The Family Planning Waiver program is for women and men who receive Medicaid benefits limited to family planning services and family planning related services. This includes one annual visit and subsequent visits related to their birth control methods and family planning services. Beneficiaries cannot exceed a total of four visits per federal fiscal year (Oct. 1-Sept. 30). These beneficiaries are not eligible to receive any other Medicaid benefits.
Beneficiaries certified as eligible for family planning services and family planning related services must re-certify every year to remain eligible for the family planning waiver demonstration. Loss of eligibility will occur when beneficiary:
- Moves from the state of Mississippi
- Becomes eligible for another Medicaid aid category
- Becomes pregnant
- Reaches 45 years of age
- Has a procedure performed that prevents them from reproducing
- Obtains Medicare, CHIP, or any other health insurance or third party medical coverage
- Requests that their case be closed.
The Family Planning Waiver demonstration program originally began on Oct. 1, 2003 and the program was renewed on January 1, 2015.
Family Planning Waiver demonstration extension request
Pursuant to 42 C.F.R. Section 431.408, public notice is hereby given to the submission of a Medicaid proposed demonstration renewal request of the Family Planning Waiver (FPW), effective January 1, 2018 through December 31, 2022. The current, extension of the Mississippi Family Planning Waiver 1115 Research and Demonstration Waiver 11-W-00157/4 will expire on December 31, 2017. Learn more by reading the following documents:
- Family Planning Waiver demonstration extension request full public notice and application
- Family Planning Waiver demonstration application submitted to CMS Dec. 20,2016
Annual Post-Award Forum
Pursuant to 42 C.F.R. Section 431.420(c), public notice is hereby given to the annual Post-Award Forum on the Division of Medicaid’s Family Planning Waiver. The annual Post-Award Forum provides stakeholders and the general public the opportunity to provide meaningful comment on the progress of the Family Planning Waiver. The Family Planning Waiver operates under the authority of an 1115(a) waiver approved by the Centers for Medicare and Medicaid Services (CMS). The Post-Award Forum will be held from 10:30 a.m. to 12:00 noon on Tuesday, July 11, 2017, in room 145 at the Woolfolk Building, 501 N. West Street, Jackson, MS 39201. There will be an opportunity for public comment at the forum.
- Public Notice for the annual Post-Award Forum on the Family Planning Wavier
- Family Planning Waiver Demonstration Year 13 Annual Report
Who is Eligible for Family Planning?
Beneficiaries must meet the following eligibility criteria:
- Family income is at or below 194% of the federal poverty level (FPL)
- Must be capable of reproducing ages 13-44 years of age.
- Must not have had a procedure that prevents them from reproducing.
- Must not have Medicare, CHIP, or any other health insurance or third party medical coverage.
Family income must be at or below 194% of the federal poverty level (FPL).
The automated voice response system (AVRS) eligibility transaction response will identify these beneficiaries as eligible for family planning services only, in Medicaid Aid Category 029 (Family Planning).
Women and men who qualify will be issued a yellow Medicaid identification card to denote that they are in the Family Planning Waiver demonstration program.
Family Planning Waiver Resources
- Family Planning Waiver diagnosis and procedure codes
- Family Planning Waiver services application form
- Family Planning Waiver Special Terms and Conditions (STCs) approved by the Centers for Medicare and Medicaid Services
- Family Planning Waiver webinar presentation – Jan. 30, 2015
- Family Planning Waiver Demonstration 2015 Annual Report
- Family Planning Waiver Drugs Covered through Point of Sale (POS)
Effective January 1, 2015, beneficiaries enrolled in the Family Planning waiver demonstration program may have a prescription for contraceptives and/or medications to treat a sexually transmitted infection (STI)/sexually transmitted disease (STD) written by any Medicaid participating provider filled at their local Medicaid participating pharmacy.