Mississippi Medicaid Eligibility 2025: Income Limits, Asset Rules & How to Apply

Mississippi Medicaid, administered by the Mississippi Division of Medicaid (DOM), is a health insurance program funded by federal and state dollars, providing medical and health-related services to low-income individuals, including children, pregnant women, parents, seniors, and disabled individuals.

This guide outlines the 2025 eligibility criteria, income limits, asset rules, and application process for Mississippi Medicaid, based on federal and DOM guidelines, with a focus on long-term care for seniors (aged 65+), as well as other eligibility groups.

Mississippi Medicaid Programs

Mississippi Medicaid offers coverage for various groups, with specific eligibility requirements based on income, assets, age, and medical needs. The main programs include:

• Institutional / Nursing Home Medicaid: An entitlement program covering nursing home care for those requiring a Nursing Facility Level of Care (NFLOC).
• Home and Community Based Services (HCBS) Waivers: Non-entitlement programs with limited slots, offering services like in-home care, adult day care, and assisted living to delay nursing home placement. Programs like the Elderly and Disabled Waiver may have waiting lists.
• Regular Medicaid (Aged, Blind, and Disabled, ABD): An entitlement program covering low-income elderly, blind, or disabled individuals, with less stringent medical requirements than long-term care programs.
• Medicaid for Children and Pregnant Women: Covers children up to age 19 and pregnant women with higher income limits through the Children’s Health Insurance Program (CHIP).
• Medicaid for Parents and Caretaker Relatives: Covers low-income parents or caretakers of dependent children under 18.

Note: Mississippi has not expanded Medicaid under the Affordable Care Act (ACA), so coverage for non-disabled, non-elderly adults without dependent children is limited, creating a coverage gap for those above parent/caretaker limits but below ACA expansion thresholds (138% FPL).

Eligibility for Mississippi Medicaid

Eligibility varies by program and population. General requirements include:

• Residency: Must be a Mississippi resident.
• Citizenship: Must be a U.S. citizen or have qualifying immigration status (e.g., lawful permanent residents, refugees, or asylees).
• Income: Varies by program, based on Federal Poverty Level (FPL) or Federal Benefit Rate (FBR). Mississippi uses Modified Adjusted Gross Income (MAGI) for children, pregnant women, and parents, with a 5% FPL disregard applied.
• Assets: Limits apply for long-term care and ABD programs.
• Medical/Functional Need: Long-term care programs require a Nursing Facility Level of Care (NFLOC), assessed through limitations in Activities of Daily Living (ADLs) or Instrumental Activities of Daily Living (IADLs).

Categorical Eligibility

Individuals receiving Supplemental Security Income (SSI) are often categorically eligible for Regular Medicaid (ABD), bypassing some income and asset tests.

Income Limits for Mississippi Medicaid

Income limits vary by program and household status. Below are the 2025 income limits for Mississippi, based on federal guidelines and DOM policies, expressed as monthly amounts.

Additional Notes on Income Limits

• Seniors/Disabled (Nursing Home/HCBS): Mississippi is an income cap state, requiring income under $2,901/month (single) or $5,802/month (couple). Excess income must be redirected into a Qualified Income Trust (QIT, or Miller Trust) to meet eligibility, with most income going toward care costs except for a $44/month Personal Needs Allowance, Medicare premiums, and a possible Needs Allowance for a non-applicant spouse.
• Married, One Spouse Applying: Applicant’s income limit is $2,901/month; non-applicant spouse’s income is not counted. The non-applicant may receive a Monthly Maintenance Needs Allowance (MMNA) of up to $3,948/month if their housing and utility costs exceed $793.13/month (effective 7/1/25–6/30/26).
• Children: Income limits vary by age, with higher thresholds for infants (194% FPL) than older children (133% FPL). A 5% FPL disregard applies.
• Pregnant Women: Coverage extends 12 months postpartum, with limits up to 194% FPL ($2,596/month for one).
• Parents/Caretakers: Very low income limit (22% FPL, $292/month for one), contributing to Mississippi’s coverage gap for adults without ACA expansion.
• CHIP: Covers uninsured children up to 209% FPL ($2,791/month for one).

2025 Federal Poverty Level (FPL) Guidelines for Reference (48 States & D.C.)

Note: Use the FPL Calculator to estimate your household’s FPL percentage.

Asset Rules for Mississippi Medicaid

Asset limits apply primarily to long-term care and ABD programs.

Long-Term Care Medicaid (Nursing Home and HCBS Waivers)

• Single Applicant: $4,000 in countable assets (e.g., bank accounts, stocks, bonds, secondary properties).
• Married, Both Applying: $6,000 total.
• Married, One Applying: $4,000 for the applicant; $157,920 for the non-applicant spouse (Community Spouse Resource Allowance, or CSRA).
• Home Equity Limit: $730,000 for the primary residence (if applicant/spouse resides there or intends to return).

Non-Countable Assets

• Primary home (if applicant/spouse resides there or intends to return)
• One vehicle (up to two in some cases)
• Household goods and personal effects
• Burial spaces or irrevocable burial funds (up to $6,000)
• Life insurance with a face value of $10,000 or less
• Medicaid Compliant Annuities

Medicaid’s Look-Back Rule

Mississippi enforces a 60-month look-back period for Nursing Home Medicaid and HCBS Waivers, reviewing asset transfers within 5 years of application. Transfers below fair market value (e.g., gifting) may result in a penalty period of ineligibility. No look-back period applies for Regular Medicaid.

Estate Recovery

Mississippi’s Medicaid Estate Recovery Program seeks reimbursement for long-term care costs after a beneficiary’s death, often targeting the home if not protected. Consult a Certified Medicaid Planner to safeguard assets.

Regular Medicaid (Aged, Blind, and Disabled)

• Asset Limit: $2,000 for an individual; $3,000 for a couple.
• No home equity limit or look-back period.

Medicaid for Children, Pregnant Women, and Parents/Caretakers

• No Asset Test: These programs focus solely on income.

Medical/Functional Requirements

For Nursing Home Medicaid and HCBS Waivers, applicants must demonstrate a Nursing Facility Level of Care (NFLOC), assessed through:

• Limitations in Activities of Daily Living (ADLs): Mobility, bathing, dressing, eating, toileting.
• Limitations in Instrumental Activities of Daily Living (IADLs): Cooking, shopping, managing finances.
• Cognitive or Behavioral Issues: E.g., Alzheimer’s or dementia, though diagnosis alone does not guarantee eligibility.

Regular Medicaid (ABD) requires proof of disability or blindness per Social Security Administration criteria but not necessarily NFLOC.

Changes Due to Federal Policy

As of 2025, federal policy changes may affect Medicaid:

• Work Requirements (Starting January 2027): May apply to parents/caretakers but not to seniors, disabled individuals, pregnant women, or children. Mississippi proposed work requirements in the past, which could resurface.
• Reduced Retroactive Coverage (Starting January 2027): Medicaid will cover only 2 months prior to application (down from 90 days), increasing potential medical debt for late applicants.
• More Frequent Eligibility Checks (Starting December 2026): Beneficiaries must renew eligibility every 6 months, requiring regular documentation to avoid coverage gaps.
• New Out-of-Pocket Costs (Starting October 2028): Non-exempt beneficiaries may face up to $35 per visit for specialist services or procedures, but primary care and preventive services remain free.

Options if Over the Income or Asset Limit

If your income or assets exceed the limit, consider:

• Qualified Income Trusts (QITs): Redirect excess income for Nursing Home or HCBS Waivers to meet the $2,901/month limit. The trust is irrevocable, and Mississippi Medicaid must be designated as the beneficiary upon the recipient’s death.
• Irrevocable Funeral Trusts (IFTs): Pre-paid funeral and burial expenses (up to $6,000) are exempt from asset limits.
• Spend Down: Convert countable assets into exempt ones (e.g., home repairs, purchasing a vehicle, or paying off debt). Mississippi does not offer a medically needy spend-down program for income.
• Certified Medicaid Planners: Professionals can help with financial strategies to achieve eligibility, such as Medicaid Compliant Annuities or asset restructuring.

Application Process

To apply for Mississippi Medicaid:

• Online: Use the AccessMS Portal at medicaid.ms.gov or the federal Marketplace at healthcare.gov. Check eligibility with the Medicaid Eligibility Calculator.
• Phone: Call the Mississippi Medicaid Office at 1-800-421-2408 for assistance.
• In-Person or Mail: Complete and submit an application to a local DOM Regional Office. Download the application from medicaid.ms.gov.
• Assistance: Contact the Mississippi Office of Consumer Services or a local Area Agency on Aging for program-related questions. Call 1-800-948-4060 for long-term care support.

Required documents include proof of income, assets, residency, citizenship, Social Security number, and medical records (for long-term care or disability programs). An interview may be required.

Processing Time

• Standard applications: Up to 45 days (90 days for disability-based applications).
• Expedited processing: May apply for urgent cases (e.g., pregnant women via presumptive eligibility for outpatient care).

Frequently Asked Questions

How do I apply for Medicaid in Mississippi?

Apply online at medicaid.ms.gov or healthcare.gov, by phone at 1-800-421-2408, in person at a DOM Regional Office, or by mail with a downloaded application from medicaid.ms.gov.

What are the 2025 Medicaid income limits for Mississippi?

For seniors/disabled (Nursing Home/HCBS), the limit is $2,901/month (single) or $5,802/month (couple). Regular Medicaid (ABD) is $967/month (single) or $1,450/month (couple). Children qualify up to 194% FPL ($2,596/month for infants), pregnant women up to 194% FPL ($2,596/month for one), parents/caretakers up to 22% FPL ($292/month for one), and CHIP up to 209% FPL ($2,791/month for one).

Are there asset limits for Mississippi Medicaid?

Yes, for long-term care: $4,000 (single), $6,000 (couple, both applying), or $157,920 for a non-applicant spouse. For Regular Medicaid (ABD): $2,000 (single), $3,000 (couple). No asset tests for children, pregnant women, or parents/caretakers.

What is the Medicaid look-back period in Mississippi?

A 60-month look-back period applies to Nursing Home Medicaid and HCBS Waivers, penalizing asset transfers below fair market value. No look-back for Regular Medicaid.

Can I qualify for Medicaid if my income or assets are too high?

Yes, through Qualified Income Trusts (QITs), Irrevocable Funeral Trusts (IFTs), or spending down assets on exempt items. Mississippi does not offer a medically needy spend-down program for income. Consult a Certified Medicaid Planner for assistance.

Why doesn’t Mississippi cover more adults?

Mississippi has not expanded Medicaid under the ACA, so non-disabled, non-elderly adults without dependent children are ineligible unless they meet other categorical requirements, creating a coverage gap.

This guide is based on 2025 federal and Mississippi Division of Medicaid guidelines. Verify details with the Mississippi Medicaid program for accuracy.