JACKSON, Miss. ( WJTV ) – If you find yourself in need of health coverage in Mississippi, checking to see if you are eligible for Medicaid may be worthwhile.

The Mississippi Division of Medicaid is a state and federal program designed to provide health coverage for eligible, low-income populations. Eligible members do not directly receive money from Medicaid for health benefits. Enrolled and qualified Medicaid providers are reimbursed for health services.

Below are answers to common Medicaid questions.

What are the level of benefits?

Though Mississippi is required to provide certain levels of coverage for particular individuals, the Magnolia State has wide flexibility over covering optional eligibility groups. Broadly speaking, there are three levels of Medicaid benefits: full benefits, reduced coverage and limited benefits.

Below are the groups under each umbrella of Medicaid coverage .

Full Medicaid benefits

• Infants and Children
• Children’s Health Insurance Program (CHIP)
• Parents/Caretakers of Minor Children
• Pregnant Women
• Disabled Child Living at Home
• Working Disabled
• Aged, Blind or Disabled Receiving Supplemental Security Income (SSI)
• Aged, Blind or Disabled Former Supplemental Security Income (SSI) Recipients
• Aged, Blind or Disabled Residing in Nursing Facility or Participating in a Home and Community Based Services (HCBS) Waiver Program
• Emergency Services for Immigrants

Reduced Coverage / Medicare Cost Sharing or Premium Payment

• Qualified Medicare Beneficiaries
• Specified Low-Income Medicare Beneficiaries
• Qualified Individuals

Limited Benefits

• Family Planning Waiver
• Healthier Mississippi Waiver

How do I apply?

One application exists for all insurance affordability programs. It may be filed online through Access.ms.gov or the federally facilitated marketplace (FFM) at Healthcare.gov . The FFM will assess potential eligibility for Medicaid or CHIP for those who apply through Healthcare.gov . The application will be sent to the Division of Medicaid for the final eligibility decision.

To fill out this application, applicants will need:

• Dates of birth for each person applying
• Employer and income information for each person in the family with income. Use income from the most recent month’s pay stubs or W-2 forms or any document that shows exactly what each person receives as income
• Information about any job-related health insurance available to your family
• Policy numbers for any current health insurance
• Social Security Numbers or document numbers for legal immigrants who need insurance

Applicants can also apply by fax, postal mail, in person or by phone.

What happens after approval?

After the application for Mississippi Medicaid health benefits is submitted, the regional office that serves your county of residence will contact applicants by phone or letter regarding the eligibility determination. If something is incorrect, missing or needs clarification a regional office staff member will contact you.

Mississippi Medicaid will mail a letter and a blue Medicaid identification card to applicants if approved to receive benefits. When you make an appointment, be sure the healthcare provider you choose accepts Mississippi Medicaid. Benefits will be reviewed on an annual basis.

What if I do not get benefits?

Beneficiaries/applicants are entitled to a fair hearing if they disagree with actions taken by the Division of Medicaid to deny, terminate or reduce services. Applicants or their representatives have the right to do the following:

• Read everything in your case record which is kept on file at the Medicaid regional office. The case record has all the documents related to your Medicaid eligibility. It is accessible anytime during the hearing process
• Have a lawyer during the hearing
• Have witnesses testify on one’s behalf
• Present evidence, which may help one’s case, at the hearing and discuss the facts about one’s situation
• Explain your case without any interference
• Question or refute any testimony or evidence and question any witness

For more information, visit medicaid.ms.gov’s website .

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