Mississippi Health Insurance Consumer Guide

To qualify for health coverage through the Marketplace in Mississippi, you must:⁷

• Live in Mississippi.
• Be lawfully present in the United States
• Not be incarcerated.
• Not be enrolled in Medicare

Eligibility for financial assistance (premium subsidies and cost-sharing reductions) depends on your household income. In addition, to qualify for financial assistance with your Marketplace plan you must:

• Not have access to affordable health coverage from an employer. If your employer offers coverage but you feel it’s too expensive, you can use our Employer Health Plan Affordability Calculator to see if you might qualify for premium subsidies in the Marketplace. 
• Not be eligible for Medicaid or CHIP.
• Not be eligible for premium-free Medicare Part A.⁸
• If married, file a joint tax return⁹ (with very limited exceptions)¹⁰
• Not be able to be claimed by someone else as a tax dependent.¹¹

In Mississippi, the open enrollment period for individual/family health coverage runs from November 1 to January 15.¹² 

Enrollments must be submitted by December 15 in order to have coverage effective January 1. Enrollments submitted in the final month of the open enrollment window have an effective date of February 1 instead.⁷

Outside of open enrollment, a special enrollment period (usually triggered by a specific qualifying life event) is necessary to enroll or make changes to your coverage.

If you have questions about open enrollment, you can learn more in our comprehensive guide to open enrollment. We also have a comprehensive guide to special enrollment periods. 

There are several ways to enroll in an ACA Marketplace plan in Mississippi:

• Online through HealthCare.gov
• By phone at (800) 318-2596
• With the help of a broker, Navigator, or certified application counselors (these individuals can provide help online, over the phone, or in person, depending on your needs)
• Via an approved enhanced direct enrollment entity.¹³

Under the Affordable Care Act (ACA), there are income-based subsidies that can help lower your premium payments each month. These subsidies are available to Mississippi residents who meet the eligibility requirements and enroll in Marketplace coverage.

Almost all of Mississippi’s exchange enrollees – 98% – qualified for premium subsidies (advance premium tax credits, or APTC) during the open enrollment period for 2024, with an average savings of $592/month. These subsidies reduced the average subsidy-eligible enrollee’s premium to about $25/month.¹⁴  

In addition to premium subsidies, the Affordable Care Act provides cost-sharing reductions (CSR) to people whose household income isn’t more than 250% of the poverty level, as long as they select a Silver-level plan through the Marketplace.¹⁵

Between the premium subsidies and cost-sharing reductions, you may find that an ACA Marketplace plan in Mississippi provides the best value for your family’s health coverage.

Source: CMS.gov¹⁶

Mississippi has not yet expanded Medicaid under the ACA, so there is still a coverage gap in the state. Adults under age 65 who are not disabled and who don’t have minor children are not eligible for Mississippi Medicaid, regardless of how low their income is. And Marketplace subsidies are not available if your income is below the poverty level. Roughly 88,000 low-income adults in Mississippi are in the coverage gap due to the state’s refusal to implement Medicaid expansion.¹⁷

For 2024 coverage, five insurers offer exchange plans in Mississippi. All five plan to continue to offer coverage in 2025.¹⁸

Coverage areas vary from one insurer to another, but all Mississippi residents can access Marketplace plans from at least three insurers for 2024.⁵

The insurers that offer plans through the Mississippi Marketplace have proposed the following average rate changes for 2025, applicable to full-price (pre-subsidy) premiums:¹⁸ (Rates are under review by state regulators and will be finalized before open enrollment begins in November 2024.)

Source: RateReview.HealthCare.gov¹⁸

(Blue Cross Blue Shield of Mississippi has proposed an average increase of 2.5% for 2025. But their individual/family plans are not available through the marketplace in Mississippi, and can only be purchased off-exchange, without any subsidies.)¹⁸

Mississippi continues to be one of just two states (the other is Indiana) where the cost of cost-sharing reductions is spread across plans at all metal levels (broad loading), instead of being added only to Silver plan rates (Silver loading). West Virginia also took that approach through 2021, but transitioned to a Silver loading approach as of 2022. A review of rate filing memos for 2025 indicates that the broad loading approach continues to be used in Mississippi.¹⁹

Silver loading makes coverage more affordable in many cases, because it increases the price of Silver-level plans, and subsidy amounts are based on the cost of the second-lowest-cost Silver plan. But Mississippi regulators have not yet taken advantage of this approach, even though it’s being used in nearly every other state. 

For perspective, here’s an overview of how average full-price (pre-subsidy) premiums have changed over time in Mississippi’s individual/family market (note that these averages include BCBS of MS, which only offers coverage outside the Marketplace):

• 2015: Average decrease of 19%.²⁰
• 2016: Average increase of 14.9%.²¹
• 2017: Average increase of 15.8%.²²
• 2018: Average increase of 38%.²³
• 2019: Average increase of 0.2%.²⁴
• 2020: Average increase of 0.3%.²⁵
• 2021: Average increase of 2.7%.²⁶
• 2022: Average increase of 3.8%.²⁷
• 2023: Average increase of 5.3%.²⁸
• 2024: Average increase of 2.3%²⁹

In Mississippi, 286,410 people enrolled in private plans through the Mississippi Marketplace during the open enrollment period for 2024, setting a significant new record high for the state (see chart below).³⁰ 

This increase in enrollment is thanks in part to the American Rescue Plan (ARP). Under the ARP, the ACA’s premium subsidies are larger and more widely available. The ARP subsidy enhancements have been extended through 2025 by the Inflation Reduction Act.³¹ 

The enrollment spike is also due to the “unwinding” of the pandemic-era Medicaid continuous coverage rule. For three years, states didn’t disenroll anyone from Medicaid, but disenrollments resumed in the spring of 2023, and some people who lost Medicaid subsequently enrolled in Marketplace coverage. CMS reported that by April 2024, more than 70,000 Mississippi residents had transitioned from Medicaid to a Marketplace plan during the unwinding period.³²

Source: 2014,³³ 2015,³⁴ 2016,³⁵ 2017,³⁶ 2018,³⁷ 2019,³⁸ 2020,³⁹ 2021,⁴⁰ 2022,⁴¹ 2023,³¹ 2024⁴²

HealthCare.gov
800-318-2596

State Exchange Profile: Mississippi
The Henry J. Kaiser Family Foundation overview of Mississippi’s progress toward creating a state health insurance exchange.

Health Help Mississippi
Assists people insured by private health plans, Medicaid, or other plans in resolving problems pertaining to their health coverage; assists uninsured residents with access to care.
(877) 314-3843 / [email protected]