Know your options for Medicare Advantage Plans in Wyoming and find out how to enroll.
TABLE OF CONTENTS
When you become eligible for Medicare, the federal government health insurance program, you have two options for how you get your coverage: through Original Medicare, which includes Medicare Part A and Part B, or through a Medicare Advantage Plan, also called Medicare Part C.
Medicare Advantage Plans are bundled plans designed to be an all-in-one alternative to Original Medicare. These plans include the same coverage as you would get through Medicare Part A and B, and often provide Part D prescription drug coverage as well. Some plans may provide other benefits for things Original Medicare doesn’t cover, such as dental, vision and hearing.
Since Medicare Advantage Plans are offered through Medicare-approved insurance companies that set their own benefits and rates, each Medicare Advantage Plan is unique. For this reason, you should compare the plans available to you before enrolling.
Continue reading this guide to learn everything you need to know about Medicare Advantage Plans in Wyoming.
You have choices in Medicare coverage. While you can opt to stick with Original Medicare, a Medicare Advantage Plan – also known as Part C – may be a better alternative for you.
|Original Medicare||Medicare Advantage Plans|
|Original Medicare covers your Part A hospital insurance and Part B medical insurance.||Medicare Advantage Plans combine Part A, Part B, and additional benefits.|
|You can add Part D prescription drug coverage.||Prescription drug coverage is usually included.|
|You’re able to use any medical provider in the U.S. that accepts Medicare.||You’ll usually need to use doctors in your plan’s network.|
|You can buy supplemental coverage to manage out-of-pocket costs, including your coinsurance.||Your Medicare Advantage Plan may have lower out-of-pocket costs than Original Medicare.|
|Vision, hearing, dental, and other benefits aren’t covered.||Your plan may offer additional benefits, including vision, hearing, and dental.|
Medicare Advantage Plans cover benefits from Original Medicare Part A (hospital insurance), Part B (medical insurance), usually Part D (prescription drug coverage), and sometimes additional benefits that Original Medicare doesn’t cover. Each Medicare Advantage Plan insurer sets the rules about how you receive and pay for these benefits.
|Hospital and skilled nursing facility inpatient care||Home health care||Prescription drug coverage (if included in your plan)|
|Medically necessary outpatient services, such as:
||Preventive services, such as:
||Additional benefits (depending on your plan), such as:
With 16 Medicare Advantage Plans available in Wyoming, your options may be limited. To help you choose the best plan for you, consider what is most important to you before selecting a plan. There are several factors to keep in mind:
There are 16 Medicare Advantage Plans available across Wyoming. These include:
|Number of Medicare Advantage Plans available||Medicare Advantage Plan types available||Medicare Advantage Plans rated 3.5 or higher by NCQA|
In Wyoming, the most common Medicare Advantage plans available are HMOs or PPOs, although there are also a few SNPs and regional PFFS plans available. Seniors eligible for Medicare may choose from plans provided by multiple private insurers, although the choices available vary by county.
|HMOs||HMOs typically require that you receive all services from in network providers:
|PPOs||PPOs include a preferred network of providers, but you have the option of choosing doctors or hospitals from outside of the network for a higher cost.
|PFFS Plans||PFFS plans don’t require a primary care physician or referrals for specialists:
|SNPs||SNPs are only for people with specific conditions and characteristics, and include care coordination and targeted benefits tailored to meet your specific needs:
You’re eligible for Medicare when you turn 65 or if you’re younger and have a qualifying disability. A qualifying disability means at least one of the following applies:
When you become eligible for Medicare, you are also eligible for Medicare Advantage Plans. There are specific times of the year when you can enroll for the first time in a Medicare Advantage Plan: during your Initial Enrollment Period and the Open Enrollment Period.
Medicare Advantage Open Enrollment occurs between January 1 and March 31 of each year. This period is only for beneficiaries already in a Medicare Advantage Plan, and you can change plans or switch to Original Medicare. You cannot switch from Original Medicare to Medicare Advantage during Medicare Advantage Open Enrollment.
There are exceptions to these enrollment periods called Special Enrollment Periods. Certain events or circumstances may make you eligible to change your Medicare Advantage Plan outside of the open enrollment periods, such as if you move outside of your existing plan’s service area or to a location with new plan options you didn’t have before. If you think you may qualify for a Special Enrollment Period, call 1-800-MEDICARE and explain your situation.
|Enrollment period||When it happens||Medicare plans you can choose||What you can do|
|Initial Enrollment Period||Three months before you turn 65, the month you turn 65, and three months after||Medicare Part A, Part B, Part D, Medigap, or Medicare Advantage Plan||Sign up for Medicare Part A and Part B. Complete your Part B enrollment to avoid a late enrollment penalty.|
|General Enrollment Period||January 1 – March 31||Medicare Part A, Part B, Part D, Medigap, or Medicare Advantage Plan. If you enroll in Medicare during this period, your MAP enrollment is April through June.||Sign up for Medicare if you missed your IEP|
|Open Enrollment Period||October 15 – December 7||Medicare Part A, Part B, Part D, Medigap, or Medicare Advantage Plan||Join, switch, or drop a plan|
|Medicare Advantage Open Enrollment Period||January 1 – March 31||Medicare Part A, Part B, Part D, Medigap, or Medicare Advantage Plan||If you’re enrolled in a Medicare Advantage Plan, you can change your plan or switch to Original Medicare|
|Special Enrollment Period||When you have a qualifying event||Medicare Part A, Part B, Part D, Medigap, or Medicare Advantage Plan||Make changes to your plan|
Most Medicare Advantage HMO and PPO plans and all SNP plans provide prescription drug coverage like you would get from Medicare Part D. Some PFFS plans may provide prescription drug coverage, but not all do. Evaluate a plan’s prescription drug coverage when deciding which Wyoming Medicare Advantage Plan to use.
Prescription drug coverage may vary by cost, coverage, and convenience among Medicare Advantage Plans. Your monthly premium may include a premium for the drug coverage in the plan. There is usually a copayment or coinsurance amount that you have to pay for each prescription after you reach your annual deductible.
Some plans use different cost tiers with different costs for different drugs. For instance, you may pay less for generic drugs than brand-name drugs or less for brand-name drugs within different tiers. If your plan uses tiers, the formulary will list all covered drugs and their tiers. Verify your preferred or local pharmacies are included in the plan’s network.
|Resource||Contact||How they help|
|Casper Senior Network||[email protected]||The mission of the Casper Senior Network is to form an active, stable network of collaborative agencies for the purpose of advocacy, education, and identification of needs and to facilitate implementation of strategies to meet the needs of the elderly and their families in our community|
|Wyoming Aging and Disability Resource Center||(800) 442-2766||The Wyoming Aging and Disability Resources Center website is designed to help connect older adults and people with disabilities to a variety of helpful information and services|
|Wyoming Department of Health||(307) 777-7656||The Wyoming Department of Health helps serve the healthcare needs of Wyoming residents|
|Wyoming Center on Aging||(307) 766-2829
|The mission of the Wyoming Center on Aging is to optimize the health and well-being of Wyoming’s older residents and their caregivers through interagency partnerships, basic and applied research, community education, and clinical training and services|
|Wyoming Department of Insurance||(307) 777-7401||The mission of the Wyoming Department of Insurance is to enforce the insurance laws and regulations of the State impartially, honestly, and expeditiously; to serve the consumer of insurance; to encourage a healthy insurance marketplace; and to promote change to better serve the public interest|
|Wyoming Medicaid||(307) 777-7531||Medicaid helps pay for certain health care services, and is available to qualifying families, children, individuals who are aged, blind or disabled, and qualified or non-qualified aliens|
|Resource||Contact||How they help|
|Buffalo Senior Center||(307) 684-9551||The Buffalo Senior Center offers a range of services that help them remain as independent as possible in their own residences as opposed to premature placement in a longer term care residential location|
|Carbon County Senior Services||(307) 328-0320||Carbon County Senior Services offers meal deliveries, bus services, and senior centers to residents of Carbon County|
|Central Wyoming Senior Services||(307) 777-7995||Central Wyoming Senior Services seeks to increase the self-sufficiency, safety, health and wellness of Wyoming’s older adults and people with disabilities in the least restrictive environment while supporting their caregivers|
|Golden Hour Senior Center||(307) 872-3223||The mission of Golden Hour Senior Center is to enrich the lives and support the independence of
older adults through nutrition, socialization, education and physical activity
|Hot Springs County Senior Citizens Center||(307) 864-2151
|Hot Springs County Senior Citizens Center provides a variety of activities, services and opportunities for participation, learning and socialization to older individuals to help them retain their personal skills & diminish stress to help them remain independent in their own homes and communities for as long as safely possible|
|Niobrara Senior Center||(307) 334-2561||The Niobrara Senior Center provides homemaking and handyman services, a personal emergency response System, lifeline caregiver support, information & assistance with Forms, elderly tax refund, property tax
LIEAP, Medicare, prescription drug plans, and Gas Choice
|Riverton Senior Citizens Center||(307) 856-6332||The Riverton Senior Center is a community center whose focus is on promoting the independence of seniors through a variety of
activities and programs that meet seniors’ needs
|Senior Center of Jackson Hole||(307) 733-7300||The Senior Center of Jackson Hole is open for exercise classes, equipment room, socially distanced activities and To-Go lunch|
|Services for Seniors||(307) 322-3424||Services for Seniors operates the four State recognized senior centers in Platte County, serving seniors under the Older Americans Act since 1974|
|Thayne Senior Center||(307) 883-2678||Thayne Senior Center provides dine-in meals, meal delivery, van service, foot care clinics, exercise classes, and other activities to area seniors|
|The Hub on Smith (Sheridan Senior Center)||(800) 795-3272||The Hub on Smith offers adult day facilities, transit, meals, a thrift store, as well as activities which cater to area seniors|
|Uinta Senior Citizens||(307) 789-3553||Uinta Senior Citizens, Inc. (USCI), is the only sanctioned, community-based In-Home Services and National Family Caregiver Service in Lincoln and Uinta Counties|
|Weston County Senior Services||(307) 746-4903||Weston County Senior Services (WCSS) is a non-profit corporation, established to serve the folks county-wide with nutrition, transportation, health services, and recreation|
|Worland Senior Center||(307) 347-3208||Worland Senior Center offers light housekeeping, Personal Emergency Response Systems, personal care, home delivered meals, transportation and activities|
|Wyoming Senior Citizens, Inc.||(800) 856-4398||WYOMING SENIOR CITIZENS, INC. (WSCI) founded in 1975 is a private, nonprofit organization whose purpose is to meet the needs of Wyoming’s older residents and help them maintain their independence|
|Resource||Contact||How they help|
|CMS Medicare Managed Care Appeals & Grievances||(800) 633-4227||Provided by the CMS, this page provides information related to dealing with Medicare managed care plan grievances and appeals|
|CMS Medicare Managed Care Eligibility and Enrollment||(800) 633-4227||Provided by the Centers for Medicare & Medicaid Services (CMS), this page offers information for contacting MAP organizations plus other health plans and related aspects to Medicare health plan enrollment|
|CMS Medicare Prescription Drug Eligibility and Enrollment||(800) 633-4227||Provided by the CMS, this page details prescription drug eligibility and enrollment as it relates to MAP|
Tammy Burns is an experienced health insurance advisor. She earned her nursing degree in 1990 from Jacksonville State University, obtained her insurance billing and coding certification in 1995, and holds a health and life insurance license in Alabama, Georgia, Iowa, Mississippi, and Tennessee. Burns is Affordable Care Act (ACA)-certified for health insurance and other ancillary, life, and annuity products. She maintains an active nursing license and practices private-duty nursing.
Burns’ background as a nurse, insurance biller and coder, and insurance consultant includes infectious disease, oncology, gynecology, phlebotomy, post operative, family medicine, geriatrics, home health, hospice, human resources, management, billing, coding, claims, fixed annuities, group and individual health and life products, and Medicare. She’s always been driven by a desire to help people, spending more than 25 years as a practicing nurse in hospitals, private doctors’ offices, home health, and hospice. As a nurse, Burns supported patients filing insurance claims with Medicare, Medicaid, and private insurance companies as well as responding to billing questions from confused patients.
Seeing firsthand how unsuspecting patients are frequently confused by an overly complex system they don’t understand led Burns to become an insurance agent and health care consultant, now helping people understand the medical system. Since becoming an insurance agent in 2013, she has worked with some of the largest and most reputable insurance carriers and agencies in the nation, and she has built a large and loyal clientele by way of her commitment to transparency and personalized service.