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Financial help for Mississippi Medicare enrollees

Medicaid estate recovery in Mississippi only applies to people who were 55+ and receiving Medicaid-funded long-term care or hospice services

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As a Medicare beneficiary, the state where you live has a significant impact on the care you receive and how much you pay for that care.

Medicare special election period

CMS has extended Medicare open enrollment in more than 20 Mississippi counties in response to the natural disasters in 2020.

This page describes resources that may help you pay for Medicare coverage and Medicaid programs that may to help pay for long-term care, which is not generally covered by Medicare.

Does Mississippi help with my Medicare premiums?

Many Medicare beneficiaries who struggle to afford the cost of Medicare coverage are eligible for help through a Medicare Savings Program (MSP). In Mississippi, these programs pay for Medicare Part B premiums, Medicare Part A and B cost-sharing, and – in some cases – Part A premiums.

  • Qualified Medicare Beneficiary (QMB): The income limit is $1,113 a month if single and $1,487 a month if married. QMB pays for Part A and B cost sharing, Part B premiums, and – if a beneficiary owes them – it also pays their Part A premiums.
  • Specified Low Income Medicare Beneficiary (SLMB):  The income limit is from QMB levels up to $1,326 a month if single or $1,774 a month if married. SLMB pays for Part B premiums.
  • Qualified Individuals (QI): The income limit is from SLMB levels up to $1,486 a month if single or $1,990 a month if married. QI pays for Part B premiums.

MSP asset limits: There is no asset limit for QMB, SLMB and QI in Mississippi.

In Mississippi, the first $20 of an applicant’s unearned income (e.g., Social Security or pensions) is not considered when determining eligibility for an MSP or Medicaid for the aged, blind and disabled (Medicaid ABD). This “income disregard” is reflected in these eligibility limits.

The income limits for MSPs and Medicaid ABD are significantly higher for applicants who are still working because less than half of income from employment is counted.

Income and asset limits for QMB, SLMB and QI vary based on an applicant’s marital status. However, eligibility rules for Medicaid ABD and Long Term Services and Supports (LTSS) benefits vary based on the number of household members.

Who's eligible for Medicaid for the aged, blind and disabled (ABD) in Mississippi?

Medicare covers a great number services – including hospitalization, physician services, and prescription drugs – but Original Medicare doesn’t cover important services like vision and dental benefits. Some beneficiaries – those whose incomes make them eligible for Medicaid – can receive coverage for those additional services if they’re enrolled in Medicaid ABD.

In Mississippi, Medicaid ABD covers “dental extractions and related treatment” for adults for a $3 co-pay.

Medicaid ABD also covers one eye exam and a pair of eyeglasses every 5 years. The co-pay is $3 each for the exam and eyeglasses.

Income eligibility: The income limit is $783 a month if single and $1,175 a month if married. (This amount is the same as the income limit for the Supplemental Security Income program – or 74 percent of the federal poverty level.)

Asset limits: The asset limit is $2,000 if single and $3,000 if married.

Federal assistance with prescription drug costs in Mississippi

Medicare beneficiaries who also have Medicaid, an MSP, or Supplemental Security Income (SSI) receive Extra Help – a federal program that lowers prescription drug expenses under Part D. Beneficiaries who don’t automatically receive this program can apply for it themselves The income limit is $1,615 a month for singles (and $2,175 a month for couples), and the asset limit is $14,610 for individuals (and $29,160 for spouses).

How does Mississippi regulate long-term services and supports (LTSS)?

Twenty percent of Medicare beneficiaries who lived at home received some assistance with LTSS in 2015, and the portion of seniors needing these services will rise as the population ages. Yet while Medicare beneficiaries increasingly rely on long-term care, it is generally not covered by Medicare.

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Medicaid does provide long-term service and supports (LTSS) for qualifying individuals, but its complex eligibility rules can be hard to navigate.

Applicants seeking Medicaid long-term care benefits have to undergo a level of care assessment.

Medicaid nursing home coverage

Income limits: The income limit is $2,349 a month if single and $4,698 a month if married (and both spouses are applying).

If only one spouse needs nursing home care, the income limit for single applicants is used and (typically) only the applying spouse’s income is counted.

However, nursing home enrollees cannot keep all of their income up to this limit. Rather, enrollees must pay nearly all their income to their nursing home, other than a small personal needs allowance (of $44 a month) and money to pay for health insurance premiums (such as Medicare Part B and Medigap).

Assets limits: The asset limit is $4,000 if single and $8,000 if married* (and both spouses are applying). If only one spouse has Medicaid, the other spouse can keep up to $128,640. Certain assets are never counted, including many household effects, family heirlooms, certain prepaid burial arrangements, and one car.

*Married spouses are allowed to keep $4,000 each.

Home and Community Based Services (HCBS) waivers

Every state’s Medicaid program covers community-based LTSS services. Programs covering this care are called Home and Community Based Services (HCBS) waivers as recipients continue living in the community, rather than entering a nursing home. Applicants must show that they can live safely in their home.

Income limits: The income limit is $2,349 a month if single and $4,698 a month if married (and both spouses are applying).

If only one spouse needs HCBS, the income limit for single applicants is used – and often only the applying spouse’s income is counted.

Asset limits: The asset limit is $4,000 if single and $8,000* if married (and both spouses are applying). If only one spouse has Medicaid, the other spouse can keep up to $128,640.

*Note that each married applicant is allowed $4,000 in assets.

Spousal impoverishment protections in Mississippi

Eligibility rules for Medicaid LTSS programs differ from those for other Medicaid benefits. When only one spouse is applying, only the applying spouse’s income is counted. Normally with Medicaid benefits, the income of both spouses is counted regardless of who is applying.

If only one spouse has Medicaid, spousal impoverishment rules allow the other spouse to keep a Minimum Monthly Maintenance Needs Allowance (MMMNA) from their Medicaid spouse’s income. This rule applies to nursing home care and HCBS, not to other Medicaid benefits.

In Mississippi in 2020, these spousal impoverishment rules allow community spouses to keep:

Medicaid home equity limit in Mississippi

Federal law requires states to limit eligibility for Medicaid nursing home and HCBS to applicants with a home equity interest below a specific dollar amount. In 2020, states set this home equity level based on a federal minimum of $595,000 and maximum of $893,000.

Mississippi limits applicants for Medicaid LTSS to a home equity interest of $595,000 or less.

Penalties for transferring assets in Mississippi

The high cost of long-term care influences some individuals to consider giving away or transferring assets to others to become eligible for Medicaid LTSS benefits. To discourage asset transfers, federal law requires states to have a penalty period for Medicaid LTSS applicants who give away or transfer assets for less than fair market value. States can choose to also have an asset transfer penalty for HCBS.

Mississippi has chosen to have a penalty period for nursing home care and HCBS. This penalty period’s length is based on the value of asset transfers or gifts made during the 60 months prior to applying for Medicaid (or entering a nursing home). The penalty is calculated by dividing the value of assets transferred or given away by the monthly cost of nursing home care (which is $6,832 in Mississippi in 2020).

Estate recovery in Mississippi

State Medicaid agencies must attempt to recover what they paid for long-term related costs for enrollees who were 55 or older. States can also pursue estate recovery for medical costs that aren’t long-term care related (and for enrollees who didn’t receive long-term care). This is called estate recovery.

Mississippi has chosen to recover only from the estates of beneficiaries who received Medicaid long-term care benefits beginning at age 55.

However, Mississippi will not pursue estate recovery if an enrollee is survived by their spouse or a child who is under 21 or disabled. The state also grants hardship exemptions from estate recovery in certain other circumstances.

When Medicaid coverage was administered by a Managed Care Organization (MCO) (i.e, a private insurer the state contracts with to administer Medicaid benefits), the state will attempt to recover what it paid that MCO. That means the estate recovery amount could differ from the actual cost of Medicaid services received.

Congress exempted Medicare premiums and cost sharing from Medicaid estate recovery starting with benefits paid after December 31, 2009, but Medicaid may try to recover what it paid for MSP through that date. In Mississippi, this could only occur if an enrollee had also received long-term care.

Where can Medicare beneficiaries get help in Mississippi?

Mississippi State Health Insurance Assistance Program (SHIP)

Medicare counseling is available by contacting the Mississippi State Health Insurance Assistance Program (SHIP) at 1-844-822-4622.

The Mississippi SHIP can help beneficiaries enroll in Medicare, compare and change Medicare Advantage and Part D plans, and answer questions about state Medigap protections. SHIP counselors may also be able to offer referrals to local agencies for services like home care and long-term care. The SHIP’s website has more information on the services it offers.

Elder Law Attorneys

Elder law attorneys can help individuals plan for Medicaid long-term care benefits. You can use this National Academy of Elder Law Attorneys (NAELA) search feature to find an elder attorney locally.

Mississippi Area Agencies on Aging (AAAs)

Medicare beneficiaries in Mississippi can also receive information and assistance from an Area Agency on Aging (AAAs). These organizations can counsel about services available to help with aging or living with a disability, and with planning for long-term care needs. This is a list of AAAs in Mississippi.

Where can I apply for Medicaid in Mississippi?

Medicaid is administered by the Department of Medicaid in Mississippi. You can use this website to apply online for Medicaid ABD or a Medicare Savings Program.

Josh Schultz has a strong background in Medicare and the Affordable Care Act. He coordinated a Medicare ombudsman contract at the Medicare Rights Center in New York City, and represented clients in extensive Medicare claims and appeals. In addition to advocacy work, Josh helped implement federal and state health insurance exchanges at the technology firm hCentive. He has also held consulting rules, including at Sachs Policy Group, where he worked with hospital, insurer and technology clients.

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