Mississippi Health Insurance Guide
Mississippi Health Insurance Information, Health Organizations and Resources and access to online health insurance quotes
If you live in Mississippi you can choose from a variety of private health insurance plans including individuals and group plans provided by an employer. Depending on your income or employment status, you may also be eligible for Mississippi State-funded affordable health insurance for individuals and families, and federal programs such as Medicaid and COBRA.
Mississippi is not a guarantee issue state. That means private insurance companies are not required to sell you an individual health insurance policy if do not meet their underwriting criteria. You can be turned down for any number of reasons including your past or current health. If you are accepted, the insurer has the right to impose an exclusionary period up to 12 months for any pre-existing conditions and a 12-month look-back period, which can be exercised at anytime if you file a claim during the first two years that your policy is in effect. If a condition is deemed to be pre-existing, benefits can be denied. Mississippi allows elimination riders and insurers do not have to give credit for prior creditable coverage. Mississippi law does not set caps on what an insurer can charge for individual health care policies. Your individual Mississippi health insurance quote can be based on your age, sex, where you live, the plan you choose and your health.
Mississippi is a guarantee issue state for group health plans issued to small businesses. If your Mississippi health insurance is provided through your employer, your coverage cannot be denied because of your past or current health. However, a 12-month exclusionary period and 6-month look-back period for pre-existing conditions can be applied if you don’t have proof of prior creditable coverage. Mississippi allows group health insurance issuers to medically underwrite policies to determine the premium they will charge the entire group, although the highest premium cannot be more than 25% of the standard rate. Rates can be adjusted based on the nature of a business, its location and the size of the group. Under Mississippi law, insurers must guarantee issue small group plans to any self-employed person as a group of one, unless he or she can obtain coverage through another employer. For example, if you are self-employed part time and employed by another company part time, if that company offers health insurance for which you are eligible, you don’t qualify for the self-employed group plan.
Mississippi is a guaranteed renewal state. Regardless of your health, your insurer must renew your individual health insurance policy as long as you’ve paid your premiums on time and haven’t defrauded the company, or in the case of some HMOs, as long as you haven’t moved out of the service area. However, your premiums can be increased to reflect your current health status.
Mississippi Mandated Health Benefits
Mississippi laws require private health insurance policies to cover several state-mandated benefits. These currently include:
- Alcoholism
- Ambulance Services
- Breast Reconstruction
- Dental Anesthesia
- Diabetic Supplies
- Mammography
- Maternity Stays
- General and Parity Mental Health
- Off-Label Drug Use
- TMJ Disorder
- Well-Child Care
- Coverage for newborns under parent's policy
- Coverage for adopted children under parent's policy
- Coverage for handicapped dependents under parent's policy
- Coverage for continuation/dependents under their parents’ policies
- Coverage for continuation/employees
Plans Available in Mississippi
The following major medical health insurance plans are generally available in Mississippi. Major medical plans cover illness and injury, hospitalization, prescription drugs and office visits, as well as the mandated services stated above.
Indemnity plans - Typically the most flexible and therefore highest priced choice, an indemnity plan lets you select your health providers and facilities. Depending on your plan, you will have to pay a deductible or co-insurance.
Preferred provider organization plans (PPOs) - You select from a network of preferred health care providers and facilities, and receive services at an agreed-upon discounted rate. You also have the option of going outside the network, but typically at a higher cost. You do not need a referral from a primary care physician to see a specialist. Premiums may be less than an indemnity plan but more than an HMO. You will have to pay a deductible or co-insurance.
Health maintenance organizations (HMOs) - HMOs plans require you to select a primary care physician from a prescribed network of providers, who must issue a referral before you can see a specialist. Services and covered costs are typically more comprehensive than those provided by a PPO. HMOs offer the advantage of affordable premiums and low out-of-pocket costs, with an emphasis on preventive care. Non-emergency services out of network are usually not reimbursed.
Point of Service plans (POS) - Similar to a PPO in that you will receive reimbursement for out-of-network care, but with an HMO’s requirement for a primary care physician who must provide referrals to specialists. Premiums, co-pays and co-insurance are typically higher than what you’d pay with an HMO.
Alternative Health Programs in Mississippi
Mississippi Comprehensive Health Insurance Risk Pool Association
MCHIRPA provides health coverage to Mississippi residents who have lived in the state at least six months prior to applying. You are eligible if you cannot obtain health insurance in the private market because of pre-existing medical conditions. Other eligibility requirements may also apply. You can choose from one different plan with four annual deductible options ranging from $1,000 to $10,000. All options require you to pay a 20% coinsurance for most covered services. There are no out-of-pocket maximums. All plans also have separate deductibles for prescription drugs. Enrollment is open. Premiums are based on similar plans at the standard risk rate, Pre-existing conditions will involve a 12-month waiting period before benefits are payable, but waivers are available.
Regulating Agency
The Mississippi Insurance Department is responsible for regulating Mississippi’s health insurance industry.
Get access to Mississippi health insurance quotes from http://www.einsurance.com/health-insurance.
Mississippi Insurance Department
1001 Woolfolk State Office Building
501 N West St
Jackson, MS 39201
http://www.mid.state.ms.us
Mississippi Comprehensive Health Insurance Risk Pool Association (MCHIRPA)
PO Box 13748
Jackson, MS 39236
(888) 820-9400
http://www.mississippihealthpool.org/index.html
(NAIC) National Association of Insurance Commissioners
The National Association of Insurance Commissioners (NAIC) is the organization of insurance regulators from the 50 states, the District of Columbia and the five U.S. territories. The NAIC provides a forum for the development of uniform policy when uniformity is appropriate. NAIC members are the elected or appointed state government officials who along with their departments and staff regulate the conduct of insurance companies and agents in their respective state or territory.
http://www.naic.org/
Insurance Information Institute (I.I.I)
The mission of the Insurance Information Institute (I.I.I.) is to improve public understanding of insurance -- what it does and how it works.
Contact info:
110 William Street
New York, NY 10038
212-346-5500
http://www.iii.org/