Coverage gap: Mississippi has not expanded Medicaid. Adults earning below $15,960/year (100% FPL) who don't fit traditional categories may have no affordable coverage option. Those above 100% FPL qualify for 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 | $15,960 | N/A | $63,840 |
| 2 | $21,640 | N/A | $86,560 |
| 3 | $27,320 | N/A | $109,280 |
| 4 | $33,000 | N/A | $132,000 |
| 5 | $38,680 | N/A | $154,720 |
| 6 | $44,360 | N/A | $177,440 |
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.
About Mississippi Medicaid
Who Qualifies in Mississippi
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 You're Near the Income Line
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.
What Mississippi Medicaid Covers
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.
Options in the Coverage Gap
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.
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 for a Silver plan after subsidies, based on the $570/month benchmark:
| Income Level | Annual Income | Your Cost | Monthly Subsidy |
|---|---|---|---|
| 150% FPL | $23,940 | ~$80/mo | $490/mo |
| 200% FPL | $31,920 | ~$173/mo | $397/mo |
| 250% FPL | $39,900 | ~$277/mo | $293/mo |
| 300% FPL | $47,880 | ~$392/mo | $178/mo |
| 400% FPL | $63,840 | ~$523/mo | $47/mo |
These estimates are for a 40-year-old individual on a benchmark Silver plan in Mississippi. Actual premiums depend on your age, household size, tobacco use, and plan choice. Households with income between 100-250% FPL also qualify for cost-sharing reductions (CSR) on Silver plans, which lower deductibles and copays. Mississippi uses the federal marketplace at HealthCare.gov.
How to Get Coverage in Mississippi
Your path depends on your income:
- Income above $15,960/year (100% FPL): You qualify for marketplace subsidies. Apply through HealthCare.gov during open enrollment (Nov 1 – Jan 15) or after a qualifying life event.
- Income below $15,960/year: Check if you qualify for traditional Medicaid (children, pregnant women, disabled). Apply through Mississippi Medicaid.
- Children: Mississippi's CHIP program covers kids in families 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.
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?
Mississippi residents with household income between 100% and 400% FPL ($15,960 to $63,840 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 $15,960/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.