Medicaid Eligibility in Mississippi: Income Limits & How to Apply
Medicaid Eligibility in Mississippi
Mississippi remains one of the states that has not adopted Medicaid expansion under the ACA. Mississippi Medicaid only provides coverage for certain categories — primarily children, pregnant women, the elderly, and disabled individuals — leaving many low-income adults without affordable options.
Coverage gap in Mississippi: Adults earning below $15,650 per year (100% FPL for an individual) may fall into the coverage gap — too much income for traditional Medicaid but too little to qualify for ACA marketplace subsidies. An estimated hundreds of thousands of Mississippi residents are affected.
Without Medicaid expansion, coverage in Mississippi is generally limited to:
- Children in families with income up to 200-300% FPL (via CHIP)
- Pregnant women with income up to 185-200% FPL
- Parents with very low incomes (often well below 50% FPL)
- Seniors and people with disabilities meeting strict income/asset limits
- Adults in the coverage gap have limited options: community health centers, hospital charity care, and free clinics
About Mississippi Medicaid
If you're a Mississippi resident trying to understand your health coverage options, it's important to know that Mississippi has not expanded its Medicaid program. This means that, unlike many other states, Medicaid eligibility is quite limited for adults. You may qualify for Mississippi Medicaid if you are a child (up to 194% of the Federal Poverty Level (FPL) for infants, 143% FPL for children aged 1-6, and 133% FPL for children aged 6-19), a pregnant woman (up to 194% FPL, with postpartum coverage for 12 months), or an adult caring for dependent children if your household income does not exceed 24% of the FPL, which is one of the lowest thresholds in the country. Seniors and individuals with disabilities may also qualify, often with specific income and asset limits, such as a monthly income under $2,982 and assets under $4,000 for a single nursing home applicant in 2026. If you are a childless adult with an income below 100% FPL, you will likely fall into a "coverage gap," meaning you don't qualify for Medicaid and also won't be eligible for marketplace subsidies.
If your income is near the Medicaid cutoff, you might transition to marketplace coverage on HealthCare.gov. For example, if your income is above the Medicaid threshold but still relatively low (above 100% FPL), you could be eligible for significant subsidies to help pay for a marketplace plan. With a benchmark Silver plan in Mississippi costing around $570 per month, subsidies can drastically reduce what you actually pay. For instance, many adults eligible for marketplace coverage qualify for plans with zero premiums. It's crucial to remember that changes in your household income can shift your eligibility between Medicaid and marketplace subsidies, so if your financial situation changes, recheck your options. In 2024, Mississippi saw a decrease in Medicaid enrollment, and those who may have lost coverage during redetermination periods can reapply at any time if they believe they now qualify.
Mississippi Medicaid generally provides comprehensive benefits, and for those who qualify, cost-sharing is often minimal or nonexistent. For instance, if you have both Medicare and Mississippi Medicaid, you could have $0 monthly plan premiums and $0 deductibles, with Medicaid covering your cost-sharing amounts. Mississippi's program covered 664,600 people in 2023, representing 23.5% of the population. There are also specific waivers like the Healthier Mississippi Waiver for individuals aged 65 or older, or disabled with no Medicare, though this waiver has an enrollment cap of 6,000 individuals. For those who are dually eligible for Medicare and Medicaid, providers must accept the Medicare and Medicaid payment as payment in full, meaning you cannot be billed the difference.
If you find yourself in the coverage gap, meaning your income is too high for Mississippi Medicaid but too low for marketplace subsidies, you still have practical alternatives. Mississippi has a higher uninsured rate than the national average, with 10.5% of residents uninsured in 2023 compared to the national average of 7.9%. Community health centers throughout the state, such as Jackson Free Clinic, Mallory Community Health, and Oasis Health Center, often offer services on a sliding-scale fee based on your income. Many free clinics, like the Bethel Free Health Clinic in Biloxi and the Free Clinic of Meridian, provide medical care at no charge to uninsured adults who meet specific income criteria. Hospital charity care programs and county indigent programs may also be options. Remember, if your income rises above 100% FPL due to a new job or increased hours, you should recheck HealthCare.gov for potential marketplace subsidies.
Mississippi Medicaid Income Limits 2026
The following table shows the key income thresholds for Mississippi in 2026:
| Household Size | 100% FPL | 138% FPL | 400% FPL (Subsidy Limit) |
|---|---|---|---|
| 1 | $15,650 | N/A | $62,600 |
| 2 | $21,150 | N/A | $84,600 |
| 3 | $26,650 | N/A | $106,600 |
| 4 | $32,150 | N/A | $128,600 |
| 5 | $37,650 | N/A | $150,600 |
| 6 | $43,150 | N/A | $172,600 |
Because Mississippi has not expanded Medicaid, the 138% FPL threshold does not apply for adult eligibility. Adults earning between 0-100% FPL may fall into the coverage gap. Those earning between 100-400% FPL can access marketplace subsidies.
Mississippi's average benchmark premium of $570/month is near the national midpoint. For residents earning between 100-400% FPL, premium tax credits offset most of this cost.
Marketplace Insurance in Mississippi
Mississippi residents who do not qualify for Medicaid can purchase private health insurance through the federal marketplace at HealthCare.gov. The average benchmark (second-lowest cost Silver) plan in Mississippi costs approximately $570/month for a 40-year-old in 2026.
Premium tax credits (subsidies) are available for households with income between 100% and 400% FPL. Here is what a 40-year-old individual in Mississippi might pay after subsidies:
| Income Level | Annual Income | Expected Contribution | Estimated Monthly Premium |
|---|---|---|---|
| 150% FPL | $23,475 | 4.01% of income | ~$78/mo |
| 200% FPL | $31,300 | 6.52% of income | ~$170/mo |
| 250% FPL | $39,125 | 8.33% of income | ~$272/mo |
| 300% FPL | $46,950 | 9.83% of income | ~$385/mo |
| 400% FPL | $62,600 | 9.83% of income | ~$513/mo |
These are estimates for an individual. Actual premiums depend on your age, household size, tobacco use, and the specific plan you choose. Households with income between 100-250% FPL also qualify for cost-sharing reductions (CSR) on Silver plans, which lower deductibles and copays.
Residents of Mississippi shop for marketplace insurance through HealthCare.gov, the federal exchange. The application process screens for Medicaid eligibility first, so you'll be directed to Mississippi's program if you qualify.
Without Medicaid expansion, Mississippi has a significant coverage gap. Adults earning below 100% FPL who don't fit traditional Medicaid categories have few affordable coverage options. Community health centers and hospital charity care programs serve as the primary safety net.
How to Get Coverage in Mississippi
Since Mississippi has not expanded Medicaid, your path to coverage depends on your income level:
- Income above 100% FPL ($15,650+ for an individual): Apply through HealthCare.gov during open enrollment (November 1 - January 15) or after a qualifying life event. You will qualify for premium subsidies.
- Income below 100% FPL: Check if you qualify for traditional Medicaid categories (children, pregnant women, disabled). If not, look into community health centers, hospital financial assistance, and free clinics in your area.
- Children: Mississippi's CHIP program covers children in families with income up to 200-300% FPL regardless of expansion status.
Calculate Your Subsidy in Mississippi
Enter your income, age, and household size to see if you qualify for Medicaid or marketplace subsidies in Mississippi.
Check Your Eligibility →Frequently Asked Questions
What are Mississippi's Medicaid eligibility requirements?
Mississippi has not expanded Medicaid, so there is no standard income limit for adults. Traditional Medicaid covers specific groups (children, pregnant women, disabled, very low-income parents). Income limits for these groups vary. Children are generally covered up to 200-300% FPL through CHIP.
Does Mississippi have Medicaid expansion?
No, Mississippi has not expanded Medicaid. This creates a coverage gap for adults earning below 100% FPL who do not qualify for traditional Medicaid categories.
Am I eligible for health insurance subsidies in Mississippi?
Yes. Mississippi residents with household income between 100% and 400% FPL ($15,650 to $62,600 for an individual in 2026) qualify for premium tax credits that reduce the cost of marketplace health insurance. Apply through HealthCare.gov.
What is the name of Mississippi's Medicaid program?
Mississippi's Medicaid program is known as Mississippi Medicaid. It provides health coverage for eligible low-income residents including children, pregnant women, seniors, and certain other qualifying groups.
How do I keep my health insurance if I lose Medicaid in Mississippi?
If your Mississippi Medicaid coverage ends due to income changes or redetermination, you qualify for a Special Enrollment Period on the marketplace. This gives you 60 days to sign up for a private plan through HealthCare.gov. If your income is between 100-400% FPL, you'll likely qualify for subsidies to help cover the cost.
What are my options if I'm in Mississippi's Medicaid coverage gap?
If you're in the coverage gap (earning below $15,650/year but not qualifying for traditional Medicaid), look into community health centers in Mississippi that offer sliding-scale fees based on income. Many hospitals have charity care programs for uninsured patients. Free clinics and the 211 helpline can connect you with local resources. If your income changes, reapply — even small income increases could qualify you for marketplace subsidies.
What's stopping Medicaid expansion in Mississippi?
Medicaid expansion has been a politically contentious issue in Mississippi. The state legislature has not passed expansion legislation, leaving an estimated coverage gap for adults earning below 100% FPL. Advocacy groups continue to push for expansion, and several neighboring states have recently adopted it. Check with Mississippi's legislative updates for the latest status.
Medicaid Eligibility in Nearby States
- Alabama Medicaid Eligibility — Non-expansion state
- Arkansas Medicaid Eligibility — Expansion state
- Louisiana Medicaid Eligibility — Expansion state
- Tennessee Medicaid Eligibility — Non-expansion state