To apply for Mississippi Medicaid for long-term care, contact the Mississippi Division of Medicaid (DOM) by phone at 1-800-421-2408, in person at a regional office, or by mail. Mississippi is an income-cap state with no medically needy spend-down: in 2026, an applicant whose gross monthly income exceeds $2,982 must set up an income trust before the application can be approved. The state uses a $4,000 countable-asset limit for a single applicant, double the default most states use.

In This Guide

Set Up Your Income Trust First

Mississippi does not operate a medically needy spend-down for nursing-facility or Home and Community-Based Services (HCBS) waiver Medicaid coverage. In 2026, if an applicant's gross monthly income is at or below $2,982, they can proceed to the application. If income exceeds that cap, the application is denied unless a Qualified Income Trust (QIT), also called a Miller Trust, is in place first.

The trust works as a waterfall. Gross income above the cap is deposited into the trust each month and paid out in a set order: first the personal needs allowance ($44, or $90 for a qualifying veteran), then the community spouse's income allowance if one applies, then the cost of care payable to the nursing facility and the Division of Medicaid. DOM will not approve an over-income applicant without the trust.

A Miller Trust must be a dedicated trust document drafted and signed by an elder law attorney, with its own bank account. It cannot be a standard revocable living trust. Setting one up takes time and legal help, so families who are over the income cap should address the trust before they file, not after, to avoid a denial and a restart.

Steps to Apply for Mississippi Medicaid

Mississippi routes all long-term care Medicaid applications through DOM regional offices. Unlike states that use county social-services offices or a MAGI online portal for these applications, Mississippi's DOM handles the aged, blind, and disabled (ABD) long-term care pathway directly through its own regional network. Work through these steps in order.

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Step 1

Set up an income trust if you are over the income cap

If gross monthly income exceeds $2,982 in 2026, an over-income applicant must establish a Qualified Income Trust (Miller Trust) before DOM can approve the application, because Mississippi has no medically needy spend-down. Have an elder law attorney draft it and open its dedicated bank account before you file, not after, so you avoid a denial and a restart.

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Step 2

Gather your full document packet

Collect proof of identity and Mississippi residency, income statements, and statements for every financial account, plus the physician's level-of-care statement for nursing-facility or waiver coverage. The complete checklist is in the documents section below. Missing paperwork is the most common reason applications stall.

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Step 3

Choose how to submit your application

DOM accepts long-term care applications three ways. By phone, call the statewide line at 1-800-421-2408, where a representative can take your information and direct you to the regional office that covers your county (TTY users reach the Mississippi Relay Service by dialing 711). In person, bring your full packet to the nearest regional office so staff can flag any missing items on the spot rather than mailing a deficiency notice later. By mail, request a paper application, call 1-800-421-2408 to confirm the correct regional-office address first (offices have separate addresses), and use a mailing method with delivery confirmation.

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Step 4

Keep copies and confirm the received date

Whichever method you use, keep a copy of everything you submit. DOM measures its processing clock from the date the application is received, not the date you mailed it, so a mail submission with delivery confirmation protects your effective date.

What Documents You'll Need

Missing paperwork is the most common reason applications stall. Gather everything below before you contact DOM.

Identity and residency:

  • Social Security card or proof of Social Security number
  • U.S. birth certificate, passport, or Certificate of Naturalization
  • State-issued photo ID or driver's license
  • 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:

Property and assets:

  • Deed to the primary residence and a recent property tax bill (the home is excluded unless equity exceeds $752,000)
  • Vehicle title or registration
  • Life insurance policies (face value and cash surrender value)
  • Burial plot deeds and prepaid funeral contracts (generally exempt)

If married:

  • Documentation of all joint and separate assets for both spouses
  • Spousal protections apply: the community spouse may keep up to $162,660 in combined countable resources for 2026, with a federal minimum of $32,532, while the applicant's share is capped at $4,000

Income trust documentation (if applicable):

  • A copy of the signed Qualified Income Trust document
  • The trust's dedicated bank account number

Medical:

  • Physician's statement confirming nursing-facility level of care (required for institutional Medicaid and most HCBS waivers)
  • 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, the agency must determine eligibility within 45 calendar days for most applicants and within 90 calendar days for applicants who apply on the basis of disability, except in unusual circumstances. If the application is incomplete, DOM sends a written request for the missing items and the clock pauses until those documents arrive.

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. For a nursing-facility resident with bills already incurred, that back-coverage can be significant, so confirm the retroactive window with DOM at approval. 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 (one month for the Medicaid expansion adult group).

If a Qualified Income Trust is required, DOM will not finalize approval until the trust is established and documented. Applicants in this situation should have the trust in place before or alongside the application.

After approval, a nursing-facility resident keeps a $44/month personal needs allowance from their income, and a veteran or surviving spouse receiving a $90 VA pension keeps $90/month. The remainder goes toward the cost of care in the order DOM specifies.

If Your Application Is Denied

DOM must issue a written denial notice explaining the reason. Common reasons include income over the $2,982 cap without an income trust in place, countable assets over the $4,000 limit, an incomplete application, or a disqualifying asset transfer within the 60-month look-back window.

You have the right to request a fair hearing to contest a denial. Under federal rule 42 CFR 431.221(d), a state must allow a reasonable time of up to 90 days from the date the notice is mailed to request a hearing, though a state may set a shorter operational deadline, so confirm the exact window printed on your notice. Request a hearing by contacting DOM at 1-800-421-2408 or by submitting a written request to the regional office that handled your application.

Before requesting a hearing, ask DOM to clarify the denial reason. Sometimes what looks like a denial is a request for additional documentation or a fixable deficiency rather than a final ineligibility finding. 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 these contacts to start an application, find your regional office, or ask about the income trust requirement.

Mississippi Division of Medicaid (DOM) Applications, regional-office directory, and eligibility questions. 1-800-421-2408 medicaid.ms.gov
Mississippi Relay Service TTY and telecommunications relay for callers who are deaf, hard of hearing, or speech-impaired. 711

Frequently Asked Questions

What is the income limit to apply for Mississippi Medicaid for nursing home care?

For nursing-facility and HCBS-waiver Medicaid, the 2026 income limit is $2,982/month (300% of the SSI Federal Benefit Rate). Mississippi is an income-cap state and has no spend-down program. If your gross monthly income is over that limit, you must establish a Qualified Income Trust before the application can be approved.

Why does Mississippi have a higher asset limit than other states?

Most states use the lower federal default countable-asset limit for a single applicant. Mississippi's DOM sets its limit at $4,000 for a single applicant, and the state lists $6,000 for a couple where both spouses apply. The higher limit is specific to Mississippi's state Medicaid plan, so some applicants who would be over-asset elsewhere may qualify here.

Can a family member apply on behalf of a nursing home resident?

Yes. A family member with legal authority through a durable power of attorney, legal guardianship, or court appointment can submit the application and act as an authorized representative throughout the process. DOM can provide the authorized-representative form. Without legal authority, a family member may help gather documents but cannot sign the application.

What is a Miller Trust and do I really need one?

A Miller Trust (Qualified Income Trust) is a legal tool for applicants whose income exceeds the monthly cap. Excess income flows into the trust and pays toward the cost of care in a DOM-specified order, bringing the applicant into compliance with the income-cap rule. Without it, an over-income applicant cannot qualify regardless of medical need or asset level. An elder law attorney must draft it; it cannot be a standard bank trust or a revocable living trust.

How far back does DOM look at asset transfers?

Mississippi applies a 60-month look-back to uncompensated asset transfers. A gift or below-market sale made within 60 months of the application date can trigger a penalty period of ineligibility, calculated by dividing the transferred value by the state's average monthly private-pay nursing-facility cost. Transfers between spouses are generally not penalized; transfers to others, including adult children, are reviewed.

Does Mississippi have a spend-down or medically needy program?

No. Mississippi does not operate a medically needy spend-down for long-term care Medicaid. If income exceeds the $2,982/month cap, the only path to eligibility is the Qualified Income Trust. There is no option to deduct medical expenses to reduce countable income below the cap the way medically needy states allow.

Learn More

MedicaidHow to Apply for Medicaid by State: Steps, Documents, and Where to ApplyApplying for Medicaid follows the same federal steps everywhere; the agency and portal are your state's. What to gather, how long it takes, and where to apply. MedicaidMississippi Medicaid: A Guide for Seniors and FamiliesMississippi Medicaid covers seniors through the Division of Medicaid. Learn about the income cap, income trust, $4,000 asset limit, MSPs, and how to apply. MedicaidMississippi Medicaid Eligibility and Income LimitsMississippi Medicaid income limits: $2,982/month for long-term care with a $4,000 asset limit, plus the MAGI limits for parents, children, and pregnancy. MedicaidMississippi Medicaid Spousal Impoverishment RulesMississippi Medicaid spousal impoverishment 2026: the community spouse keeps up to $162,660 in assets and up to $4,066.50/month in income for LTC. MedicaidMedicaid Planning StrategiesSee which assets you keep, how the 5-year look-back works, and the legal moves that qualify you for Medicaid long-term care without losing the house. MedicaidMedicaid Estate Recovery ExplainedMedicaid estate recovery explained: federal law, 51-state matrix, categorical protections, hardship waivers, and 2025-2026 reform updates. Verify before acting. MedicaidHelp Paying Medicare Premiums in MississippiMississippi Medicare Savings Programs 2026: QMB, SLMB, and QI income limits, no asset test, Part B premium help, and how to apply through DOM.

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.

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Brevy Care Team

Expert eldercare guidance from Brevy's team of healthcare professionals and researchers.