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Click ‘Get Form’ to open the ms medicaid crossover form in the editor.
Begin by entering the patient’s information in the designated fields, including their name, date of birth, and Medicaid number. Ensure accuracy to avoid processing delays.
Next, provide details about the healthcare provider. Fill in the provider's name, address, and NPI number in the appropriate sections.
In the services section, list all relevant medical services provided. Be specific about dates and types of services to ensure proper reimbursement.
Review all entered information for completeness and accuracy. Use our platform’s editing tools to make any necessary adjustments before finalizing your submission.

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What are the different types of Medicaid in Mississippi?

Mississippi Medicaid includes multiple health benefits programs administered by DOM: fee-for-service Medicaid, MississippiCAN and CHIP.

What is the highest income to qualify for Medicaid in Mississippi?

Income Limits for Medicaid and CHIP Programs Family Size15 Monthly Income $2,791 $6,715

Where to apply for Medicaid in MS?

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.

Can I use my MS Medicaid in another state?

Within these parameters, each of the fifty states operates their Medicaid program differently. Therefore, Medicaid eligibility requirements are not consistent across states. One cannot transfer their Medicaid benefits from one state to another state, nor can they receive Medicaid benefits simultaneously in two states.