Medicare in Mississippi

Medicare is a federal health insurance program for adults aged 65+ and younger individuals with qualifying disabilities. As of 2022, 65 million Americans have enrolled in Medicare, with seniors accounting for 57.3 million beneficiaries. Almost 618,000 of those reside in Mississippi, at an annual cost to the state of $4.9 billion. Medicare Advantage is less burdensome and Mississippians are adopting it in greater numbers than in most states. As of 2023, 39% of residents had purchased a plan, representing a 5% increase compared to 2022, yet remaining below the national average of 48%. However, there has been a 1.88% increase in eligible enrollees from 2022, indicating a growing pool of potential participants in Medicare Advantage Plans.

Original Medicare, known as Part A and Part B, is the foundation program. Part A covers essential services, such as blood transfusions, hospital stays, nursing home care and home health care. Part B covers outpatient services, including medical transportation, doctors’ visits and medical equipment or supplies. Most seniors don’t pay a premium for Part A, but Part B’s monthly premium is $164.90 as of 2023. Medicare Part D provides coverage for prescription drugs. Premiums vary as numerous factors affect costs, including the individual’s prescription and the tier their medications have been assigned. Medicare Supplement Insurance, known as Medigap, covers expenses Medicare won’t pay for, such as deductibles, copays and coinsurance. 

The Centers for Medicare and Medicaid Services (CMS) administer Original Medicare, while the private insurance companies it approves handle Medicare Advantage. Also known as Part C, this program blends the coverage provided by Parts A and B into a single plan, minus hospice care. Mississippians have a choice of 69 plans, eight more than in 2022. Premiums start at 0% but increase as the senior adds more coverage, such as prescription drugs, vision and dental care. As a result, Mississippi’s median monthly premium is $17.68, an 11.8% reduction from the previous year’s average. 

This guide considers Medicare options in Mississippi, including how seniors can get tailored coverage and financial advice. There’s also a list of nonprofits that can help beneficiaries get the most from Medicare.

Options for Medicare Coverage in Mississippi

The basic coverage under Original Medicare is adequate for many older adults. However, sometimes seniors need extra health care coverage. Fortunately, Mississippi’s aging population has several options regarding health insurance to ensure policies meet individual needs. Alongside the standard federal program, private insurance companies offer alternative plans or additional options for older adults.

Original Medicare (Parts A & B)

Original Medicare provides the same coverage nationwide, regardless of where the beneficiary lives. Consequently, seniors can access all eligible services, even if they become ill while vacationing or moving to another state. However, Medicare doesn’t pay for medical care delivered outside the country. The U.S. Department of State strongly advises citizens venturing abroad to purchase health insurance appropriate to their destination before traveling. 

Part A’s annual deductible for 2023 is $1,600, while Part B’s is $226. The beneficiary pays their medical care expenses upon receipt, with Medicare covering 80% of the eventual cost and the senior covering the remaining 20%.

Who Should Consider Original Medicare

Original Medicare may be a good option for those who:

• Travel frequently within the United States
• Don’t need extra benefits such as home-delivered meals and coverage for over-the-counter medication
• Want to choose their own prescription drug coverage

Medicare Advantage (Part C)

While Original Medicare is fixed, the appeal of Medicare Advantage is the flexibility of its plans. There are five of these:

• Health Maintenance Organization (HMO)
• Preferred Provider Organization (PPO)
• Private Fee-for-Service plans (PFFS)
• Special Needs Plans (SNPs)
• Medicare Savings Account (MSA)

Approved private insurance companies can mold and shape each of these plans to suit their customers’ coverage needs, so long as the plans conform to the rules and regulations set forth by the CMS. This ensures standards are at least equal to Original Medicare’s offering while also providing customers with more choices in regard to coverage. 

Who Should Consider Medicare Advantage

Part C Medicare plans may be appropriate for seniors who:

• Can’t meet their health needs through Original Medicare
• Are generally healthy and would benefit from decreased premiums
• Want greater predictability concerning personal medical expenses
• Are comfortable receiving managed care

The Top 10 Medicare Advantage Plans in Mississippi 

The following table details the top Medicare Advantage plans in Mississippi, showing the total number of enrollees and general costs each month per provider as of August of 2023. The table also shows the types of plans available. There’s more information about Medicare Part C on the Medicare Advantage Plans in Mississippi page.

Medicare Prescription Drug Coverage (Part D)

Original Medicare doesn’t pay for most prescription drugs through Part A or B coverage. Instead, seniors purchase separate prescription drug policies, also called Part D coverage. Medicare contracts with private health insurance companies to provide this coverage. There are multiple plans to choose from with varying monthly premiums, which beneficiaries pay in addition to their Original Medicare premiums. While seniors don’t have to purchase prescription drug coverage when they’re first eligible for Medicare, not obtaining this coverage at this time may result in late enrollment penalties they pay for as long as they have Medicare if they enroll later.

Each prescription drug plan has its own formulary, or list of covered drugs. Formularies are typically split up into tiers. The tier a medication is in determines how much the insurance company pays and how much the beneficiary pays for it. Lower-level tiers are usually made up of generic and low-cost brand name drugs, while higher tiers are composed of more expensive brand name and specialty drugs. In most cases, the lower the tier, the lower the policyholder’s cost-sharing responsibility.

Who Should Consider Medicare Prescription Drug Coverage

Seniors who may benefit from prescription drug coverage include those who:

• Currently take prescription medication or expect to in the future
• Want to avoid late enrollment penalties
• Want to reduce out-of-pocket prescription drug expenses

Medicare Supplement Insurance (Medigap)

While Original Medicare provides coverage for many medical costs, seniors may still have significant out-of-pocket expenses. These may include copays, coinsurance and deductibles. Seniors may be able to reduce their cost-sharing obligations by purchasing a Medigap plan. These plans can only be used with Original Medicare. It’s illegal for private insurance companies to sell Medigap plans to those with Medicare Advantage plans.

For more information on Medigap plans, seniors can refer to the Best Medicare Supplement Companies of 2023 page.

Who Should Consider Medicare Supplement Insurance

Good candidates for Medigap may be those who:

• Have ongoing health issues and expenses
• Travel overseas often
• Want to access an expanded network of health care providers
• Expect to need health services not covered by Original Medicare

Medicare Resources in Mississippi

While understanding the many Medicare and health insurance options can feel overwhelming, Mississippi’s seniors can get help from several sources. Trained advisors offer one-on-one counseling, helping seniors understand various plans, benefits and costs to ensure they enroll in the best policy for their needs. As well as providing information about available plans, including Medicare Advantage and Medigap, advisors can perform eligibility checks and help individuals enroll for coverage.