Health Insurance in Mississippi

Health Insurance in Mississippi
Health coverage is plays a pivotal role in to securing your future against huge medical bills and ensuing financial worries. Indeed, purchasing health coverage is costly and requires an assessment of all potential risks and its impact on your financial health. In the U.S., nearly 47 million people are uninsured, among whom most of them are working families. These families, especially children, become the victim of financial catastrophes due to the lack of proper health coverage. For those families who are not covered by their employers’ group plan, there are low-cost state sponsored health insurance programs that provide insurance to the medically-uninsurable individuals.

According to United Health Foundation’s 2008 Health Rankings, Mississippi holds the 49th position when it comes to the state’s health system. Mississippi has maintained its least healthy state slot since last two years as it stood at 50th and 49th spot in 2007 and 2006 respectively. Several factors contributed to the poor healthcare system in the state including low public health funding, high crime rate, a higher prevalence of smoking, higher percentage of children in poverty. The state of Mississippi, with more than a two million population, offers both private-market and public health insurance alternatives. The private-market health insurance consists of various types of health plans including family, Medicare supplemental, short-term, student, group and dental. Additionally, the state and federal government sponsored programs provide economical health coverage to the uninsurable citizens of Mississippi who meet specific eligibility requirements of age and income.

The Mississippi Insurance Department manages and administers all kinds of insurance sold through private-market health insurers as well as public health coverage programs. However, approximately 19.8% of the state population is still uninsured as the state government strives to provide accessible health care to its residents. According to the Censor Bureau’s 2007 and 2008 Current Population Survey, roughly 18.7% of uninsured residents come under the above 200% FPL category.

Overall, Mississippi lawmakers and the citizens need to work together to build a stronger health system and provide health insurance to everyone. Buying health insurance is a tedious task, but with the guidance of a licensed health insurance agent/broker, you can choose a suitable health insurance policy for your family.

Individual/Family Health Insurance

Below is the guidelines for applying for and obtaining individual health insurance in the state of Mississippi. These regulations apply to all insurance companies offering individual or family health insurance in Mississippi:

Medical Underwriting
Yes
Pre-Existing Condition Exclusion Period
12 months
Look Back Period
12 months
Look Back Standard
Prudent person
Mandatory Benefits
Cancer screening for women including breast cancer screening, direct access to OB/GYNs, OB/GYNs are primary care providers
Market Rate Restrictions
None
Guaranteed Issue Options
None
Small Group Health Insurance

Below is the guidelines for small group health insurance in the state of Mississippi. These regulations apply to all insurance companies offering small group health insurance in Mississippi:

Small Group Size
1-50
Employee Qualifications
Two employees must work for at least 6 months out of the year, and work 20 hours per week
Guaranteed Issue
Yes
Premium Rating Factors
Rate Bands
Rate Adjustment Factors
25%
Look-Back Period
6 months
Pre-existing condition exclusionary period
12 months
Mandatory Benefits
Same as individual
State Cobra Variations for Small Groups

Below are the COBRA guidelines for small groups in the state of Mississippi. For employer groups of more than 20 employees, refer to the federal COBRA guidelines:

Mini-Cobra Option
Yes
Eligible Group Sizes
2-19
Extension of Benefits Period – Standard
12 months
Extension of Benefits Period – Disabled
12 months
Maximum Premium Increase
100%
State Legislation Reference
Insurance Code 83-9-51 of 1972
Additional Notes
Terminated employees are allowed to remain covered under the group insurance plan for a period of 12 months, following a 3 month waiting period.
State Sponsored Health Insurance Programs

There are several state sponsored health insurance programs in the State of Mississippi to assist those without insurance in obtaining adequate coverage.

High-Risk Pools

Some states offer special state sponsored health insurance plans for qualified persons that are not eligible for individual health insurance due to pre-existing medical conditions. The guidelines for enrollment in these programs vary by state. The high-risk pool in the State of Mississippi is summarized in the chart below:

Plan Name
Mississippi Comprehensive Health Insurance Risk Pool Association (5MCHIRPA)
Website
http://www.mississippihealthpool.org/index.php
Phone Number
888-820-9400
HIPPA Eligibility Required?
Yes
Available Carriers
Blue Cross and Blue Shield of Mississippi
Pre-Existing Condition Waiting Period
12 months
Enrollment Periods
Open to New Enrollment
Premium Limits
Between 150% – 175% of standard rate
Lifetime Maximum Benefit
$5 million
Special Notes
To be eligible, you must be:
A Legal Resident of Mississippi,
Under age 65,
Without access to other medical coverage, and
Uninsurable due to medical reasons.
Children’s Health Insurance Program

Through shared funding from the federal government, the State of Mississippi provides health insurance for uninsured children that meet certain eligibility guidelines. A summary of this program is outlined in the chart below:

Program Name
Mississippi Children’s Health Insurance Program (5CHIP)
Website
http://www.msdh.state.ms.us/msdhsite/_static/41,0,96.html
Phone Number
877-543-7669
Apply Online
Yes
Age Limits
Under 19
Insurance Carrier

Length of Coverage
12 months
Residency Requirements
MS resident, U.S. citizen or eligible immigrant
Other Eligibility Requirements
Eligibility is based on household income, the age of each child and the insured status of each child.
Only uninsured children can qualify for CHIP.
Pre-Existing Condition Exclusions
None
Cost
There are no premiums or deductibles, although there may be a small co-payment for some services for higher-income families on CHIP.
Medicaid

Medicaid is a state program partially funded through the federal government. Qualification guidelines, as well as the types of people that are eligible, will vary by state. The chart below provides a summary of the Medicaid programs in the State of Mississippi:

Governing Agency
Mississippi Division of Medicaid
Website
https://medicaid.ms.gov/
Phone Number
800-421-2408
Residency Requirements
Legal Mississippi resident
Federal Poverty Line Income Limits
Pregnant Women: 185% FPL
Children (5ages 1-5): 133% FPL
Children (5Ages 6-19): 100% FPL
Aged, Blind and Disabled: 95% FPL
Working Parents: 35% FPL
Non-Working Parents: 28% FPL
Additional Resources

Mississippi Health Care Options Matrix™ Guide
Provided by the Foundation for Health Coverage Education, the guide is a quick reference guide prepared by the non-profit Foundation for Health Coverage Education that outlines Mississippi’s public and private health care choices for individuals and groups with various demographic profiles.
Family Health Insurance Guide by HealthInsuranceFinders.com
The guide created by HealthInsuranceFinders.com provides useful information regarding health insurance coverage such as individual/family health insurance, group health insurance, separate child health insurance and state-sponsored programs that are available for low to middle income families.
Mississippi: At-A-Glance
Provides all-inclusive health data of Mississippi. Statehealthfacts.org is a project of the Henry J. Kaiser Family Foundation and is designed to provide free, up-to-date, and easy-to-use health data on all 50 states.