How to Apply for Mississippi Medicaid Health Benefits
There are multiple ways you can apply for Mississippi Medicaid Health Benefits:
| APPLY | RESOURCE | INSTRUCTION |
|---|---|---|
| Online | Access.ms.gov | Mississippi’s Common Web Portal is a convenient way to:
|
| By Fax | 601-576-4164 | Print the correct application below and submit by fax. |
| By Mail | 550 High Street, Suite 1000 Jackson, MS 39201 |
Print the correct application below and submit by mail. |
| In Person | Regional Office | Visit one of our 30 regional offices. |
| Phone Assistance | 800-421-2408 | Call our Contact Center to request an application be mailed and for any questions on submitting an application. |
* Account Required
Applications:
- MAGI Application Form (Application in Spanish): Use this application to apply for children, pregnant women, low-income parents of children under age 18 and anyone in your family that needs to apply for health coverage.
- ABD Application Form (Application in Spanish): Use this application to apply for Medicaid due to age, blindness or disability.
- Family Planning Application Form (Application in Spanish): Use this application if you are age 13-44, have not had any surgery to prevent reproduction, and are applying for family planning services only.
When submitting an application, please be sure to have the following:
- Social Security Numbers or document numbers for legal immigrants who need insurance.
- Dates of birth for each person applying.
- Employer and income information for each person in the family with income. 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.
- Policy numbers for any current health insurance.
- Information about any job-related health insurance available to your family.
