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MississippiCAN Health Plans must cover all medications covered by regular (fee for service) Medicaid, but may cover additional medications if they choose to do so. MississippiCAN Health Plans must use the Universal Preferred Drug List (PDL) and the same prior authorization criteria as regular Medicaid.
You qualify for a Special Enrollment Period if you've had certain life events, including losing health coverage, moving, getting married, having a baby, or adopting a child, or if your household income is below a certain amount.
You can make changes to your Medicare Advantage and Medicare prescription drug coverage when certain events happen in your life, like if you move or you lose other insurance coverage. These chances to make changes are called Special Enrollment Periods (SEPs).
Normally, coverage is only available for purchase during the annual open enrollment period, but a special enrollment period allows people to sign up for coverage outside of that annual window, as long as they have a qualifying event.
If you get married, you're eligible to get coverage effective the first of the following month, regardless of how late in the month you enroll. If you have a baby, adopt a child, or receive a court order for medical child support, the coverage can be backdated to the date of the birth, adoption, or court order.
Your coverage won't start until you pay your first premium. If confirmation delays kept you from using your plan after the coverage start date, you may have to pay premiums for one or more previous months. When you do, medical expenses you had after the start date may be covered. This is called retroactive coverage.
Why do we have an open enrollment period? The open enrollment period was put into place to discourage adverse selection which happens when sick people sign up for health insurance and healthy people don't. It greatly skews the amount of financial risk a health plan takes when insuring customers.
A change in your situation like getting married, having a baby, or losing health coverage that can make you eligible for a Special Enrollment Period, allowing you to enroll in health insurance outside the yearly Open Enrollment Period.