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How to Apply for Aged, Blind or Disabled Medicaid Benefits

Contact the regional office that serves your county of residence.

Call the Office of Eligibility toll-free at: 80.

If you want an application mailed to you or if you need telephone assistance:

Apply in person at one of the 30 regional offices that serves your county of residence.

An original signature is not required for a faxed application. You may request to have a paper application mailed to you.

Mail to: 550 High Street, Suite 1000, Jackson, MS 39201 or the regional office that serves your county of residence.

Fax the Office of Eligibility at the Division of Medicaid: 60.There is no resource test for any insurance affordability program, including Medicaid and CHIP.Īn application form can be printed at either website, completed and submitted to the Division of Medicaid by one of the following ways: View the income limits for Medicaid and CHIP programs.

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You will only be asked to provide verification of needed eligibility information, if eligibility factors cannot be verified through an available electronic source or if the information you give conflicts with data from electronic sources. The Division of Medicaid and the FFM will verify as much data as possible from electronic sources in order to verify what is reported on your application. If not potentially eligible for Medicaid, applicants view other insurance affordability program options on.If potentially eligible, then applications are transferred to the state to determine eligibility. Applications are assessed for potential Medicaid eligibility.Applications are evaluated through the website.

If determined applicant is not eligible for Mississippi Medicaid, applications are automatically referred to the FFM.Eligibility assessment and determination is approved or denied.Applications are reviewed by state staff.Initially handled on a local, state level Note: If you open and fill out the application in your browser, the processing of your application may be delayed.ĭirect application through Mississippi MedicaidĪpplication for insurance affordability options and Medicaid, if eligibleĭirect application for Mississippi MedicaidĪpplication is routed through website Select the Submit button at the bottom of the form.Digitally sign the application and date your application.Open the form and fill out the application with as much information as you can.

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Download the Mississippi Medicaid Application form (PDF) to your computer.

To fill out the Mississippi Medicaid Application, please follow the steps below: Important Information to Successfully Submit Your Application FormĪpply by completing and submitting a Mississippi Medicaid Application Form (PDF)

Information about any job-related health insurance available to your family.

Policy numbers for any current health insurance.

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.

Employer and income information for each person in the family with income.

Dates of birth for each person applying.

Social Security Numbers or document numbers for legal immigrants who need insurance.

To fill out this application, you will need: If you apply through, the FFM will assess your potential eligibility for Medicaid or CHIP and then return your application to the Division of Medicaid for the final eligibility decision. Application for any of the insurance affordability programs may be filed online through Access.ms.gov or the FFM at. The Mississippi Division of Medicaid and the federally facilitated marketplace (FFM) has one single application for all insurance affordability programs. This lets us know you are asking for a Medicaid decision that considers age, blindness or disability as a condition of your eligibility. NOTE: If you want to apply for Medicaid due to age, blindness or disability on Access.ms.gov, be sure to check YES to a limiting or disabling condition when those questions appear in the application flow. Medicaid Specialists in the Regional Office check available electronic sources to verify as much information as possible and then follow-up if additional information is needed. Documents can be uploaded and sent electronically with your application to the Medicaid Regional Office serving your county of residence. Mississippi’s Common Web Portal at Access.ms.gov is a convenient way to apply for children, pregnant women, low-income parents of children under age 18 and anyone else who needs to apply. How to Apply for Mississippi Medicaid Health Benefits Online

There are multiple ways you can apply for Mississippi Medicaid health benefits.

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