Medicare Advantage Plans In Mississippi

Fact Checked
Published: 5/23/2021

When you join Medicare, you have the option of enrolling in the federal government's Original Medicare program or a Medicare Advantage Plan through a private insurer. Original Medicare, known as Parts A and B, helps to pay for medically necessary services such as physician visits, diagnostic tests, surgeries, and inpatient hospital stays. Medicare Advantage coverage includes the same services as Original Medicare plus supplemental benefits such as vision, dental, hearing, fitness, and prescription drugs.

  • In 2019, there were 26 Medicare Advantage Plans available in Mississippi.
  • 17% of the total Medicare population in Mississippi is enrolled in Medicare Advantage Plans as of 2018.
  • In 2018, Original Medicare spent an average of $ $11,427 per beneficiary in Mississippi, which is 13% higher than the national average.
  • Available Medicare Advantage Plans range from 4 to 28 across Mississippi’s 82 counties.

Medicare Advantage Plans are designed to offer you choices in how you receive your health care, so be sure to shop around to find one that matches your needs and preferences. Some plans may require you to have a primary care doctor or limit which health care providers you can see. Plans also differ in terms of premiums, deductibles, copays, and benefits. Knowing the differences between how plans are structured can help you narrow your choices.

Medicare Advantage Plans in Mississippi

Types of Medicare Advantage Plans

Companies offering Medicare Advantage programs are contracted by the federal government to ensure they meet certain standards. The plans must cover Part A and B expenses, but otherwise, insurers have some flexibility in how they deliver benefits. Mississippi’s Medicare Advantage program includes four main types of plans, although not all may be available in your service area.

Health Maintenance Organizations (HMO)

With an HMO plan, you’re receiving health care through the doctors, hospitals, and facilities that form the HMO’s network of providers. Typically, services you receive outside of the network aren’t covered. You must select a primary care doctor to oversee your care and refer you to specialists.

Preferred Provider Organizations (PPO)

Similar to an HMO, a PPO has a network of preferred providers. With this type of plan, you can use any doctor or hospital that you wish, but it’s less costly to use the plan’s preferred providers. You can also guide your own health care — you don’t need a primary physician or referrals to see specialists.

Private Fee-For-Service Plans (PFFS)

PFFS plans establish the fees that are paid for services. While you don’t need a primary care doctor and can choose your health care providers, you do need to ensure your providers accept the plan’s fees before you’re treated. For example, your doctor may accept the plan’s rate for some services but not others. Some PFFS plans may have a network to make it easier for you to find providers that have agreed to the fees.

Special Needs Plans (SNP)

People with chronic illnesses can choose an SNP plan customized to meet their particular needs. There are SNPs for conditions such as diabetes, stroke, HIV/AIDS, heart disease, and lung disorders, and enrollment is limited to those with the specific condition. The plans usually have specialists in the field and require you to have a primary care physician to coordinate your treatments.

Enrollment and eligibility for Medicare Advantage Plans in Mississippi

Most Americans are automatically enrolled in Original Medicare (Parts A and B) when they turn 65 if they’re already receiving Social Security benefits. You may also qualify for Medicare if you’re younger than 65 and have a disability.

Once you have Part A and Part B coverage, you can remain in Original Medicare or receive your health care coverage through a Medicare Advantage Plan. You can only enroll in Medicare Advantage programs offered in your service area. Keep in mind that if you’re enrolled in a Medigap policy, you can’t also enroll in Medicare Advantage.

Enrollment Periods

There are certain times of year that you can make changes to your Medicare coverage if your plan isn’t meeting your needs.

  • Initial Enrollment: You can join a Medicare Advantage Plan during your initial enrollment period, which is when you first become eligible for Medicare. This period begins three months before the month you turn 65. It lasts for seven months, ending three months after the month you turn 65.
  • Open Enrollment: You can enroll in or change plans during Medicare’s open enrollment period, held annually from October 15 to December 7. These plans include Original Medicare, Medicare Advantage, Medigap, and Part D prescription drug plans. Your new coverage begins on January 1.
  • Medicare Advantage Enrollment Period: If you’re already in a Medicare Advantage Plan in Mississippi, you can switch to another Medicare Advantage Plan or return to Original Medicare during the Medicare Advantage enrollment period, between January 1 and March 31 of each year.
  • Special Enrollment: You may be eligible for a special enrollment period under certain circumstances. This includes moving outside of your current plan’s service area, losing your insurance coverage from an employer, no longer qualifying for a Special Needs Plan, or developing a chronic condition that makes you eligible for a Special Needs Plan.

New rules now allow individuals with end-stage renal disease to enroll in Medicare Advantage Plans as of 2021.

Prescription drug coverage

Private insurers also offer separate Medicare Part D prescription drug plans in Mississippi. These plans help offset the costs of your medication and can be added on to Original Medicare if you’re not enrolled in a Medicare Advantage Plan. Part D plans can’t be combined with some Medicare Advantage Plans, including HMO and PPO plans, so if you need drug coverage with Medicare Advantage, be sure to choose a plan that offers it. Part D plans can supplement some, but not all, Private Fee-For-Service plans, and all SNPs include drug coverage. Prescription drug coverage is optional with Medicare, but there are usually late, lifetime enrollment penalties if you add drug coverage after you’re first eligible.

Medicare Advantage Resources in Mississippi

Medicare can help make health care more affordable if you choose the right plan for your personal needs. There are several organizations in Mississippi that can help answer your Medicare questions and provide you with health insurance information.

Mississippi State Health Insurance Assistance Program (SHIP)

SHIP’s specially trained volunteers provide free, one-on-one Medicare counseling services to beneficiaries, caregivers, and their families. They can provide you with information about the different options available, answer questions, and help compare plans to find the right coverage. They can also assist with paperwork, including enrollment, claims, and appeals.

Contact Information: Website | 601-359-4500

Southern Mississippi Planning and Development District (SMPDD)

The SMPDD is the designated Area Agency on Aging. It offers a range of services to help older adults, including caregiver support, meal services, legal services, and information about health insurance.

Contact Information: Website | 228-868-2311

Mississippi Insurance Department

When it comes to health insurance, you have certain protections and benefits under the Affordable Care Act. The state insurance department has a customer service division that can help answer questions if you’ve purchased health insurance in Mississippi.

Contact Information: Website | 1-800-562-2957

Mississippi Division of Medicaid

This federal and state-run program helps ensure low-income residents in Mississippi can access health coverage. If you’re eligible for both Medicaid and Medicare, the programs can work together to help you lower your health care costs.

Contact Information: Website | 800-421-2408

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