![]() Applications are evaluated through the website.If determined applicant is not eligible for Mississippi Medicaid, applications are automatically referred to the FFM.Eligibility assessment and determination is approved or denied.Applications are reviewed by state staff.Initially handled on a local, state level Note: If you open and fill out the application in your browser, the processing of your application may be delayed.ĭirect application through Mississippi MedicaidĪpplication for insurance affordability options and Medicaid, if eligibleĭirect application for Mississippi MedicaidĪpplication is routed through website Select the Submit button at the bottom of the form.Digitally sign the application and date your application.Open the form and fill out the application with as much information as you can.Download the Mississippi Medicaid Application form (PDF) to your computer. ![]() To fill out the Mississippi Medicaid Application, please follow the steps below: Important Information to Successfully Submit Your Application FormĪpply by completing and submitting a Mississippi Medicaid Application Form (PDF)
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