How to Apply

There are multiple ways you can apply for Mississippi Medicaid health benefits.

How to Apply for Mississippi Medicaid Health Benefits

Online

Mississippi’s Common Web Portal at Access.ms.gov is a convenient way to apply for children, pregnant women, low-income parents of children under age 18 and anyone else who needs to apply. Documents can be uploaded and sent electronically with your application to the Medicaid Regional Office serving your county of residence. Medicaid Specialists in the Regional Office check available electronic sources to verify as much information as possible and then follow-up if additional information is needed. NOTE: If you want to apply for Medicaid due to age, blindness or disability on Access.ms.gov, be sure to check YES to a limiting or disabling condition when those questions appear in the application flow. This lets us know you are asking for a Medicaid decision that considers age, blindness or disability as a condition of your eligibility.

The Mississippi Division of Medicaid and the federally facilitated marketplace (FFM) has one single application for all insurance affordability programs. Application for any of the insurance affordability programs may be filed online through Access.ms.gov or the FFM at Healthcare.gov. If you apply through Healthcare.gov, the FFM will assess your potential eligibility for Medicaid or CHIP and then return your application to the Division of Medicaid for the final eligibility decision.

To fill out this application, you will need:

Important Information to Successfully Submit Your Application Form

To fill out the Mississippi Medicaid Application, please follow the steps below:

  1. Download the Mississippi Medicaid Application form (PDF) to your computer (Application in Spanish)
  2. Open the form and fill out the application with as much information as you can.
  3. Digitally sign the application and date your application.
  4. Select the Submit button at the bottom of the form.

Next steps after applying

For Mississippi Medicaid applications:

For HealthCare.gov applications:

The Division of Medicaid and the FFM will verify as much data as possible from electronic sources in order to verify what is reported on your application. You will only be asked to provide verification of needed eligibility information, if eligibility factors cannot be verified through an available electronic source or if the information you give conflicts with data from electronic sources.

View the income limits for Medicaid and CHIP programs. There is no resource test for any insurance affordability program, including Medicaid and CHIP.

Fax or Postal Mail

An application form can be printed at either website, completed and submitted to the Division of Medicaid by one of the following ways:

You may request to have a paper application mailed to you. An original signature is not required for a faxed application.

In Person

By Phone

If you want an application mailed to you or if you need telephone assistance:

How to Apply for Aged, Blind or Disabled Medicaid Benefits

If you are applying for aged, blind or disabled Mississippi Medicaid benefits and services, an in-person interview may be required. If so, you will be contacted by staff at the regional office that serves your county of residence.

How to Apply for Family Planning Benefits

For assistance, call the Office of Eligibility toll-free at 800-421-2408. Submit the application as follows:

Mail: MS Division of Medicaid ATTN: Office of Eligibility
550 High Street, Suite 1000
Jackson, MS 39201-1399

Voter Registration

To register to vote in Mississippi, click on the form below and complete prior to visiting a Medicaid regional office.