies for a plan through the Marketplace.
How Do I Enroll in the Mississippi Health Insurance Marketplace?
You can enroll in ACA health coverage through Mississippi’s Health Insurance Marketplace (also called an “exchange”), run through the federal government’s healthcare.gov website.
There you can compare plans, purchase coverage and possibly qualify for subsidies. The website also lets you determine your eligibility for Medicaid and other government-assisted programs.
How Much Does Mississippi Individual Health Insurance Cost?
The individual plans available on and off the Marketplace are organized into “metal” tiers (bronze, silver and gold). The more valuable the metal, the more coverage you get and the more expensive the plan.
All metal plans include the 10 “essential health benefits” Obamacare requires.
From 2018 to 2020, premiums in Mississippi for qualified bronze plans went down by 9%, while silver fell by over 6% and gold by over 11%. Here are the average monthly costs for a 40-year-old Mississippi resident for bronze, silver and gold plans sold through the Marketplace:6
| Average Premiums for Mississippi Marketplace Plans (for a 40-year-old person) | 2018 | 2019 | 2020 |
| Lowest-Cost Bronze Plan | $464 | $455 | $422 |
| Lowest-Cost Silver Plan | $479 | $456 | $449 |
| Lowest-Cost Gold Plan | $648 | $621 | $575 |
Remember that these are the costs before any savings you might be eligible for based on your family size and household income.
Your monthly premium could be much less if you qualify for tax credits or cost-sharing subsidies for a plan you buy through the Marketplace. How much you pay also depends on the type of plan you choose. Among metal plans, bronze-level coverage typically has the cheapest monthly premiums in Mississippi but the highest out-of-pocket costs.
Subsidies are calculated based on a Marketplace silver “benchmark” plan. In Mississippi, on average, that benchmark plan will cost you $487 a month for 2020, down from $521 in 2019 and $519 in 2018.7
Which Companies Offer Individual Health Insurance Plans in Mississippi?
For 2021, one health insurance company, Ambetter of Magnolia, offers individual and family plans through the Mississippi Marketplace to residents of all counties.8
Molina Healthcare offers coverage in a growing number of counties, but not all.9
Individual plans, called “Private Coverage,” are also available off the Marketplace.10 Blue Cross & Blue Shield of Mississippi offers off-exchange plans for 2021.
What Are My Coverage Options If I’m Low-Income and I Live in Mississippi?
ACA Marketplace Plans (Obamacare)
Submitting one application to Mississippi’s Marketplace at either healthcare.gov or the Access.MS website will tell you how much you might save on an Obamacare plan and if you qualify for Medicaid or the Children’s Health Insurance Program (CHIP).11
You can only qualify for premium tax credits on ACA plans you buy through the Marketplace. Your household income must also be below four times the federal poverty level (FPL).12 That means a family of three’s annual household income would have to be below $85,320 in 2019 to qualify for Mississippi subsidy assistance in 2020.13
About 98% of Mississippians enrolled in an individual plan through the Marketplace received this assistance.14
Here are some examples of cost savings with subsidies:
- A 28-year-old in Jackson who earns $24,000 a year could get a 2020 silver plan for $122 per month after subsidies.15 The same policy would cost $615 per month without the premium tax credits, which cover 71% of the cost.
- A family of three in Gulfport with an income of $50,000 a year could pay $322 per month after subsidies for a 2020 silver plan.16 This policy would cost them $1,042 per month without the premium tax credits, which cover 69% of the cost.
Cost-sharing reductions are another way you can save money on health insurance. They could help lower your deductible, copayments, coinsurance and other out-of-pocket expenses, but they only apply to silver plans you buy through the ACA Marketplace.17 Generally, you must earn up to 250% of the FPL to qualify.18
Medicaid
Mississippi’s Medicaid program provides health coverage for people who are low-income and considered vulnerable, including children, families, pregnant women, senior citizens and people with a disability. Eligibility is based on household income and family size, plus other requirements.
Medicaid covers:19
- Low-income parents or caretakers who meet specific criteria and who have a child under age 18 living at home and who meet fixed income limits based on the size of the household.
- Children under age 19 with a household income between 133% and 194% of FPL (depending on the child’s age) or disabled children in need of institutional care.
- Pregnant women with an income below 194% of FPL.
- Disabled adults who are working, with income under 250% of FPL and unearned income under 135% of FPL.
As mentioned above, Mississippi chose not to expand Medicaid under the Affordable Care Act. If the state does decide to do so in the future, Medicaid expansion would provide health coverage to between 200,000 and 300,000 uninsured adults, or nearly all nonelderly adults earning under 138% of FPL.20 Many of these are low-income adults with children.
Nearly 545,000 Mississippians, or more than one in five, have Medicaid as of May 2020; and 625,000 do, when CHIP enrollment is included.21
You can enroll in Medicaid at any time of the year.
Children’s Health Insurance Program (CHIP)
If your household income is too high to qualify for Medicaid but you can’t afford private insurance, you may qualify for the Children’s Health Insurance Program (CHIP). Children must be younger than 19 and uninsured, living in a household with income under 209% of FPL.22
In May 2020, nearly 80,000 residents were covered under CHIP.23
How Do I Apply for Mississippi Health Coverage Assistance?
Mississippi’s Division of Medicaid and its Health Insurance Marketplace use one single application for all insurance affordability programs. The application can be filed online through the state’s Access.MS website or the federal government’s healthcare.gov website.24
To apply, download the Mississippi Medicaid Application Form to your computer, fill it out, digitally sign and date it, and submit it using the button at the bottom of the PDF form. You can also fax or mail a completed application or deliver it in person to a Medicaid regional office. To have the form mailed to you or for phone assistance, call (601) 576-4164.25
What About Medicare for Mississippi Seniors and People With Disabilities?
Medicare is a federal health insurance program that primarily covers people age 65 and older, younger people with a disability and kidney dialysis patients. Your income isn’t taken into consideration for Medicare coverage.
As of 2018, over 600,000 Mississippians, or one-fifth of the state’s population, had Medicare Part A (hospital insurance) and Part B (medical insurance).26
Four in five Medicare enrollees access Part A and Part B coverage through the federal government’s Original Medicare program. The rest get these benefits through private Medicare Advantage (Part C) plans.27 Part C plans roll in other benefits, including Part D prescription drug coverage.
If you get your Part A and Part B coverage through Original Medicare, you may also want to buy an individual Part D prescription drug plan from a private insurer. In 2018, more than 325,000 Mississippi residents had a standalone Part D plan.28
Original Medicare only covers about 80% of approved costs. If you choose coverage through Original Medicare, you can add a Medicare Supplement Insurance plan (called a Medigap policy).
Like most states, 10 standardized Medigap plans are available in Mississippi to help pay some to all of your uncovered, out-of-pocket costs. These include copayments, coinsurance and deductibles.
The federal government sets the benefits for each standardized plan, so the basic benefits for each type of plan are the same, no matter where you buy it. But since the insurance company can charge what it wants for its policies, premiums can vary depending on the insurer you buy it from.
If you receive Medicare coverage, you may qualify for Medicaid assistance in the form of cost-sharing or premium payment through three programs: Qualified Medicare Beneficiaries (QMB), Specified Low-Income Medicare Beneficiaries (SLIMB) and Qualified Individuals (QI).29
Can I Buy Short-Term Insurance in Mississippi?
Mississippi lets you buy short-term insurance through private insurance companies any time of the year. It follows the federal rules for these plans: an initial term of up to 364 days and, with renewals, a maximum term of 36 months.30 Several private insurers in the state offer the plans.
Short-term insurance policies have budget-friendly premiums, but they rarely cover essential benefits such as preexisting conditions. Although these policies don’t have to meet the ACA’s comprehensive coverage requirements, insurance companies can still use your health information to approve or deny coverage and decide what premium to charge. Short-term plans can be useful as a stop-gap if you missed open enrollment or lost an employer-sponsored plan.
