Insurance Plans

If you are enrolled in a managed care plan (HMO, PPO or POS), your treatment at North Mississippi Health Services (NMHS) may be covered by insurance. Before scheduling an initial appointment, please call your health plan/insurance company and ask if you have access to health care services at NMHS.

If NMHS is not a participating provider, you may still be able to receive treatment here. Contact your insurance company and ask about obtaining authorization. It is important to note that some benefit plans utilize what is referred to as "narrow" or "limited" networks; that is, they further narrow or limit the choices of doctors and hospitals that their customers can use. Often, these networks exclude NMHS.

Additionally, some plans, such as HMOs, have primary care physician referral and/or other authorization guidelines.

Your NMHS patient access specialist will help you obtain the full benefit from your insurance plan by:
• Answering your questions about insurance verification and/or prepayment requirement
• Responding to insurer requests for additional medical information.


Commercial Insurance

Commercial Insurance

Commercial health insurance is provided and administered by non-governmental entities. It can cover medical expenses and disability. Any type of coverage that isn’t provided or maintained by a government-run program can be considered a type of commercial insurance.

Commercial policies can be sold individually or as part of a group plan and are offered by public or private companies.

Health insurance in the commercial market is commonly obtained through an employer. Since employers typically cover at least a portion of the cost, this is often a cost-effective way for employees to obtain health coverage.

Employer Health Plans

Employer Health Plans - Group Medicare Advantage Plans

Employer Health Plans - PPO Network Contracts

Individual Health Insurance www.healthcare.gov

Medicaid

Medicaid

Medicaid is a joint federal and state program that helps pay medical costs for people with limited income who meet certain eligibility criteria. Medicaid also offers financial assistance for nursing home and personal care services. Every state has different rules for Medicaid. NMHS accepts State of Mississippi Medicaid.

Traditional Mississippi Medicaid is accepted at NMHS. Managed Medicaid HMO plans are managed by a health insurance company.

NMHS is contracted with the following Managed Medicaid Plans in Mississippi.

  • Children’s Health Insurance Program (CHIP)
  • United Health Care Community and State Plan (MS CAN)
  • Magnolia Health Plan (MS CAN)
  • Molina Healthcare (MS CAN)

Individual Medicaid Plans

Individual Medicare/Medicaid - Dual Complete Plans

Medicare

Medicare

Medicare is the federal health insurance program for people age 65 or older and certain younger people with disabilities. North Mississippi Health Services accepts Medicare.

  • Medicare Part A, or Hospital Insurance, covers hospital stays, hospice care, skilled nursing facilities and some home health care.
  • Medicare Part B, or Medical Insurance, covers doctor visits, preventive care and screening, and medical supplies.
  • Medicare Parts A and B are both accepted at NMHS.
  • Medicare Part C, also known as the Medicare Advantage Plan, replaces traditional Medicare.

Individual Medicare Plans

Medicare Supplemental (MediGap) policies allow enrollees to see any provider that accepts Medicare.

Medigap is Medicare Supplement Insurance that helps fill "gaps" in Original Medicare and is sold by private companies. Original Medicare pays for much, but not all, of the cost for covered health care services and supplies. A Medicare Supplement Insurance (Medigap) policy can help pay some of the remaining health care costs, like: Copayments, Coinsurance and Deductibles

Medicare Advantage Plans

Medicare Advantage Plans

  • Medicare Advantage Plans are another way to get your Medicare Part A and Part B coverage. Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by Medicare-approved private companies that must follow rules set by Medicare. Most Medicare Advantage Plans include drug coverage (Part D).
  • In many cases, you’ll need to use health care providers who participate in the plan’s network and service area for the lowest costs. These plans set a limit on what you’ll have to pay out-of-pocket each year for covered services, to help protect you from unexpected costs. Some plans offer out-of-network coverage, but sometimes at a higher cost.
  • Remember, you must use the card from your Medicare Advantage Plan to get your Medicare-covered services. Keep your red, white, and blue Medicare card in a safe place because you’ll need it if you ever switch back to Original Medicare.
  • Please review the list of contracted Medicare Advantage Plans which are considered “in-network” with NMHS.

Individual Medicare Advantage Plans

Individual Medicare/Medicaid - Dual Complete Plans

*The health insurance carriers offering Individual Medicare Advantage Plans are required to disclose to consumers that Medicare Advantage plans replace traditional Medicare coverage. Please consult with your insurance agent/broker for specifics.

State Employees

State Employees

The Mississippi State and School Employees’ Life and Health Insurance Plan is a self-insured plan that provides coverage for more than 197,000 active employees, dependents, spouses and retirees.

Health benefits are administered by Blue Cross & Blue Shield of Mississippi.

NMHS is considered an “in-network” provider for the AHS State Network.

You can find more information about benefits or search for a participating provider here.

DISCLAIMER: NMHS' participation with any product or insurance plan is subject to change without notice. Additionally, insurance companies offer a variety of plans and may change the names and benefits at any point. A patient’s level of coverage depends on the specific benefits outlined in your level of coverage and your plan).

To ensure that NMHS and its physicians are in-network, it is the patient's responsibility to verify that NMHS is a participating provider and their benefit plan allows them access as of the day of a visit and/or admission. Please contact your insurance plan to obtain this information.

Revised June 1, 2021