How to Apply for Mississippi Medicaid Long-Term Care (2026)

To apply for Mississippi Medicaid long-term care, you file an Aged, Blind and Disabled (ABD) application with the Mississippi Division of Medicaid (DOM). You can file it in person at a regional office, by mail or fax to a regional office, by phone, or online.1 Before you file, check income: in 2026, an applicant whose total monthly income is $2,982 or more can qualify only through an income trust, and the countable-resource limit for an individual is $4,000.2

In This Guide

• Key Facts
• Set Up Your Income Trust First
• Steps to Apply for Mississippi Medicaid
• Medical Requirements for Nursing-Home Medicaid
• What Documents You'll Need
• What Happens After You Apply for Mississippi Medicaid
• If Your Application Is Denied
• Where to Get Help
• Frequently Asked Questions
• Learn More

Set Up Your Income Trust First

Mississippi is an income-cap state for nursing-facility and Home and Community-Based Services (HCBS) waiver Medicaid coverage.2 In 2026, an applicant's total income is compared to a limit of $2,982 a month.2 Total income doesn't include VA Aid and Attendance, VA payments for unreimbursed medical expenses received by a veteran or a veteran's spouse, or income that federal law excludes.4 If income is equal to or more than that cap, the applicant can qualify only through an Income Trust, also called a Qualified Income Trust (QIT) or Miller Trust.2

Only income can go into the trust; savings and other assets can't be used to set it up or add to it. An Income Trust is limited to institutionalized applicants, such as nursing-facility residents, not someone in an acute care hospital, and HCBS-waiver participants can use one too. Where the money goes depends on the care setting. For a nursing-facility resident, for each month after the first, if income is less than the facility's cost of care, all income, less the deductions DOM allows, is paid directly to the facility. For an HCBS-waiver participant, the trust can release no more than $1.00 less than the current Medicaid income limit to the participant, who pays DOM the share of income the trust's terms require. If income is above the private-pay rate of the facility where the applicant lives, a trust can't make them eligible.2 Once a nursing-facility resident is eligible, what they pay toward care is figured from income after allowed deductions, such as the personal needs allowance and any allowance for a spouse still living at home, which can't exceed $4,066.50 a month in 2026 minus that spouse's own income. HCBS-waiver participants aren't subject to these patient-liability rules.2

Federal law sets the core terms of a Miller Trust: it can hold only the applicant's income (pension, Social Security and other income), and the state must receive whatever is left in it when the applicant dies, up to the total Medicaid paid on the applicant's behalf.5 An elder law attorney can draft one. If income is at or over the cap, you need the trust to qualify, so ask DOM or the attorney when it must be in place relative to the month you want coverage to start.

Steps to Apply for Mississippi Medicaid

Long-term care Medicaid in Mississippi is for people who are 65 or older, or who meet the SSI definition of blindness or disability, and who are U.S. citizens or qualified non-citizens living in Mississippi.2 DOM uses one application, the Aged, Blind and Disabled (ABD) application, for this group. If you already receive Supplemental Security Income (SSI), you applied through the Social Security Administration and don't need a separate Medicaid application, unless you need to apply separately for retroactive Medicaid or for months SSI didn't cover.1 If the goal is care at home through the Elderly and Disabled Waiver, someone not already on Medicaid files the ABD application and is referred to the waiver program's initial point of contact for a clinical evaluation.4 Work through these steps in order.

Medical Requirements for Nursing-Home Medicaid

Financial eligibility isn't enough on its own. For any long-term care coverage group, verification that a physician has certified the need for long-term care is required documentation that DOM must have before it can approve eligibility.2

To qualify under the $2,982 institutional income limit, the applicant generally must be in a medical facility for 30 consecutive days or more (counted from the day of admission through midnight on the 30th day). That requirement doesn't apply to someone who dies before the 31st day of continuous institutionalization, or to someone whose income doesn't exceed 135% of the federal poverty level.2

Nursing-facility clinical eligibility, the nursing facility level of care, comes from a scored Level I screening. In most cases nursing facility staff complete the screening and upload supporting documentation. Mississippi's administrative code calls it the Pre-Admission Screening and Resident Review (PASRR) Level I and requires a score of 50 or more, or a finding of clinical eligibility through a secondary review or a physician's determination. DOM's 2022 training materials announced that a new LTSS Screening Tool, scored 0 to 3, would replace that Level I, with a score of 0 sent for a secondary clinical review by a DOM nurse, and noted that code updates were pending. Under both versions, someone who doesn't meet the score gets a secondary review, and the DOM nurse may ask for more information.6 Ask the facility's admissions or social services staff whether the screening has been done.

For the Elderly and Disabled Waiver, nursing facility level of care is determined by a comprehensive long-term services and supports (LTSS) assessment instead.4

What Documents You'll Need

The list below is a practical packet, not an official DOM checklist: each item lines up with an eligibility rule in this guide, so gathering it before you file leaves you ready for DOM's questions.

Identity and residency:

• Social Security card or proof of Social Security number
• Proof of U.S. citizenship: a U.S. passport or Certificate of Naturalization is enough on its own, while a U.S. birth certificate must come with an identity document such as a state driver's license.8 Federal rules exempt anyone receiving SSI or enrolled in any part of Medicare from providing citizenship documents, and the agency must accept a photocopy, fax, or scan to the same extent as an original.8
• Proof of Mississippi residency (utility bill, lease, or similar)

Income:

• Social Security award letter or most recent SSA-1099
• Pension and retirement benefit statements
• Documentation of any other income (annuity, rental income, VA benefit letter)

Financial accounts:

• Recent statements for every checking and savings account
• Statements for certificates of deposit, stocks, bonds, and retirement accounts
• For nursing-facility or waiver applications, records covering the 60-month look-back on asset transfers3

Property and assets:

• Deed to the primary residence and a recent property tax bill. One home is excluded, but Medicaid must deny payment for nursing-facility and other long-term care to someone with substantial home equity. Mississippi's rule set the cap at $500,000 in 2009, rising each year since 2011 with the consumer price index, so ask DOM for the current figure; CMS lists the 2026 federal minimum home-equity limit as $752,000. The bar doesn't apply when a spouse, a child under 21, or an adult blind or disabled child lives in the home, and it can be waived for undue hardship.2
• Vehicle title or registration
• Life insurance policies (face value and cash surrender value)
• Burial plot deeds and prepaid funeral contracts

If married:

• Documentation of all joint and separate assets for both spouses
• Spousal rules apply: the couple's countable resources are combined, the at-home spouse's share is $162,660 for 2026, and the applicant's share is the $4,000 limit plus anything above the at-home spouse's share, which must be spent down before the applicant qualifies2

Income trust documentation (if applicable):

• A copy of the signed Qualified Income Trust document

Medical:

• The physician's certification of the need for long-term care, which DOM must have before it can approve eligibility2
• Medical records showing the applicant's care needs
• Your Medicare insurance card and any supplemental coverage cards

What Happens After You Apply for Mississippi Medicaid

Federal regulation caps how long DOM can take to decide. Under 42 CFR 435.912, except in unusual circumstances, a determination may not exceed 45 days for most applicants, or 90 days for applicants who apply on the basis of disability.7 Those are federal maximums; DOM must also set its own time standards in its State plan and tell applicants what they are. DOM can't treat the time limits as a waiting period, and it can't deny you because it ran out of time; if it is delayed, the reasons must be documented in your case record. One of the unusual circumstances that excuses a delay is an applicant or examining physician who delays or fails to take a required action, so answer any DOM request for missing items quickly.7

When the date you apply matters: federal law requires retroactive eligibility, so once you are approved, Medicaid can cover services furnished in or after the third month before the month you applied, if you would have been eligible then.9 In Mississippi it applies only if you request it, were eligible in each month you ask about, and received covered Medicaid services in that month, so ask for it when you apply.4 Note a coming change: under Public Law 119-21, for applications filed on or after January 1, 2027, this window shrinks to two months before the application month for most enrollees.9

For the Elderly and Disabled Waiver, eligibility can't begin until the waiver placement is approved and you're found eligible under institutional rules, whichever is later.2,4

After approval, a nursing-facility resident pays toward the cost of care from what's left after allowed deductions, starting with the $44/month basic personal needs allowance ($90 for a veteran or dependent whose reduced VA pension payment is $90) and any allowance for a spouse still living at home.2 For keeping coverage after approval, see Mississippi Medicaid recertification and renewal.

Plan for estate recovery too. DOM is required to seek recovery of its payments for nursing facility services, HCBS, and related hospital and prescription drug services from the estates of deceased recipients who were 55 or older when they received benefits. Recovery doesn't apply if, at death, the recipient has a legal surviving spouse living in the home, a dependent child under 21 or a dependent blind or disabled child of any age living in the home, or an undue hardship condition exists.5 The details are in Mississippi Medicaid estate recovery.

If Your Application Is Denied

Start with the notice DOM mails you, which is also what starts your appeal clock. Income at or over the $2,982 cap with no income trust in place, or countable resources over the $4,000 limit, will keep an applicant from qualifying. An asset transfer for less than fair market value within the 60-month look-back works differently, through a transfer penalty: for nursing-home care, Medicaid won't pay the facility's room and board during the penalty period but still covers other services, and for an HCBS-waiver applicant whose eligibility depends on the waiver, the application is denied or the case closed for that period.2

You have the right to request a fair hearing to contest a denial. The deadlines that matter:10

• 30 days from the postmark date of the notice to request a hearing. DOM may extend this if you show good cause, as DOM determines it, for filing late.
• 15 days from the postmark date of a local hearing decision for your state-hearing request to be received, if you lose the local hearing.

Federal rule 42 CFR 431.221(d) caps a state's window at 90 days, but that ceiling binds DOM, not you, so count your 30 days from the notice's postmark date.11 You can ask for a hearing in writing, orally, or in person at a Medicaid Regional Office, and a written request can be mailed to the regional office or DOM's central office. When the action reduces, denies, suspends or terminates covered services, DOM's rule calls for a written request within the 30 days, so putting it in writing is the safe route.10

You can ask for a local hearing, a state hearing, or both:

• Local hearing: an informal proceeding at the Medicaid Regional Office, run by a staff member who didn't take part in the eligibility decision.
• State hearing: heard by an impartial hearing officer. The decision of DOM's Executive Director is final and binding, though you can seek judicial review in court.10

Before requesting a hearing, read the reason the notice gives and ask DOM about anything you don't understand. An elder law attorney can review the notice and advise whether an appeal or a corrected application is the better path.

Where to Get Help

Use this contact to request a paper application or ask about submitting one.

Learn More

Find personalized help applying for Mississippi Medicaid long-term care coverage at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.