Mississippi Medicaid Long Term Care Programs, Benefits & Eligibility Requirements

Summary
Medicaid’s rules, benefits and name can all vary by state. This article focuses on Mississippi Medicaid Long Term Care for seniors, which is administered by the Mississippi Division of Medicaid and will pay for care in a nursing home, a beneficiary’s home and other settings through one of three programs – Nursing Home Medicaid, HCBS Waivers or ABD Medicaid. This is different from regular Medicaid, which is for financially limited people of all ages.

 

Mississippi Medicaid Long Term Care Programs

Nursing Home / Institutional Medicaid

Mississippi Nursing Home Medicaid will cover the cost of long-term care in a nursing home for financially limited Mississippi seniors who require a Nursing Facility Level of Care. Coverage includes payment for room and board, as well as all necessary medical and non-medical goods and services, such as:

  • Personal care assistance with the Activities of Daily Living (mobility, bathing, dressing, eating, toileting)
  • Skilled nursing care
  • Physician’s visits
  • Prescription medication
  • Medication management
  • Mental health counseling
  • Social activities

Items not covered include a private room, specialized food, comfort items not considered routine (tobacco, sweets and cosmetics, for example) and any care services not considered medically necessary.

Mississippi Nursing Home Medicaid beneficiaries are required to give most of their income to the state to help cover the nursing home expenses. They are only allowed to keep a “personal needs allowance” (PNA) of $44/month, which can be spent on personal items such as clothes, snacks, books, haircuts, flowers, etc. They can also keep enough of their income to make Medicare premium payments if they are “dual eligible,” and enough to make any Medicaid-approved spousal income allowance payments to financially needy spouses who are not Medicaid applicants or recipients.

Mississippi Nursing Home Medicaid is an entitlement. This means all qualified applicants are guaranteed by law, aka “entitled,” to receive benefits without wait. However, not all nursing homes accept Medicaid, and those that do may not have any available spaces when you or your loved one needs care. So, eligible applicants are guaranteed nursing home coverage without wait, but they are not guaranteed coverage in any facility they choose.

 

Home and Community Based Services (HCBS) Waivers

Mississippi Home and Community Based Service (HCBS) Waivers will pay for long-term care services and supports that help financially limited Mississippi seniors who require a Nursing Facility Level of Care remain, or return to, living in the community instead of residing in a nursing home. The word “waiver” means something like voucher in this instance. Think of it as a voucher that will pay for long-term care services for Mississippi residents who live in their home, the home of a loved one, licensed personal care homes, state-approved assisted living residences, congregate housing, community residential care centers and TBI (traumatic brain injury) residential care facilities. While Mississippi’s HCBS Waivers will cover some long-term care services and supports in those settings, it will not cover room and board costs.

The HCBS Waivers relevant to Mississippi seniors are:

  1. Assisted Living (AL) Waiver – covers long-term care services and supports for seniors living in personal-care home-assisted living (PCH-AL) facilities
  2. Independent Living (IL) Waiver – covers long-term care services for seniors with severe neurological and/or orthopedic impairments
  3. Elderly and Disabled (E&D) Waiver – pays for long-term care services for seniors who live in their own home or the home of a loved one

1. Assisted Living (AL) Waiver
Mississippi’s Assisted Living (AL) Waiver delivers long-term care benefits to Mississippi seniors who require a Nursing Facility Level of Care but live in a personal-care home-assisted living (PCH-AL) facility. The following facilities qualify as a PCH-AL – licensed personal care homes, state-approved assisted living residences, congregate housing, community residential care centers and TBI (traumatic brain injury) residential care facilities. While the AL Waiver will provide long-term care services and supports in those settings, it will not cover room and board costs.

Benefits of the AL Waiver include intermittent skilled nursing services, medication management, therapeutic activities, homemaker services and personal care assistance with the Activities of Daily Living (mobility, bathing, dressing, eating, toileting). Benefits are intended to delay nursing home placement and will be made available depending on each AL Waiver beneficiary’s needs and circumstances.

Unlike Nursing Home Medicaid, HCBS Waivers are not an entitlement. Remember, entitlement means guaranteed by law. Instead, there are a limited number of enrollment spots for each waiver program, and once those spots are full, additional eligible applicants are placed on a waitlist. Mississippi’s AL Waiver had about 1,100 enrollment spots per year as of 2022.

2. Independent Living (IL) Waiver
Mississippi’s Independent Living (IL) Waiver provides long-term care services and supports to Mississippi Medicaid beneficiaries who require a Nursing Facility Level of Care due to severe neurological and/or orthopedic impairments. This includes Alzheimer’s disease and other related dementias, as well as arthritis and osteoarthritis.

IL Waiver beneficiaries can live in their own home or the home of a loved one. The IL Waiver can also be used by individuals who are currently residing in a nursing home, but want to and would be able to transition back to living in the community with the help of IL Waiver benefits.

IL Waiver benefits include home modifications, specialized medical equipment, transition assistance (such as paying for security deposits, utility set-up and moving expenses) and personal care assistance with the Activities of Daily Living (mobility, bathing, dressing, eating, toileting). These benefits can be provided by a licensed caregiver, but IL Waiver beneficiaries also have the option to self-direct some of their benefits by hiring a caregiver of their choice. This includes friends and family members, although spouses can not be hired.

Mississippi’s IL Waiver had roughly 5,700 enrollment spots per year as of 2022, and 25 of those were reserved for applicants who currently reside in a nursing home but want to transition back to living in the community. Once those spots are full, additional eligible applicants will be placed on a waitlist.

3. Elderly and Disabled (E&D) Waiver
Mississippi’s Elderly and Disabled (E&D) Waiver offers long-term care services and supports to Mississippi Medicaid beneficiaries who are age 65 or older and require a Nursing Facility Level of Care but live in their own home or the home of a loved one. The E&D Waiver can also be used by individuals who are currently residing in a nursing home, but want to and would be able to transition back to living in the community with the help of E&D Waiver benefits.

E&D Waiver benefits include home health visits from skilled nurses and home health aides, adult day care, meal delivery, therapy services (physical and speech), transition assistance (such as paying for security deposits, utility set-up and moving expenses) and personal care assistance with the Activities of Daily Living (mobility, bathing, dressing, eating, toileting).

Mississippi’s E&D Waiver had about 21,000 enrollment spots per year as of 2022, and approximately 150 of those were reserved for applicants who currently reside in a nursing home but want to transition back to living in the community. Once those spots are full, additional eligible applicants will be placed on a waitlist.

 

Aged, Blind, and Disabled Medicaid

Mississippi’s Aged, Blind and Disabled (ABD) Medicaid provides healthcare coverage and long-term care services and supports to Mississippi residents with limited financial resources who are aged (65 and over), blind or disabled and live in the community. ABD Medicaid can sometimes be referred to as regular Medicaid for seniors, but it should not be confused with the regular Medicaid that is available for low-income people of all ages. ABD Medicaid is an entitlement, which means that anyone who meets the requirements is guaranteed by law to receive healthcare coverage without wait. Access to long-term care benefits via ABD Medicaid depends on the availability of funds, programs and caregivers in the area where the beneficiary lives.

1. ABD Long Term Care Benefits
Eligible Mississippi seniors who show a medical need for long-term care services can receive those services through ABD Medicaid. These benefits can include in-home personal care, adult day care, meal delivery, home modifications and Personal Emergency Response Systems (PERS). ABD Medicaid recipients qualify for these benefits one at a time. This is different from Nursing Home Medicaid, which makes all of its benefits immediately available for anyone who qualifies. Instead, Mississippi seniors will be evaluated by the state to determine what kind of long-term care benefits they need and will receive.

2. Program of All-Inclusive Care for the Elderly (PACE)
PACE coordinates medical, social service and long-term care coverages into one comprehensive plan and delivery system for ABD Medicaid recipients, including Medicare coverage for those who are “dual eligible.” PACE also administers vision and dental care, and PACE day centers provide adult day care, meals, social activities and regular health checkups. PACE program participants are required to need a Nursing Facility Level of Care, but they must live in their home or somewhere else in the community. Although Mississippi does not have a PACE program of its own as of Jan. 1, 2024, four of its bordering states have programs – Louisiana, Arkansas, Alabama and Tennessee. While seniors can not use PACE programs (or receive any kind of Medicaid benefits) in other states, or transfer their Medicaid coverage from state to state, they can re-apply for Medicaid in a new state without any waiting period if they relocate. To learn more about PACE, click here.

 

Eligibility Criteria For Mississippi Medicaid Long Term Care Programs

To be eligible for Mississippi Medicaid, a person has to meet certain financial and functional (medical) requirements. The financial requirements vary by the applicant’s marital status, if their spouse is also applying for Medicaid, and what program they are applying for – Nursing Home / Institutional Medicaid, Home and Community Based Services (HCBS) Waivers or Aged, Blind, and Disabled (ABD) Medicaid.

  Just For You: The easiest way to find the most current Mississippi Medicaid eligibility criteria for one’s specific situation is to use our Medicaid Eligibility Requirements Finder tool.

 

Mississippi Nursing Home Medicaid Eligibility Criteria

Financial Requirements
Mississippi residents have to meet an asset limit and an income limit in order to be financially eligible for nursing home coverage through Mississippi Medicaid. For a single applicant in 2024, the asset limit is $4,000, which means they must have $4,000 or less in countable assets. Countable assets include bank accounts, retirement accounts, stocks, bonds, certificates of deposit, cash and any other assets that can be easily converted to cash. An applicant’s home does not always count as an asset (see the How Medicaid Treats the Home section below for more details), and there are other non-countable assets, like Irrevocable Funeral Trusts and Medicaid Compliant Annuities.

The 2024 income limit for Mississippi Nursing Home Medicaid for a single applicant is $2,829/month. Almost all income is counted – IRA payments, pension payments, Social Security benefits, property income, alimony, wages, salary, stock dividends, etc. COVID-19 stimulus checks and Holocaust restitution payments are not considered income. However, Mississippi Nursing Home Medicaid beneficiaries must give most of their income to the state to help cover the cost of nursing home care. They are only allowed to keep $44/month of their income as a “personal needs allowance,” plus enough to make Medicare premium payments if they are “dual eligible,” and they can make any allowable spousal income allowance payments to financially needy, non-applicant spouses.

For married applicants with both spouses applying, the 2024 asset limit for Mississippi Nursing Home Medicaid is a combined $6,000, and the income limit is a combined $5,658/month. For a married applicant with just one spouse applying, the 2024 asset limit is $4,000 for the applicant spouse and $154,140 for the non-applicant spouse, thanks to the Community Spouse Resource Allowance. The income limit is $2,829/month for the applicant. The income of the non-applicant spouse is not counted.

  Plan Ahead: There are alternative pathways to eligibility for Mississippi Nursing Home Medicaid applicants who don’t meet their financial limits, such as Medicaid Planning. However, applicants are not allowed to simply give away their assets in order to get under the asset limit. To make sure they don’t, Mississippi has a Look-Back Period of five years. This means the state will look back into the previous five years of the Nursing Home Medicaid applicant’s financial records to make sure they have not given away assets.

Functional Requirements
The functional, or medical, criteria for nursing home coverage through Mississippi Medicaid is needing a Nursing Facility Level of Care (NFLOC), which means the applicant requires the kind of full-time care that is normally associated with a nursing home. To determine level of care for Medicaid purposes, the state will conduct an assessment of applicants and their ability to complete the Activities of Daily Living (mobility, bathing, dressing, eating, toileting) and the Instrumental Activities of Daily Living (such as shopping, cooking, cleaning, scheduling). Cognitive impairments such as Alzheimer’s disease and other related dementias are also considered. A licensed social worker and a registered nurse will administer the assessment using the Long Term Services and Supports tool.

 

Mississippi Home and Community Based Services (HCBS) Waivers Eligibility Criteria

Financial Requirements
Mississippi residents have to meet an asset limit and an income limit in order to be financially eligible for Home and Community Based Services (HCBS) Waivers. For a single applicant in 2024, the asset limit for HCBS Waivers in Mississippi is $4,000, which means they must have $4,000 or less in countable assets. Countable assets include bank accounts, retirement accounts, stocks, bonds, certificates of deposit, cash and any other assets that can be easily converted to cash. An applicant’s home does not always count as an asset (see the How Medicaid Treats the Home section below for more details), and there are other non-countable assets, like Irrevocable Funeral Trusts and Medicaid Compliant Annuities.

The 2024 income limit for a single applicant is $2,829/month. Almost all income is counted – IRA payments, pension payments, Social Security benefits, property income, alimony, wages, salary, stock dividends, etc. COVID-19 stimulus checks and Holocaust restitution payments are not considered income.

For married applicants with both spouses applying, the 2024 asset limit for HCBS Waivers in Mississippi is a combined $6,000, and the income limit is a combined $5,658/month. For a married applicant with just one spouse applying, the 2024 asset limit is $4,000 for the applicant spouse and $154,140 for the non-applicant spouse, thanks to the Community Spouse Resource Allowance. The 2024 income limit is $2,829/month for the applicant, and the income of the non-applicant spouse is not counted.

  Plan Ahead: There are alternative pathways to eligibility for Mississippi HCBS Waivers applicants who don’t meet their financial limits, such as Medicaid Planning. However, applicants are not allowed to simply give away their assets in order to get under the asset limit. To make sure they don’t, Mississippi has a Look-Back Period of five years. This means the state will look back into the previous five years of the Nursing Home Medicaid applicant’s financial records to make sure they have not given away assets.

Functional Requirements
The functional, or medical, criteria for Home and Community Based Services (HCBS) Waivers through Mississippi Medicaid is needing a Nursing Facility Level of Care (NFLOC), which means the applicant requires the kind of full-time care that is normally associated with a nursing home. To determine level of care for Medicaid purposes, the state will conduct an assessment of applicants and their ability to complete the Activities of Daily Living (mobility, bathing, dressing, eating, toileting) and the Instrumental Activities of Daily Living (such as shopping, cooking, cleaning, scheduling). Cognitive impairments such as Alzheimer’s disease and other related dementias are also considered. A licensed social worker and a registered nurse will administer the assessment using the Long Term Services and Supports tool.

 

Mississippi Aged, Blind, and Disabled Medicaid Eligibility Criteria

Financial Requirements
Mississippi residents have to meet an asset limit and an income limit in order to be financially eligible for Aged, Blind, and Disabled (ABD) Medicaid. For a single applicant in 2024, the asset limit is $2,000, which means they must have $2,000 or less in countable assets. Countable assets include bank accounts, retirement accounts, stocks, bonds, certificates of deposit, cash and any other assets that can be easily converted to cash. An applicant’s home does not always count as an asset (see the How Medicaid Treats the Home section below for more details), and there are other non-countable assets, like Irrevocable Funeral Trusts and Medicaid Compliant Annuities.

The 2024 income limit for Mississippi ABD Medicaid for a single applicant is $943/ month. Almost all income is counted (IRA payments, pension payments, Social Security benefits, property income, alimony, wages, salary, stock dividends, etc.) other than COVID-19 stimulus checks and Holocaust restitution payments.

For married applicants, the 2024 asset limit for Mississippi’s ABD Medicaid is a combined $3,000, and the income limit is a combined $1,415/ month. This applies to married couples with both spouses applying or with just one spouse applying.

  Plan Ahead: There are alternative pathways to eligibility for ABD Medicaid applicants who are over the asset limit and/or the income limit, such as Medicaid Planning. While Mississippi has a Look-Back Period of five years for Nursing Home Medicaid and HCBS Waivers applicants to make sure they don’t give away their assets to get under the limit, the Look-Back Period does not apply to ABD Medicaid applicants. However, ABD applicants should be cautious about giving away their assets. They might eventually need Nursing Home Medicaid or HCBS Waivers, and those programs will deny or penalize the applicant for giving away assets.

Functional Requirements
The only functional requirements for Mississippi’s Aged, Blind, and Disabled (ABD) Medicaid are being disabled, blind or aged (65 or over). For ABD Medicaid applicants who require long-term care services and supports, Mississippi Medicaid will conduct an assessment of their ability to perform the Activities of Daily Living (mobility, bathing, dressing, eating, toileting) and the Instrumental Activities of Daily Living (such as shopping, cooking, cleaning and taking medications) to determine what kind of services the applicant needs and the state will cover.

 

How Mississippi Medicaid Treats the Home for Eligibility Purposes

One’s home is often their most valuable asset, and if counted toward Medicaid’s asset limit, it would likely cause them to be over the limit. However, in many situations the home is not counted against the asset limit:

  • If the applicant lives in their home and the home equity interest (the portion of the home’s equity value that the applicant owns minus any outstanding mortgage/debt) is less than $713,000 (as of 2024) then the home is exempt.
  • If the applicant’s spouse, minor child, or blind or disabled child of any age lives there, the home is exempt regardless of the applicant’s home equity interest, and regardless of where the applicant lives.
  • If none of the above-mentioned people live in the home, the home can be exempt if the applicant/beneficiary files an “intent to return” home and the home equity interest is at or below $713,000.

These rules apply to all three types of Medicaid, with one important exception – ABD Medicaid applicants can disregard the home equity limit. Value does not matter regarding their home’s exempt status. To learn more about the impact of home ownership on Medicaid eligibility, click here.

Mississippi Medicaid applicants and recipients may also want to consider protecting their home (and other assets) from estate recovery. States are required by law to try and collect reimbursement for long-term care after the death of Medicaid recipients. They do this through their Medicaid Estate Recovery Programs (MERPs). The rules and regulations regarding estate recovery can vary greatly by state, but all states have a MERP. To learn more about the MERP in Mississippi and how you can protect your home from it, click here.

 

Applying For Mississippi Medicaid Long Term Care Programs

The first step in applying for Mississippi Medicaid Long Term Care coverage is deciding which of the three Medicaid programs discussed above you or your loved one wants to apply for – Nursing Home Medicaid, Home and Community Based Service (HCBS) Waivers or Aged Blind and Disabled (ABD) Medicaid.

The second step is determining if the applicant meets the financial and functional criteria, also discussed above, for that Long Term Care program. Applying for Mississippi Medicaid coverage when not financially eligible will result in the application, and benefits, being denied.

During the process of determining financial eligibility, it’s important to start gathering documentation that clearly details the financial situation for the Mississippi Medicaid applicant. These documents will be needed for the official Medicaid application. Necessary documents may include tax forms, Social Security benefits letters, deeds to the home, proof of life insurance and quarterly statements for all bank accounts, retirement accounts and investments. For a complete list of documents you might need to submit with your Medicaid Long Term Care application, go to our Medicaid Application Documents Checklist.

After financial eligibility requirements are checked and double checked, documentation is gathered, and functional eligibility is clarified, Mississippi residents can apply online for many Medicaid programs at Access MS. However, there is no current online application process for ABD Medicaid, so those wishing to apply for that program can download the “Application for Mississippi Aged Blind and Disabled Medicaid Programs,” complete it and submit it to their regional Division of Medicaid office. They can also fax completed applications to 601-576-4164. They can also call the state Division of Medicaid at 800-421-2408 to request an application via the mail.

For step-by-step guides to applying for each of the 3 types of Medicaid Long Term Care, just click on the name: 1) Nursing Home Medicaid 2) HCBS Waivers 3) ABD Medicaid.

  Professional Help: Many seniors need support when it comes to Medicaid Long Term Care’s rules, benefits and application process. These are all complicated, constantly changing and vary by state. The best place to get help with Medicaid Long Term Care is through a professional like a Certified Medicaid Planner or an Elder Law Attorney.

 

Choosing a Mississippi Medicaid Nursing Home

After getting approved for nursing home coverage through Mississippi Medicaid, seniors need to choose which Medicaid-accepting nursing home best fits their needs. Even though Nursing Home Medicaid is an entitlement, not all nursing homes take Medicaid, and those that do might not have any available spaces. Finding the right nursing home can be a chore, especially if you’re looking in a specific area.

Mississippi has roughly 200 total nursing homes that accept Medicaid, and they are spread throughout the state. There are about 25 nursing homes that take Medicaid in and around Jackson, including the towns of Clinton, Madison and Brandon. There are a dozen or so nursing homes on the Gulf Coast within 25 miles of Biloxi, and another dozen within 25 miles of Tupelo in the northern part of the state.

Residents in some Mississippi communities may regularly cross the state line for personal or business reasons, including healthcare. Medicaid coverage, however, does not cross state lines. So, someone with Mississippi Medicaid would not be covered for nursing homes in Memphis, Tennessee, or Mobile, Alabama, even if facilities in those places are well-suited and convenient for the Mississippi resident.

 TOOLS: To find and compare nursing homes, Mississippi residents can use Nursing Home Compare, which is a search tool administered by the Centers for Medicare & Medicaid Services (CMS) that has information on more than 15,000 nursing homes across the country. They can also use this Mississippi State Department of Health search tool, which can be filtered by city, town or county.

When you’ve found nursing homes in your area that accept Medicaid, you can start comparing them, if you have multiple options. The search on Nursing Home Compare can be filtered by staffing, health inspections, quality measures and overall rating, which can be a good place to start. The healthcare professionals who work with you can be a great source of information. You can find out more information on Mississippi nursing homes by contacting your local Area Agency on Aging.

After doing some research, you or someone you trust should visit any nursing homes you’re considering before making a final decision. Call first to make an appointment for the visit, and arrive with a list of questions, like: Does the residence offer social activities? How does it help residents with vision and dental care? Who are the staff doctors? What is the food like? CMS has a comprehensive “Nursing home checklist” you can use to evaluate a nursing home while visiting.

CMS data shows that nursing homes in Mississippi have significantly fewer health deficiencies and fire safety deficiencies than the average American nursing home. Mississippi facilities averaged 12.6 health deficiencies that led to citations during a three-year time period from 2019-2022, while the national average was 25.7. And the fire safety numbers showed an even greater disparity: 1.7 vs. 13.5 fire safety deficiencies that led to citations from 2019-2022.