Medicare in Mississippi

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Mississippi Medicare Plans

In Mississippi, Medicare beneficiaries can obtain Medicare benefits in two ways, either through Original Medicare or through Medicare plans offered by private insurance companies approved by Medicare like Medicare Advantage plans, stand-alone Medicare Part D Prescription Drug Plans, and Medicare Supplement Plans.

For the 2019 Medicare coverage around 591,509 Mississippi residents were enrolled in Medicare that accounts for approximately 20% of the state’s population. In Mississippi 23% of Medicare beneficiaries are eligible because of disability, which is highest in the nation.

Original Medicare

Original Medicare is the federally-run program offering coverage to individuals of 65 years or older or younger individuals having certain disabilities, end stage renal disease. Medicare Part A covers hospital insurance and Medicare Part B covers medical insurance. Part A or hospital insurance coverage includes inpatient hospital care, skilled nursing facility care, limited home health care, and hospice care whereas Medicare Part B coverage includes outpatient services like doctor visits, preventive screenings, and durable medical equipment. Beneficiaries of Original Medicare are offered with the flexibility of choosing their healthcare providers and they are not limited to a network. Though, there is no limit on out-of-pocket medical expenses and the insured should pay 20% coinsurance for medical service costs. Original Medicare is administered and managed by the centers for Medicare & Medicaid Services, which is a division of the Department of Health and Human Services. All premium payments, claims and payouts are administered through CMS.

Medicare Advantage Plan in Mississippi

Medicare Part C or Advantage Plan is another Medicare health plan which residents may have as part of Medicare. These plans are offered by private companies approved by Medicare and by joining Medicare Advantage Plan, members get Medicare Part A and Part B coverage from Advantage Plan and not Original Medicare. Advantage Plans cover all the healthcare services covered by Original Medicare except for the hospice care. These plans may even offer extra coverage like dental, vision, hearing and wellness programs. Members of these plans need to pay a monthly premium for the plans in addition to their Part B premium. Private companies offering Advantage Plans are offered a fixed amount by the Medicare for the care of the members of the plans. The private companies have to abide by the rule of Medicare, though every Advantage plan can charge different out-of-pocket costs and have different rules for the members to receive healthcare services. Commonly in Mississippi there are four types of Medicare Advantage Plans namely, Health Maintenance Organization Plans, Preferred Provider Organization Plans, Private Fee-for-Service Plans, and Special Needs Plans.

Medicare Part D Prescription Drug Plan

Medicare Part D is the federally run program designed for offering prescription drug coverage and can be obtained either through a Medicare Advantage plan that offer this coverage or as a stand-alone Medicare Part D Prescription Drug Plan. Medicare Part D plans are stand-alone Prescription Drug Plans available through Medicare contracted private insurance companies. Beneficiaries can sign up for this plan if they like to add prescription drug coverage to their Original Medicare coverage. Since, prescription drug costs are not covered by Medicare Part A and Part B, this plan should be purchased by the majority of Mississippi residents. There are around 20 Medicare Part D Prescription Drug Plans available in Mississippi. About fifty-five percent of Medicare beneficiaries have stand-alone Medicare Part D prescription Drug Plans in Mississippi. In Mississippi there are 24 Medicare Part-D Plans available from nine different health insurance carriers.

Medigap Plans in Mississippi

Medicare beneficiaries who decide to stay with Original Medicare may sign up for a Medicare Supplement Plan that help them pay for out-of-pocket costs of Original Medicare. There are ten standard Medigap plans in Mississippi that pay for different amount of these costs like coinsurance, copayments, and deductibles. Medigap only works with Original Medicare and beneficiaries cannot use these plans to pay for Medicare Advantage costs. Medigap or Medicare Supplement Plans differ from other private Medicare plans as there is no open enrollment window for Medigap plans. Residents of this state instead are provided with a single six-month guaranteed-issue window that begins when residents are of 65 years age and are enrolled in both Part A and Part B. As per the federal rules people under 65 and enrolled in medicare due to a disability so not have guaranteed access to Medigap plans but Mississippi is one of the states, which have implemented rules to provide at least some access to Medigap coverage for people under 65 years of age. Insurance carriers have to offer all their Medigap plans to disabled enrollees, though they can charge higher premiums.

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