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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.
This page describes resources that may help you pay for Medicare coverage and Medicaid programs that may help pay for long-term care, which is not generally covered by Medicare.
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.
MSP asset limit: MSP asset limits: There is no MSP asset limit in Mississippi.[/hio_question]
Medicare covers many 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 $914 a month if single and $1,371 a month if married.
Asset limits: The asset limit is $2,000 if single and $3,000 if married.
Medicare beneficiaries who also have Medicaid, an MSP, or Supplemental Security Income (SSI) will receive Extra Help. This program lowers Medicare Part D prescription drug costs. When beneficiaries apply for this program themselves, the income limit is $1,843 a month for singles and $2,485 a month for couples. The asset limit is $16,660 for individuals and $33,240 for spouses.
Medicare beneficiaries increasingly rely on long-term care, and the portion of seniors needing these services will keep rising as the population ages. However, long-term care is mostly not covered by Medicare. While Medicaid fills the gap in Medicare coverage for long-term care, its complex eligibility rules can make qualifying for benefits difficult. What’s more – eligibility rules vary significantly from state to state.
Applicants seeking Medicaid long-term care benefits have to undergo a level of care assessment.
Income limits: The income limit is $2,742 a month if single and $5,484 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 $6,000 if married (and both spouses are applying). If only one spouse has Medicaid, the other spouse can keep up to $148,620. Certain assets are never counted, including many household effects, family heirlooms, certain prepaid burial arrangements, and one car.
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 $2,742 a month if single and $5,484 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 $6,000 if married (and both spouses are applying). If only one spouse has Medicaid, the other spouse can keep up to $148,620.
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 as of 2022, these spousal impoverishment rules allowed community spouses to keep:
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. States set this home equity limit by choosing between a federal minimum of $688,000 and maximum of $1,033,000 in 2023.
Mississippi limits applicants for Medicaid LTSS to a home equity interest of $688,000 or less.
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 $7,107 in Mississippi in 2023).
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.
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.
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.
