Providers are responsible for verifying eligibility every time a member is seen in the office. PCPs should also verify that a member is assigned to them.
To verify member eligibility, please use one of the following methods:
1. Log onto DOM’s Envision website to verify a member’s eligibility with Magnolia Health MississippiCAN. We encourage providers to use this method first when attempting to verify eligibility.
2. Log on to our secure Provider Portal at www.magnoliahealthplan.com. Using this secure website, you can check member eligibility. You will have the ability to search by date of service, plus any one of the following: member name, date of birth, or Medicaid ID number. You can submit multiple member ID numbers in a single request.
3. Call our automated member eligibility Interactive Voice Response (IVR) system. Call 1-866-912- 6285 from any touch-tone phone and follow the prompts to select the appropriate menu options to reach our automated member eligibility verification system, twenty-four (24) hours a day. The automated system will prompt you to enter the member ID number and the month of service, to check eligibility.
4. Call Magnolia Provider Services. If you cannot confirm a member’s eligibility using the methods above, call our toll-free number at 1-866-912-6285. Follow the menu prompts to speak to a Provider Services representative to verify eligibility before rendering services. Provider Services will need the member name or member ID number to verify eligibility
To be eligible to enroll in Magnolia Health, MississippiCAN program, a person must be a beneficiary of Mississippi Medicaid. In addition, a beneficiary must be a resident of the state of Mississippi.
For purposes of this program, MississippiCAN beneficiaries include:
Required Mandatory Populations (Age):
- SSI (19 - 65)
- Working Disabled (19-65)
- Breast and Cervical Cancer (19-65)
- Pregnant Women (8-65)
- Infants (0-1)
- Children (0-1)
- TANF Adults (19-65)
Optional Populations (Age):
- SSI (0-19)
- Disabled Child Living at Home (0-19)
- Foster Care and Foster Care
- Adoption Assistance (0-19)
- Native Americans (0-65)
Magnolia does not determine eligibility. Eligibility is determined by the Mississippi Medicaid Regional Office that serves your area. To locate your Mississippi Medicaid Regional Office, please visit www.medicaid.ms.gov/RegionalOffices.aspx. You may also call Medicaid’s toll-free telephone number at 1-800-421-2408.
Major Life Changes
Life changes might affect your eligibility with Magnolia. If you have a major change in your life, please contact your eligibility source (such as your local Social Security Administration office, Mississippi Department of Human Services county office, or Mississippi Medicaid Regional office) within 10 days after the change happens (or within 10 days after you realize the change has taken place). You should also contact Member Services at 866-912-6285.
Some examples of major life changes are:
- A change in blindness or disability
- Moving to a new county or out of state
- A change in your name
- A move to a different address
- A change in your job
- Having or obtaining health coverage under another policy or if there are changes to the coverage
Also, you should call your eligibility source if you have a change in your family size. This might mean that your family got bigger because of a birth or a marriage. You should also report when your family gets smaller. This may happen because a family member moves away or there is a death in the family. A divorce could also change family size.