Application Processing and Case Overview
Case Review
After you submit an application for Mississippi Medicaid health benefits, the regional office that serves your county of residence will be in contact with you by phone or you may get a letter regarding your eligibility determination. If something is incorrect, missing or needs clarification a regional office staff member will contact you.
Case Approval
If you are approved to receive health benefits, a letter and a blue Medicaid identification card will be mailed to you. Mississippi Medicaid has a large network of health care providers available for medical services. When you make an appointment be sure the provider you choose accepts Mississippi Medicaid.
You may be eligible for health benefits through a coordinated care program called Mississippi Coordinated Access Network (MississippiCAN). Those who are automatically qualified for this program will have the option of choosing between one of three Coordinated Care Organizations (CCO): Magnolia Health, UnitedHealthcare Community Plan and Molina Healthcare. Mandatory populations are not eligible for dis-enrollment.
Those individuals who qualify for this program in an optional population have the choice to either enroll in a CCO or choose to stay in the traditional Medicaid “fee-for-service” program.
The Children’s Health Insurance Program (CHIP) is currently administered by Molina Healthcare and UnitedHealthcare Community Plan.
Case Renewal
If you are eligible for Mississippi Medicaid health benefits and your case is approved, it will be reviewed on an annual basis. Near your renewal date you will receive a letter to review your personal information and have the opportunity to make changes. If anything needs to be updated, indicate the changes on the form and mail it back or notify your case worker.
Eligibility Hearings and Appeals
An eligibility hearing is an administrative process that you may ask for if you do not agree with a decision that has been made about your Medicaid eligibility. Beneficiaries/applicants are entitled to a fair hearing if they disagree with actions taken by the Division of Medicaid to deny, terminate or reduce services.
For more information regarding hearings, visit the Eligibility Hearing webpage.
Eligibility Hearings Contacts
The Office of Appeals is responsible for coordinating, scheduling, and facilitating appeals for Medicaid beneficiaries. Cases are heard by an impartial hearing officer employed by or on contract with the agency. If you have questions regarding fair hearings for Medicaid eligibility decisions, contact the Mississippi Division of Medicaid:
Toll-free: 800-421-2408
Phone: 601-359-6050
Or contact the regional office that serves your county of residence
If you have questions regarding fair hearings for Medicaid eligibility decisions that are part of a Supplemental Security Income (SSI) decision for the low income aged, blind or disabled, contact the Social Security Administration (SSA):
Toll-free: 800-772-1213
Social Security Administration website: http://www.ssa.gov
