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Healthy Mississippi Institutional (PPO I-SNP) H1823-003 • 2027 • Madison County, MS

CMS Rating: Not yet rated by CMS.
Monthly Premium
$6.30Plus Part B premium.
Medical Deductible
$900
Maximum Out-of-Pocket
$9250.00In-network
Part B Giveback
Not offered
Prescription Coverage
Enhanced, $700.00 deductible
Additional Benefits
Dental, Vision, Hearing
Service Area
Madison County, MS
Local Enrollment
0 beneficiaries in Madison County
Last update:

Introduction

Healthy Mississippi Institutional is a Medicare Advantage Institutional Special Needs Plan (I-SNP) offered by Healthy Mississippi. The plan uses a Preferred Provider Organization (PPO) provider network and includes Medicare Part D prescription drug coverage. For the 2027 plan year, it has a $6.30 monthly premium, $900 medical deductible, and $9250.00 in-network maximum out-of-pocket. CMS Plan ID H1823-003 identifies this plan. The 2027 Part D prescription drug deductible is $700.00.

This plan is available to eligible residents of Madison County, Mississippi. CMS reports 0 beneficiaries enrolled in this plan in Madison County. For assistance with this plan, new members can call (833)201-6413 (TTY (800)582-2233).

Eligibility

Healthy Mississippi Institutional is a Hybrid Institutional (HI-SNP) plan for individuals that require nursing care.

Special Needs Plan Type
Institutional Special Needs Plan (I-SNP)
Medicare Requirement
Must have Medicare Part A and Part B
Special Needs Requirement
This plan accommodates individuals in a long-term care facility. It is also available to people who need the level of care given in a long-term care facility who can remain at home or live in an assisted living facility.
Service Area Requirement
Must live in the plan's service area
Prescription Drug Coverage
Medicare Part D prescription drug coverage is included.

Compare Similar Plans in Madison County

No other PPO I-SNP plans are available in Madison County, Mississippi using the same plan-type comparison criteria.

Plan Benefits

Healthy Mississippi Institutional has cost-sharing, meaning there are out-of-pocket costs when receiving covered healthcare services. The tables below detail the most common in-network out-of-pocket expenses for plan H1823-003.

You can also compare 2027 costs and coverage with last year, side-by-side: Plan H1823-003-0 Cost Compare.

Office Visits

Primary care
In-network: $0 copay
Out-of-network: 30% coinsurance
Specialist
In-network: 0%-20% coinsurance
Out-of-network: 30% coinsurance

Preventive and Wellness Services

Annual wellness exam
In-network: 0% coinsurance
Out-of-network: 30% coinsurance
Telehealth benefit
In-network: 0%-20% coinsurance
Routine chiropractic
Not covered
Fitness benefits
Coming soon
Health education
Not covered
Counseling services
Not covered
Over-the-counter drug benefits
In-network: $0 copay
Out-of-network: 50% coinsurance
Health transportation (non-emergency)
Coming soon

Diagnostic, Lab, and Imaging Services

Diagnostic radiology services
In-network: 20% coinsurance
Out-of-network: 30% coinsurance
Lab services
In-network: $0 copay
Out-of-network: $0 copay
Outpatient x-rays
In-network: 20% coinsurance
Out-of-network: 30% coinsurance
Diagnostic tests and procedures
In-network: 20% coinsurance
Out-of-network: 30% coinsurance

Emergency and Urgent Care Services

Emergency room care
20% coinsurance
Worldwide emergency care
Coming soon
Urgent care
20% coinsurance
Inpatient hospital care
In-network:
Tier 1
$0 per day for days 1-60
$434 per day for days 61-90
$868 per day for days 91-150
Out-of-network:
$0 per day for days 1-60
$434 per day for days 61-90
$868 per day for days 91-150
Skilled Nursing Facility
In-network:
Tier 1
$0 per day for days 1-100
Out-of-network:
30% per stay
Ground ambulance
In-network: 20% coinsurance
Out-of-network: 20% coinsurance

Mental Health Services

Outpatient individual therapy
In-network: 0%-20% coinsurance
Out-of-network: 30% coinsurance
Outpatient group therapy
In-network: 0%-20% coinsurance
Out-of-network: 30% coinsurance
Inpatient psychiatric hospital care
In-network:
Tier 1
$0 per day for days 1-60
$434 per day for days 61-90
$868 per day for days 91-150
Out-of-network:
$0 per day for days 1-60
$434 per day for days 61-90
$868 per day for days 91-150

Rehabilitation Services

Physical therapy and speech and language therapy
In-network: 0%-20% coinsurance
Out-of-network: 30% coinsurance
Occupational therapy
In-network: 0%-20% coinsurance
Out-of-network: 30% coinsurance

Medical Equipment and Supplies

Diabetes supplies
In-network: 0% coinsurance
Out-of-network: 30% coinsurance
Durable medical equipment
In-network: 20% coinsurance
Out-of-network: 30% coinsurance
Prosthetics
In-network: 20% coinsurance
Out-of-network: 30% coinsurance

Medicare Part B Drugs

Chemotherapy
In-network: 0%-20% coinsurance
Out-of-network: 30% coinsurance
Other Part B drugs (Medicare-covered)
In-network: 0%-20% coinsurance
Out-of-network: 30% coinsurance

Dental Services

Oral exam
In-network: $0 copay
Out-of-network: 50% coinsurance
Dental x-rays
In-network: $0 copay
Out-of-network: 50% coinsurance
Cleaning
In-network: $0 copay
Out-of-network: 50% coinsurance
Periodontics
In-network: $0 copay
Out-of-network: 50% coinsurance
Endodontics
In-network: $0 copay
Out-of-network: 50% coinsurance
Restorative services
In-network: $0 copay
Out-of-network: 50% coinsurance
Implant services
Not covered
Orthodontics
Not covered
Oral/Maxillofacial surgery
In-network: $0 copay
Out-of-network: 50% coinsurance

Vision Services

Routine eye exam
In-network: $0 copay
Out-of-network: 50% coinsurance
Contact lenses
In-network: $0 copay
Out-of-network: 50% coinsurance
Eyeglass frames only
In-network: $0 copay
Out-of-network: 50% coinsurance
Eyeglass lenses only
In-network: $0 copay
Out-of-network: 50% coinsurance
Eyeglasses (frames & lenses)
In-network: $0 copay
Out-of-network: 50% coinsurance
Upgrades
In-network: $0 copay
Out-of-network: 50% coinsurance

Hearing Services

Hearing exam
In-network: $0 copay
Out-of-network: 50% coinsurance
Fitting/evaluation
In-network: $0 copay
Out-of-network: 50% coinsurance
Prescription hearing aids
In-network: $0 copay
Out-of-network: 50% coinsurance
OTC hearing aids
Not covered

Additional and Special Needs Services

Adult day health services
Not covered
Home-based palliative care
Not covered
Personal emergency response system
Coming soon
Weight management programs
Not covered
Wigs for chemotherapy-related hair loss
Coming soon
Alternative therapies
Not covered
Massage therapy
Not covered
Home/bathroom safety devices
In-network: $0 copay
Out-of-network: 50% coinsurance

Certain preventive services are covered 100% by Healthy Mississippi Institutional as a Part B benefit.

Prescription Drug Coverage

Healthy Mississippi Institutional includes a Medicare Part D prescription drug plan (PDP). Plan type and coverage level are defined by CMS and may vary between basic and enhanced benefit designs.

Prescription Drug Plan Premium

The Part D prescription drug plan premium is included in the overall Medicare Advantage plan cost. Additional adjustments may apply through the Low-Income Subsidy (LIS) program, also known as Extra Help, administered by Social Security. LIS benefits are separate from Medicare Special Needs Plan coverage.

Healthy Mississippi Institutional (H1823-003-0) Prescription Drug Plan Premium Details
Part D Premium Component Amount
Basic Part D Premium:$6.30
Supplemental Part D Premium:$0.00
Total Part D Premium:$6.30
Low-Income Premium Subsidy:$6.28
Low-Income Premium Subsidy Paid by CMS:$6.30
Low-Income Subsidy Premium:$0.00

For more details, visit the Social Security Extra Help program .

Prescription Drug Plan Deductible

This plan has a $700.00 annual Part D deductible. You'll pay this deductible at the pharmacy before Healthy Mississippi starts contributing towards your prescription costs.

Prescription Drug Plan Out-of-Pocket Costs

Beyond premiums and deductibles, Healthy Mississippi Institutional may have additional costs at pharmacies. The table below outlines out-of-pocket expenses by drug tier.

Healthy Mississippi Institutional (H1823-003-0) Pharmacy Out-of-Pocket Costs by Drug Tier
Drug Tier Retail Mail Order
Preferred Generic$0.00 copayNot available
Generic$0.00 copayNot available
Preferred Brand25% coinsuranceNot available
Non-Preferred Drug25% coinsuranceNot available
Specialty Tier25% coinsuranceNot available
*Deductible does not apply.

CMS 5-Star Performance Ratings (Contract ID: H1823)

Medicare assigns star ratings to plans based on quality and performance across multiple measures, including customer service, member experience, and health outcomes. Ratings are updated annually by the Centers for Medicare & Medicaid Services (CMS) and are shown on a 1 to 5 star scale, with 5 stars representing the highest quality.

2027 Medicare Star Ratings for Contract H1823
CMS Measure Star Rating
2027 Overall Rating ☆☆☆☆☆
Staying Healthy: Screenings, Tests, Vaccines {hd1}
Managing Chronic (Long Term) Conditions {hd2}
Member Experience with Health Plan {hd3}
Complaints and Changes in Plans Performance {hd4}
Health Plan Customer Service {hd5}
Drug Plan Customer Service {dd1}
Complaints and Changes in the Drug Plan {dd2}
Member Experience with the Drug Plan {dd3}
Drug Safety and Accuracy of Drug Pricing {dd4}

Contact Information for Healthy Mississippi

Website
Healthy Mississippi Plan Page
Providers
Healthy Mississippi Providers Page
Formulary
Healthy Mississippi Formulary Page
Pharmacy
Healthy Mississippi Pharmacy Page
New Member Health Plan Help
(833)201-6413
New Member Health Plan TTY
(800)582-2233
New Member Part D Help
(833)201-6413
New Member Part D TTY Users
(800)582-2233

Enrollment status and eligibility information are available through the Social Security Administration. Additional information about Medicare Advantage is available at Medicare.gov.

Medicare Plan Data Sources and Methodology
Primary CMS datasets used for this Medicare Advantage Plan resource.
Data Source Publisher CMS Version
Landscape Source Files Centers for Medicare & Medicaid Services CY2027 Landscape (202609.1)
Medicare Part C & D Performance Centers for Medicare & Medicaid Services 2027 Star Ratings Data Tables
Plan Benefits Package Centers for Medicare & Medicaid Services PBP Benefits-2027
Monthly Enrollment by Contract/Plan/State/County Centers for Medicare & Medicaid Services 2026-09

Data sources and methodology documentation.

Official plan information and secondary Medicare references.
Publisher Reference Last Accessed
Healthy Mississippi (official source) http://www.healthy-ms.com October 4, 2026
CMS.gov Institutional Special Needs Plans (I-SNPs) April 28, 2026
CMS.gov Medicare Advantage Plan Fact Sheet April 28, 2026
NCOA.org 5 Steps to Choosing the Right Medicare Plan for You April 28, 2026

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Provenance documentation for this data is maintained under the U.S. Core Data for Interoperability (USCDI) Provenance standard.