At a glance: Medicare health insurance in Mississippi
- Of Mississippi’s Medicare beneficiaries, 23 percent are eligible due to a disability, rather than age.
- Only 16 percent of Mississippi Medicare beneficiaries had Medicare Advantage plans as of 2017
- In Mississippi, 99 insurers offer Medigap plans, and insurers are required to offer all plans to beneficiaries under age 65.
- Nearly 55 percent of Mississippi Medicare beneficiaries have stand-alone Medicare Part D prescription drug plans.
- Per-enrollee Original Medicare spending in Mississippi is the fourth-highest in the nation.
Medicare enrollment in Mississippi
As of November 2018, there were 591,509 Mississippi residents enrolled in Medicare. That amounts to almost 20 percent of the state’s population, compared with a little more than 18 percent of the United States population enrolled in Medicare.
Most people become eligible for Medicare when they turn 65, but Medicare eligibility is also triggered once a person has been receiving disability benefits for 24 months. Nationwide, 16 percent of all Medicare beneficiaries are eligible due to disability, but 23 percent of Mississippi Medicare beneficiaries are eligible because they’re disabled. This is the highest rate in the nation, although Mississippi is tied with Alabama and Kentucky, both of which also have 23 percent of their Medicare beneficiaries eligible due to disability.
Medicare Advantage in Mississippi
As of 2017, only 16 percent of Medicare beneficiaries in Mississippi had selected Medicare Advantage plans, compared with an average of 33 percent nationwide. The large majority of Mississippi Medicare beneficiaries had opted for Original Medicare instead.
There are Medicare Advantage plans for sale in all 82 counties in Mississippi in 2019, although the number of available plans varies widely across the state: Some counties have only four plans from which to choose, while others have as many as 21.
During the Medicare annual election period (October 15 to December 7), Medicare beneficiaries can switch between Medicare Advantage and Original Medicare (and can add or drop a Medicare Part D prescription plan), with their coverage changes effective January 1. As of 2019, Medicare Advantage enrollees also have the option to make coverage changes during the Medicare Advantage open enrollment period (January 1 to March 31) during which they can switch to a new Medicare Advantage plan or drop their Medicare Advantage plan and enroll in Original Medicare instead.
Medigap in Mississippi
More than half of Original Medicare beneficiaries have employer-sponsored insurance or Medicaid to supplement their Medicare coverage. But for those who don’t, Medigap plans (also known as Medicare supplement plans) will cover some or all of the out-of-pocket costs for Medicare coinsurance and deductibles that the enrollee would otherwise have to pay themselves. Original Medicare does not cap out-of-pocket costs, and coinsurance and deductibles can add up quickly.
Medigap plans are sold by private insurers, but are standardized under federal rules, with ten different plan designs (differentiated by letters, A through N). The benefits of a particular plan (Plan A, Plan F, etc.) are the same from one insurer to another, making it fairly easy for consumers to compare plans (the plans will differ on things like price and customer service).
Medigap plans differ from other private Medicare coverage (Medicare Advantage and Medicare Part D plans) in that there is not an annual open enrollment window for Medigap. Instead, people are given a single six-month guaranteed-issue window that begins when they are at least age 65 and enrolled in Medicare Part B (you have to be enrolled in both Part A and Part B to buy a Medigap plan).
Federal rules do not guarantee access to Medigap plans for people who are under 65 and enrolled in Medicare due to a disability. But Mississippi is one of the majority of the states that have implemented rules to ensure at least some access to Medigap coverage for people under age 65. As explained in the state guide to Medicare supplement plans, people who become eligible for Medicare under the age of 65 are granted the same six-month open enrollment window for Medigap as people who gain eligibility for Medicare when they turn 65. Insurers have to offer all of their Medigap plans to disabled enrollees, but the premiums can be higher — the state notes that they can be up to 50 percent higher than the rates that apply to people who are 65 years old. A disabled beneficiary under age 65 will have another Medigap open enrollment period upon turning 65, allowing them the option to switch plans and enroll at a lower price than they were paying before turning 65.
It’s important to understand that although pre-existing conditions are no longer an issue in most of the private health insurance market as a result of the Affordable Care Act, those regulations don’t apply to Medigap plans. When you enroll in a Medigap plan, the insurer can impose a pre-existing condition waiting period of up to six months, if you didn’t have at least six months of continuous coverage prior to your enrollment. And if you apply for a Medigap plan after your initial enrollment window closes (and assuming you aren’t eligible for one of the limited guaranteed-issue rights), the insurer can use your medical history to determine your eligibility for coverage and your premium amount.
Medicare Part D in Mississippi
Original Medicare does not cover for outpatient prescription drugs. Again, more than half of Original Medicare beneficiaries have supplemental coverage from Medicaid or an employer-sponsored plan, and these plans often include prescription coverage. But Medicare beneficiaries who don’t have such coverage need to obtain prescription coverage under a Medicare Medicare Part D plan. These can be purchased as stand-alone coverage, or as part of a Medicare Advantage plan that includes Part D prescription drug coverage.
There are 24 stand-alone Part D plans for sale in Mississippi in 2019, with premiums that range from about $11 to $100/month.
324,689 Mississippi Medicare beneficiaries (almost 55 percent of the state’s total Medicare population) had stand-alone Part D plans as of late 2018. Another 103,323 had Part D prescription coverage integrated with their Medicare Advantage plans.
Medicare spending in Mississippi
In 2016, Original Medicare’s per-beneficiary spending in Mississippi averaged $10,704 (based on data standardized to eliminate regional differences in payment rates, but not including Medicare Advantage costs).
Nationwide, average per beneficiary Original Medicare spending was $9,533 per enrollee, so Medicare spending in Mississippi was about 12 percent higher than average. Mississippi was one of only six states where per-beneficiary Medicare spending exceeded $10,000; 0nly Texas, Louisiana, and Florida had higher average costs than Mississippi. Louisiana had the highest average per-beneficiary Original Medicare spending, at $11,399, while Hawaii had the lowest, at just $6,441.
You can read more about Medicare in Mississippi in our state Medicare guide. You can also contact the Mississippi Health Insurance Assistance Program (SHIP), with questions related to Medicare coverage in Mississippi. The Mississippi Insurance Department has an information brief about Medicare that provides a helpful overview for state residents who are covered by Medicare or will be soon.
Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org. Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.