Family Planning Medicaid in Mississippi is a limited-benefit Section 1115 waiver that pays for contraception, sexually transmitted infection screening and treatment, reproductive health exams, counseling, and voluntary sterilization for state residents ages 13 to 44 whose household income sits at or below 194% of the federal poverty level. It is not full Medicaid. Enrollees get family planning care only, capped at four visits per calendar year for core services, and the waiver runs through December 31, 2027.
What the Waiver Covers
The program pays for one annual exam plus up to three follow-up visits per year tied to birth control and family planning. Within that framework, covered care includes:
- Contraception, including oral pills, injectables such as Depo-Provera, patches, self-inserted products like NuvaRing, IUDs, and implants such as Nexplanon.
- STI and STD testing during family planning visits, along with prescription treatment. Covered drugs include azithromycin, ceftriaxone, doxycycline, acyclovir, and valacyclovir. HIV pre-exposure prophylaxis is also covered, including Truvada, Descovy, and Apretude.
- Preventive screenings, including Pap smears, clinical breast exams, and pelvic exams as part of the annual visit.
- Lab work, including pregnancy tests, blood counts, glucose, urinalysis, and infectious disease testing for HIV, hepatitis B and C, syphilis, chlamydia, herpes, and trichomoniasis.
- HPV vaccination.
- Birth control education and counseling, including information about abstinence and natural family planning.
- Voluntary sterilization, including tubal ligation, vasectomy, and related follow-up care.
Prescriptions can be written by any Medicaid-participating provider and filled at any Medicaid-participating pharmacy.
What the Waiver Does Not Cover
The program is narrow, and it’s easy to assume it does more than it does. It does not pay for:
- Primary care or general medical services.
- Prenatal care or any pregnancy-related services. Becoming pregnant ends eligibility.
- Hospitalization.
- HIV/AIDS or hepatitis treatment, even though screening for those conditions is covered.
- Anything not classified as family planning or family planning related.
Enrollees who need primary care are referred to federally qualified health centers, rural health centers, or other providers outside the waiver.
The Four-Visit Cap and How STI Treatment Fits
The waiver draws a line between “family planning services” and “family planning related services.” The four-visit annual cap applies only to core family planning services: contraceptive management, counseling, and STI screening. Treatment and follow-up care for an STI or STD diagnosed at a family planning visit falls into the related-services category, which is not subject to the cap.
CMS approved an amendment in April 2025 that formally reclassified STI/STD screening as a family planning service and STI/STD diagnosis and treatment as a family planning related service, confirming that treatment visits do not count against the annual limit. Treatment for HIV/AIDS and hepatitis remains excluded.
Sterilization as a Covered Benefit
Eligibility for the waiver requires that a person be capable of reproducing, so sterilization ends enrollment. But the sterilization procedure itself is covered. The program pays for tubal ligation, vasectomy, or tubal sterilization by hysteroscopy, along with all necessary follow-up. Once follow-up is complete, enrollment ends. In practice, sterilization functions as a final covered benefit.
Who Qualifies
You must meet all of the following:
- Be between 13 and 44 years old.
- Have household income at or below 194% of the federal poverty level. Applicants under 19 are exempt from providing household income information.
- Be capable of reproducing, with no prior sterilization procedure.
- Have no Medicare, CHIP, or other health insurance or third-party medical coverage.
- Live in Mississippi.
Both men and women are eligible. Women who lose Medicaid pregnancy coverage at the end of the 60-day postpartum period can move onto the waiver for continued family planning access.
When Eligibility Ends
Enrollees have to recertify every year. Coverage ends if you become pregnant, turn 45, move out of state, gain other health insurance, become eligible for a different Medicaid category, undergo sterilization, or ask to close your case.
How to Apply
Applications can be submitted five ways:
- Online through the state’s eligibility portal at access.ms.gov.
- By mail to the Mississippi Division of Medicaid, P.O. Box 2222, Jackson, MS 39225.
- By fax to 601-576-4164.
- In person at any of Mississippi’s 30 regional Medicaid offices.
- By phone at 800-421-2408 for an application or help with the process.
You’ll need personal identification (Social Security number and date of birth), proof of income such as pay stubs or W-2 forms, and information about any existing health insurance.
Where to Use the Coverage
Any Medicaid-participating provider can see waiver enrollees. Mississippi State Department of Health clinics offer family planning services across the state’s counties, including counseling, contraception, annual exams, and STI testing. Appointments are available at 855-767-0170, and county health departments accept walk-ins.
Title X clinics operated by Converge provide free or low-cost reproductive health care based on income. Federally qualified health centers serve all community residents regardless of insurance status, and locations can be found through the HRSA health center finder at findahealthcenter.hrsa.gov.
How the Waiver Differs from Full Medicaid
The family planning waiver is a limited-benefit program, Medicaid Aid Category 029. Enrollees get a yellow Medicaid identification card that distinguishes them from full-benefit recipients, and they cannot use Medicaid for anything outside family planning.
Pregnant women who qualify for full Mississippi Medicaid get comprehensive coverage, including prenatal care and delivery, with benefits continuing for twelve months postpartum. Children born to Medicaid-eligible mothers are automatically covered until age one. A waiver enrollee who becomes pregnant or qualifies for another Medicaid category transitions out of the waiver and into the broader program.
Under federal law, family planning is a mandatory Medicaid benefit, and states are prohibited from charging enrollees out-of-pocket for family planning care.