A Guide to Wyoming Medicaid

Do you want healthcare that doesn't put your financial stability in jeopardy? You should consider applying for Wyoming Medicaid. Keep reading to learn everything you should know about the program, including coverage, eligibility, how to apply, and more. As of June 2023, 84,529 Wyomingites were enrolled in the program.

If you're looking for more complete coverage, consider supplementing Medicaid with third-party insurance so you can have coverage for things the public plan doesn't include. With everything you learn in this guide, you can determine the combination of coverage that will work best for you. To prevent shouldering the debt of unexpected medical expenses, many people in Wyoming extend their Medicaid coverage to include a more comprehensive range of benefits and services by way of private health insurance.

In this guide, we'll discuss Wyoming Medicaid, including what the plan covers, how to apply, and the most common procedures people seek on the plan. You can then search for additional coverage through the Insurdinary website.

    What Is Wyoming Medicaid?

    What is Wyoming Medicaid? It is the state-funded extension of the federal Medicare program that provides free or affordable healthcare to eligible people and families. The Wyoming Department of Health administers the program.

    It provides this healthcare to both families and individuals. Depending on what program you qualify for, coverage ranges from preventive healthcare to routine doctor visits and surgical procedures.

    What does this Wyoming health insurance cost? While certain programs, such as Employed Individuals with Disabilities, have a small monthly fee or copay, most covered individuals won't pay anything for the majority of their healthcare.

    Where do the funds for Wyoming Medicaid come from? Wyoming is one of the few states that does not accept federal funding for its Medicaid plan, and thus, the state funds 100% of the cost.

    As of 2021, over 12% of Wyoming citizens were without healthcare, and the state's legislature has denied expanding Medicaid several times. Doing so would accept federal funds for the health insurance plan and grant an additional 10,000 citizens or more access.

    What Is a Wyoming Medicaid Card?

    Wyoming Medicaid

    A Wyoming Medicaid Card acts as your patient identification and confirmation of your eligibility for receiving care. You'll receive your card in the mail along with your letter confirming your enrollment. The card contains a unique plan number that helps apply your benefits to your healthcare treatments.

    You can only use your card and receive benefits from eligible medical providers. Carry the card with you at all times in case you need it for a medical emergency.

    Applying for Wyoming Medicaid

    Are you wondering how to apply for Wyoming Medicaid? You can apply online, over the phone at 1-855-294-2127, or by mailing a paper application or returning it to the Wyoming Department of Health Customer Service Center in Cheyenne. If you filled out a paper copy, you can also scan it and email it to wesapplications@wyo.gov.

    You might wait up to 45 days for the administration to review and accept your application after you apply for Medicaid. When you apply for the program, have the following documents on hand:

    • Your social security number, which proves you're eligible to receive public benefits
    • Additional evidence of your US citizenship, including a passport, driver's license, or birth certificate
    • Records of all income sources, even if they're illegal
    • Your proof of origin if you are a legal US immigrant
    • Proof of your Wyoming residency
    • Any cards from your existing insurance, including car insurance and life insurance
    • If you're pregnant, any documents proving your condition
    • If you're applying for your child, proof that they're your dependent.

    Eligibility Requirements

    What makes you eligible for Wyoming Medicaid? You could receive coverage if any of the following apply to you:

    • Parents with dependant children who make up to 56% of the poverty line
    • Pregnant women or children up to five years old whose household makes up to 159% of the poverty level
    • Children up to age 18 whose household income doesn't exceed 138% of the poverty limit

    You may qualify for other programs contained under Wyoming Medicaid if you're a senior citizen, disabled, or require some form of long-term care. Check the Medicaid income requirements for more information.

    Getting a Wyoming Medicaid Card

    You're not required to perform extra steps to obtain your Wyoming Medicaid Card, as you receive it in the mail with your acceptance letter. If you incur medical expenses after you apply but before you receive your card, keep records of the bills, and Medicaid may pay the expenses retroactively.

    Renewing or Replacing Your Wyoming Medicaid Card

    If you lose your Medicaid or Kid Care CHIP card, you can ask for a new one by visiting your Department of Health patient portal or calling 855-294-2127. In most cases, you won't pay to replace your card.

    You'll need to reapply and renew your healthcare coverage every year to ensure you still meet the income requirements. However, your original card stays valid for as long as you're eligible for coverage. Do not apply for a new card when you renew your enrollment in Medicaid.

    In Wyoming, Magellan Healthcare, Inc. provides your Medicaid coverage. This care management entity acts as a centralized hub for providing care and managing claims. Magellan Healthcare divides its services into the following four categories:

    • Family Care Coordinators: When a child or family enrolls with Medicaid, they choose an FCC to work with.
    • Family Support Partner: If you have a child who needs additional emotional or behavioral support, you can choose to work with an FSP.
    • Youth Support Partner: Children enrolled without the rest of their family can opt to work with a youth support partner.
    • Respite Providers: If your required medical care includes respite, an RP can help you navigate the process.

    Wyoming Medicaid Coverage

    What is Wyoming Medicaid coverage? Most people are most interested in learning about what Wyoming Medicaid covers concerning the following most popular areas. You can find more information in the Wyoming Medicaid Handbook.

    Dental

    Children and adults under the age of 21 have full dental coverage under Wyoming Medicaid. However, only children between ages six and 18 qualify for braces if they have severe alignment issues. Members older than 20 years old can receive covered dental care classified as preventive or emergency, including two check-ups per year, extractions, and maintenance.

    The dental coverage offered by Wyoming Medicaid is comprehensive, but it only covers limited and emergency services. Restorative procedures are not offered. For this reason, investing in private dental plans in Wyoming is advisable.

    Prescription Drugs

    Change Healthcare is the Medicaid program that handles prescription drug coverage under Wyoming Medicaid. Members under the age of 21 and a couple of other demographics, like pregnant women, won't have any copays. Other members might have small copays for certain medications, but the copays don't exceed $5.

    Vaccines, family planning, and emergency prescriptions never require payment. You can check the preferred drug list for more information. Copays should never exceed more than 5% of your household's annual income.

    Extended Health Care

    Wyoming Medicaid offers a wide variety of programs that expand care to the elderly, disabled, and more. The following are the most popular programs:

    • Kid Care CHIP: The CHIP program is the child-focused branch of Wyoming Medicaid. It includes full dental coverage and small copays for most other health services.
    • Children's Mental Health Waiver: This short-term home and community program provides alternatives for children with severe emotional disturbances. Rather than prolonged psychiatric hospitalization, they receive other methods of intensive care.
    • Pregnant By Choice: This program extends the coverage for eligible women up to 12 months after the birth. It includes mandatory cooperation with the Child Support Enforcement team.
    • Medicare Savings programs: The Qualified Medicare Beneficiary and Specified Low-Income Medicare Beneficiary programs help members pay premiums and copays they can't afford. To qualify, the member's household income cannot exceed 135% of the federal poverty limit.
    • Institutional Programs: These programs help people, particularly seniors, who require long-term care but can't continue living within the community. The program requires the person receiving the care to contribute a small percentage of their income to help the state pay for the cost.
    • Employed Individuals with Disabilities: The EID extends Medicaid coverage to certain people with disabilities, provided they work and meet the Social Security Disabilities guidelines. Under this program, you'll pay a small monthly premium.
    • Parent and Caretaker Relative: This program provides various forms of support for parents, caretakers, or relatives who care for a minor that is eligible for Medicaid.
    • Household Medical Items: Should an accident occur leaving a person permanently or temporarily disabled, the program will provide any equipment needed to maintain mobility. However it won’t replace your finances. Investing in quality disability insurance will provide the financial protection required to protect your family.

    Travel and Out of State Coverage

    If you're traveling out of state, you might have trouble finding coverage. For children requiring emergency medical attention, the program covers treatment provided by any medical professional enrolled as a provider under Wyoming Medicaid. Other services will require special approval for coverage. The States Medicaid program will provide transportation to and from appts should the member have no other means of transportation. Refer to the Wyoming Medicaid Travel Assistance Guide for full details.

    It is imperative to know that the program does not cover instances when an enrolled individual is traveling for leisure. If you are traveling outside of Wyoming for leisure, invest in proper travelers insurance.

    Students & Seniors

    Wyoming Medicaid doesn't specifically cover students, such as those enrolled in colleges. However, any child or young adult can receive coverage, regardless of their educational or enrollment status, depending on their income eligibility.

    Seniors at least 65 years of age or older are eligible for coverage under the general Wyoming Medicaid program. They are also eligible for additional programs, such as institutional programs, under certain conditions.

    Coverage for Subgroups

    Wyoming Medicaid extends its coverage to special groups such as Military and Indigenous People.

    Indigenous Peoples

    Wyoming Medicaid doesn't provide special coverage for indigenous populations. However, the Indian Health Service has created a special handbook for providers that serve Native American Populations.

    Military

    Military veterans should seek help from the Department of Veteran Affairs for medical coverage beyond what's provided for their enrollment in Medicaid.

    What Wyoming Medicaid Does Not Cover

    You can better understand what Wyoming Medicaid covers by knowing what services you won't have coverage for. Like other states, Wyoming Medicaid does not cover any service from a non-enrolled provider or for procedures and devices that are not medically necessary, such as cosmetic plastic surgery. The program also does not cover the following treatments or services:

    Abortions, except those mandated under federal law
    Fees incurred from canceled or missed appointments
    Rehabilitation from chronic pain
    Community mental health services
    Cosmetic services, such as plastic surgery or dental work
    Educational equipment
    Non-medical exams
    Experimental procedures
    Gender reassignment surgery, even when included under a diagnosis of gender dysphoria
    Eyewear, such as glasses or contacts, for adults over 21
    Treatments for infertility, such as in-vitro fertilization
    Items used exclusively for personal comfort
    Podiatry services, such as insoles or orthopedic shoes
    Private nursing services and long-term in-home care
    Excessive (more than 12) non-emergency hospital visits for adults per year
    Excessive (more than 20) occupational therapy, speech therapy, or physical therapy for adults in a calendar year

    This list is not exhaustive, so consult the handbook to learn more.

    Also, Wyoming Medicaid only provides up to $1000 towards the cost of a funeral. Considering the rising cost of burials and associated fees, ensure that you and your family are secured with comprehensive funeral insurance.

    Common Procedures and Wyoming Medicaid Eligibility

    Understanding Wyoming Medicaid coverage is a complicated and nuanced process. While you can read the handbook for details, what follows is more in-depth information about the most popular medical services and what way the program covers them.

    Dental
    Members under the age of 21 receive full dental coverage, except for braces, which require a referral. Adults at least 21 years old can receive the following covered dental services:
    X-Rays Yes, included in two preventative and maintenance check-ups a year
    Exams Yes, included in two preventative and maintenance check-ups a year
    Basic Cleaning Yes, included in two preventative and maintenance check-ups a year
    Emergency Dental Services Yes, if needed to relieve pain
    Extractions Yes
    Denture Maintenance Yes
    Wisdom Teeth Removal Yes, but requires pre-approval
    Vision
    Eye Exams For members under the age of 21 and if deemed medically necessary
    Eyeglasses or Contacts For members under the age of 21 and if deemed medically necessary
    Emergency Eye Care Older adults only receive coverage for emergency care, which includes treating an eye injury or disease
    Laser Eye Surgery Yes, if it is considered medically necessary
    Surgery
    No matter your age, Wyoming Medicaid provides coverage for medically necessary surgical procedures. The program does not cover surgical procedures for purely cosmetic reasons, such as breast augmentation or lip enhancement.
    Rhinoplasty Yes, pre-approval is required
    Breast Reduction Yes, pre-approval is required
    Hospital
    Wyoming Medicaid covers the following in-patient hospital services with a few exceptions:
    Hospital stays Wyoming Medicaid covers hospital stays for members of all ages. This includes any medically necessary tests, treatments, and procedures ordered by a qualified professional during the stay.
    Transportation The program covers all emergency transportation services and may cover non-emergency ambulance services if other transportation would put the person in danger. You can also seek reimbursement for costs associated with transporting yourself to the hospital.
    Labor and Delivery Wyoming Medicaid covers all costs associated with labor and delivery, including the services of a nurse practitioner or midwife.
    Therapy and Counselling

    No matter your age, you can receive coverage for mental health therapy and counseling services when provided by a community health center under the supervision of a qualified and licensed mental health professional. This includes substance abuse and rehabilitation services.

    Coverage for psychiatric hospitalization and long-term in-patient treatment requires pre-approval.

    Sexual Health
    Wyoming Medicaid covers a wide range of sexual health treatments, products, and procedures, including the following.
    Gynecology Medicaid covers all medically necessary gynecological services and check-ups, including pregnancy testing
    Erectile Dysfunction No
    Family Planning The program covers all costs associated with delaying pregnancy, including contraception medication
    Birth Control Covers birth control devices, like the intrauterine device
    STI Management Wyoming Medicaid provides coverage for screening and managing sexually transmitted infections
    Infertility Treatment No
    Specialist Services
    Dermatologist Medicaid might cover dermatology services when considered medically necessary and after a referral from a general practitioner. Medically necessary dermatology includes treatment for skin cancer or some forms of acne but may require pre-approval.
    Physiotherapy The Wyoming Medicaid handbook makes no mention of whether it covers physiotherapy, but it allows for up to 20 physical therapy (an associated treatment) sessions a year. You'll likely have coverage for these expenses if your provider deems them medically necessary and you have a referral from a qualified professional.
    Massage Therapy While the handbook doesn't mention massage coverage, many insurance programs group it under acupuncture, which Medicaid doesn't cover. If you have questions, ask your provider under what circumstances you might obtain coverage for massage services.
    Podiatry and Foot Care Medicaid doesn't cover any podiatry services except in the rare situation where they previously paid primary.
    Allergist and Allergy Testing The Medicaid handbook doesn't explicitly state whether it covers services from an allergist. However, based on general policy, the program likely covers these services when medically necessary and provided by a qualified healthcare professional.
    Sleep Physician Services and CPAP Machines Like other services that the handbook doesn't mention, you can likely receive coverage for sleep services and devices under certain qualifying conditions.
    If you require medical care from a specialist outside the Medicaid network or from a healthcare sector not covered under Medicaid, consider supplementing the plan with additional private insurance.

    Extending Wyoming Medicaid Coverage

    Now that you understand what Wyoming Medicaid covers, you can make an educated choice about whether you should expand your coverage. While the program can provide for your basic medical needs, many people choose to supplement it with third-party insurance.

    When you extend your healthcare coverage with additional insurance, you gain the following benefits:

    • Out-of-network access: If you have additional insurance, you have a wider choice of healthcare professionals you can visit. If you don't like your doctor within the Medicaid network, you can find one you like through your private insurance.
    • Avoid enrollment caps: Medicaid imposes caps on how often you can visit the doctor, such as limiting your physical therapy visits to 20 sessions a year. With additional insurance, you can avoid many of these caps.
    • Alternative or experimental access: Medicaid doesn't allow experimental or alternative treatments, such as acupuncture or non-approved drugs. However, depending on the type of private insurance you obtain, you could find a way to obtain and cover the procedures.
    • Prompt reimbursements: To cover some of your costs, such as non-emergency transportation, you'll receive reimbursement from the state. The bureaucracy required to receive the payment can take months, but with private insurance, the process proceeds much faster.
    • Out-of-state coverage: If you have a medical emergency while traveling outside Wyoming, you likely won't obtain coverage for the treatment if you're an adult. However, most private insurance providers cover such cases, which helps you protect your financial situation.

    Your options for extending your medical coverage include the following:

    • Health and dental insurance: Expanding your health and dental coverage with similar coverage is an obvious choice for obtaining the complete coverage you need to stay healthy and financially secure.
    • Disability insurance: While Medicaid can treat and manage your disability, it won't replace your lost income. Disability insurance is an essential way of protecting your financial stability, while Medicaid covers your associated medical expenses.
    • Travel insurance: Part of travel insurance covers emergency medical expenses incurred while traveling abroad or out of state. Because Wyoming Medicaid doesn't cover most out-of-state medical costs, travel insurance can help protect you from those rare occurrences.
    • Car insurance: While Medicaid will likely cover most expenses associated with a car accident, it might not provide for all the physical therapy or other treatments you require. Having car insurance that can pay these expenses can help make up the difference.

    How can you determine the best third-party insurance for you? First, consider your budget. If you qualify for Medicaid, you probably don't have much income to spare, but even if you can only find an extra $100 in your monthly budget, consider how much money you'll save in the event something goes wrong. Other types of private insurance, such as life insurance, can help pay for medical costs Medicaid will not cover, especially in the event of your passing.

    Next, consider what type of treatment you need that Medicaid doesn't cover. Rather than looking for a general insurance plan that doubles up coverage with Medicaid, consider finding a policy that only covers things like podiatry, eye care, or massage. Also, consider a catastrophic plan that has a deductible but a low monthly premium.

    If you want greater coverage than Wyoming Medicaid can supply, search the Insurdinary website today. We help you compare prices and find the best coverage for your needs. To evaluate your options, apply for a free online quote.

    FAQ’s

    How long is the approval process for Wyoming Medicaid?

    The approval timeline for Wyoming Medicaid can vary based on individual circumstances. On average, the process takes approximately 30 to 45 days. Urgent cases can be expedited for quicker processing.

    What are the application methods for Wyoming Medicaid?

    You can apply for Wyoming Medicaid online, in person, by mail, or at a local Department of Health Services office. Ensure you submit necessary documents, including proof of income, household size, and residency, with your application.

    Does Wyoming Medicaid cover funeral expenses?

    No, Wyoming Medicaid primarily provides healthcare coverage and does not include benefits for funeral expenses. If you require assistance with funeral costs, consider exploring options like funeral insurance.

    Who is eligible for Wyoming Medicaid?

    Eligibility for Wyoming Medicaid is based on factors such as income, household composition, and other considerations. The program typically covers low-income individuals, families, pregnant women, children, elderly individuals, and those with disabilities.

    What is Wyoming Medicaid?

    Wyoming Medicaid is a program designed to provide medical coverage to eligible low-income residents of the state. Funded jointly by federal and state resources, its goal is to ensure access to essential healthcare services for qualifying individuals.

    What other types of insurance does Insurdinary offer?

    Insurdinary, and its network of partners offer many different types of insurance. In addition to health, dental, disability, life, funeral and travel insurance as discussed on this page, you may also be interested to explore the following:

    References

    1. http://health.wyo.gov/
    2. http://usafacts.org/topics/health/state/wyoming/
    3. http://files.kff.org/attachment/fact-sheet-medicaid-state-WY
    4. http://www.wyomingmedicaid.com/portal/find-doctor-hospital-or-clinic
    5. http://www.wesystem.wyo.gov/access/login
    6. http://health.wyo.gov/healthcarefin/apply/
    7. http://health.wyo.gov/wp-content/uploads/2023/01/Application-for-Health-Coverage-Help-Paying-Costs-January-2023-10-1.pdf
    8. http://health.wyo.gov/healthcarefin/medicaid/programs-and-eligibility/medicaid-income-requirements/
    9. http://wyomingmedicaid.com/portal/Medicaid_Handbook
    10. http://www.wymedicaid.org/
    11. http://health.wyo.gov/healthcarefin/medicaid/programs-and-eligibility/
    12. http://health.wyo.gov/wp-content/uploads/2023/03/Tribal_Provider_Manual.pdf
    13. http://health.wyo.gov/healthcarefin/medicaid/care-management-entity/
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