Wyoming Health Insurance: Find Affordable Plans

There are multiple ways to obtain affordable health insurance coverage if you live in Wyoming. Your employer can provide it to you, you can purchase a plan on Healthcare.gov or directly from a broker or a health insurance company, and you can also buy a cheap short-term insurance plan. You can apply for Medicare if you are 65 and over or have a qualifying disability. If your income falls below a certain limit, you may be eligible for Medicaid.

Read this guide to learn about your health insurance options, their costs, and how to enroll a plan.

• Enrollment options: Wyoming residents can purchase Affordable Care Act (ACA) plans on Healthcare.gov, where you may be eligible for premium tax credits and cost-sharing reductions (CSRs). Alternatively, you can buy a plan from brokers, insurance agents, and health insurance companies.
• Open enrollment: Open enrollment in Wyoming starts on November 1 and ends on January 15. You’ll need a qualifying event to enroll outside of this period, such as getting married or divorced, becoming a U.S. citizen or permanent resident, having or adopting a baby, or moving to Wyoming.
• Individual plans: Off-exchange options are also available if you don’t want to buy health insurance coverage on Healthcare.gov. Under the ACA, all plans must cover pre-existing conditions, mental health care, and other essential benefits, but they don’t include tax credits or CSRs.
• Coverage types: 51.1% of Wyoming residents have access to health insurance through an employer. The next highest group is made up by seniors with disabilities who receive Medicare, at about 16.2%, followed by Medicaid beneficiaries, who represent 11.5% of the population. Non-group insurance — which includes short-term insurance and alternative health plans — comprise 7.1%, while the military provides health coverage for 1.8% of residents. Wyoming has a relatively high rate of uninsured residents at 12.3%.

If you’re interested in an ACA plan, the first thing you’ll need to do is create an account on Healthcare.gov.

Once you have an account, you can apply for health insurance. The Health Insurance Marketplace checks your eligibility for Medicaid and uses the information you provide to determine if you qualify for an Advanced Premium Tax Credit. Make sure you have the full name, birth date, and Social Security number of every person in your family who needs coverage before you start the application process.

The application will ask you several questions related to your income and family, including the following:

• Are you single or married?
• How many tax dependents will you claim on your current return?
• How much income will your household make this year?
• Do you want to see if you can get help paying for coverage?

Once you finish setting up your account, you’ll be able to view up to three plans side by side in order to help you select one that suits your family’s budget and health care needs. Depending on your income, many of these plans offer tax credits and other savings benefits.

State residents can purchase health insurance coverage from the following companies:

• Blue Cross Blue Shield of Wyoming
• Mountain Health CO-OP

There are some important considerations when shopping for individual coverage, whether for yourself or multiple people. These considerations include:

• Medical needs
• Preferred plan type
• Premium affordability
• Individual vs. family deductibles

Insurance for individuals in Wyoming

When shopping for an individual plan, your budget and your overall health are the two most important factors to consider. For most plans, the monthly premium isn’t your only out-of-pocket cost. You also have to think about the deductible, the copay for each service, and the coinsurance requirements.

If you’re in good health and don’t plan to use your insurance often, you may save the most money by enrolling in the plan with the lowest premium. You’ll be covered in the event of a sudden illness or injury, but you won’t have to worry about paying a high premium each month.

If you have a chronic health condition, however, you need to weigh the low premium against other out-of-pocket costs. A plan that costs $350 per month and has a $500 deductible may be a better fit for your financial needs than a plan that costs $250 per month and has a $5,000 deductible if you require regular medical care. A more expensive plan may also give you access to more specialists or better coverage for your prescriptions.

There are different types of plans you can choose from:

• A Health Maintenance Organization plan (HMO) offers the best choice if you don’t make many visits to a doctor or a specialist or require prescriptions. It has lower monthly premiums and higher deductibles. HMO plans are the least expensive plans. However, there are restrictions with an HMO plan. You’ll need to get a referral if you want to see a specialist, you’ll need to name a primary care physician, and you’re limited to using the HMO plan’s in-network medical providers.
• A Preferred Provider Organization (PPO) plan is a better idea if you regularly visit doctors or specialists. You’ll have more flexibility with a PPO plan, although you’ll pay more for it. You aren’t limited to in-network providers, you don’t need to name a primary care physician, and you’ll never need to obtain a referral to see a specialist.
• A Point of Service Plan (POS) is a hybrid of an HMO and a PPO. You can use out-of-network providers, but any time you want to see a specialist, you’ll need to get a referral.

Insurance for families in Wyoming

If you need coverage for multiple people, you need to think about how each person might use the plan. A spouse may need maternity care or fertility services, while a child might need to be covered for a tonsillectomy or other common childhood procedure. Review the plan details carefully to make sure the services you need are covered. If someone in your family receives specialty care, you should also check to make sure the specialist participates in the plan’s network.

Another consideration for family plans is that many plans have an individual deductible and a family deductible. An individual deductible applies to each person covered by the plan, while the family deductible applies to the entire family. If one of your family members is hospitalized or undergoes an expensive surgery, it’s possible to meet the family deductible before every person on the plan has met their individual deductible.

Healthcare.gov insurance plans in Wyoming are organized in four metal tiers: Bronze, Silver, Gold and Platinum, which indicate the level of coverage. All plans available on Healthcare.gov offer quality health coverage. While Wyoming has some of the highest premiums in the country, there are free bronze plans (and even some Gold plans) if you qualify for subsidies.

• Bronze plans have low monthly premiums but high deductibles and a coinsurance payment of 40%. These are ideal plans if you’re healthy and don’t require much health care. The most affordable Bronze plan in Wyoming, not considering any benefits or tax credits, is $507 per month for 2022.
• Silver plans have higher monthly premiums but lower deductibles and a lower coinsurance payment of 30%. These plans also offer premium tax credits and CSRs to eligible individuals and families. In 2022, the lowest priced Silver plan in Wyoming costs $745 per month before factoring in any benefits or tax credits.
• Gold and platinum plans are an excellent choice if you have a chronic health condition with= medications or regular visits to specialists. These plans are eligible for tax credits and benefits, and have low deductibles and low coinsurance payments — 20% for gold plan and 10% for a platinum plan. However, monthly premiums are usually high. The most affordable gold plan in 2022 within Wyoming, before any benefits or tax credits, is $631 per month.

Low-income households in Wyoming may qualify for Medicaid. Children without health insurance can get coverage through the Children’s Health Insurance program. As of February 2021, the state has enrolled 65,245 individuals in Medicaid and in CHIP (Children’s Health Insurance Program).

Medicaid in Wyoming

To be eligible for Medicare in Wyoming, you need to reside in the state, be a U.S. citizen, permanent resident, or a legal alien who needs health care coverage, and your income must be described as low or very low. You also need to belong to one of the following categories:

• Be at least 65 years old
• Pregnant, regardless of age
• Be responsible for a child or children who are 18 years old or younger
• Be blind or have responsibility for a child who is blind
• Have a disability or live with a person who has a disability

Individuals or families whose income is at or below 140% of the federal poverty level (FPL) qualify for Medicaid in Wyoming. Those who are in the categories listed above can obtain health insurance with different income requirements in relation to the FPL. A wide variety of resources are factored in when considering income, including a pension, Social Security, salary from a job, or earnings from real estate or stocks.

There are also asset or resource limits for those seeking assistance from Medicaid. While these can vary, in most cases it is $2,000 for an individual and $3,000 for a couple. Your home, household appliances, and your primary car are not taken into account when calculating your total assets.

Children’s Health Insurance in Wyoming

Wyoming offers two levels of health insurance for children with no coverage. Kid Care CHIP provides healthcare for the children of working parents. This includes free dental care, prescription medicines and immunizations. Other services are also available for a small co-pay.

The Medicaid Children’s Program provides health coverage for eligible children from birth through the age of 18. This plan is broken down into two levels based on the recipient’s situation: children aged 0 to 5 whose family income is at or below 154% of the FPL, and children who are 6 to 18 years old with a household income at or below 133% of the FPL.

Both plans provide preventive health services, mental health care, vision care, physical therapy, and medically necessary orthodontics.

Medicare, the federal government’s health care insurance program for people 65 and older or who have a qualifying disability, has four parts: A, B, C, and D.

• Original Medicare is the basic form of Medicare. It comprises Part A (hospitalizations and skilled nursing home care) and Part B (medical services and mental health care). This option doesn’t cover prescription drugs, so you might need to purchase a Medicare Part D plan. There are no out-of-pocket limits on deductibles, co-pays, or coinsurance with Original Medicare. The Medicare Part A premium and deductible for inpatient hospital stays is $1,556 in 2022, up from $1,484 in 2021. Medicare Part B enrollees pay a standard monthly premium of $170.10 for 2022, up from $148.50 in 2021.
• Another option is a Medicare Advantage Plan, also known as Medicare Part C. These are individual plans approved by Medicare. They often have dental, vision, and hearing coverage, and some programs also offer fitness memberships and prescription drug coverage. Medicare Advantage has four types of plans, each one suited to a particular group, with different premiums and deductibles: HMO, PPO, Private Fee-For-Service, and Special Needs. For 2022, there are nine Medicare Advantage plans available in the state.

If you’re worried about out-of-pocket costs that come with Original Medicare, consider purchasing a Medicaid Supplemental Insurance plan, which is designed to help pay for the deductibles, co-pays, and coinsurance associated with Original Medicare, although vision, dental, hearing, or long-term care are not included. If you’re thinking about traveling, this type of plan is also a good idea for you because it may provide health coverage outside of the United States. Keep in mind that supplemental plans don’t work with Medicare Advantage.

Eligibility

• You must be a U.S. citizen, national, or a permanent resident who has lived in the U.S. for at least the previous five years
• You must be aged 65 or older or have a qualifying disability regardless of age
• You may also qualify if you have amyotrophic lateral sclerosis (ALS — also known as Lou Gehrig’s disease) or end-stage renal disease (ESRD)

Enrollment

If you start receiving your Social Security or Railroad Retirement Board benefits at least four months before you turn 65, you’ll be automatically enrolled in Medicare. Otherwise, you must fill out an application online or contact your local Social Security office. You can enroll in Medicare during the following periods:

• Initial enrollment: Your initial enrollment period starts three months before your 65th birthday and ends three months after your 65th birthday. If you’ve never had Medicare, you can enroll during this period. If you started receiving Medicare when you were younger, you can also make changes to your plan.
• Medicare Advantage open enrollment: You can make changes to your Medicare Part C, also known as Medicare Advantage, from January 1 to March 31.
• Open enrollment: You can join, switch plans, or drop your coverage from October 15 to December 7 each year.
• Special enrollment periods: You may qualify for a special enrollment period if you lose your coverage or have changes to your eligibility outside the regular enrollment periods.

Medicare Resources

The Wyoming State Health Insurance Information Program provides free, unbiased, and confidential counseling to Medicare beneficiaries, their families, or their caregivers about their health insurance options. This includes Original Medicare, Medicare Advantage, Medicare Supplemental Insurance, Medicare Part D, and other plans. You can speak to these trained and certified counselors in person or over the phone, and since none of them work for a healthcare company, you can rest assured that they won’t try to sell you a plan.

Yes. Wyoming uses federal guidelines for short-term health care coverage, which means these plans may have an initial duration of up to 364 days and can be renewed three times. However, Wyoming’s former Insurance Commissioner warned state residents in 2016 to approach short-term insurance with caution, since these plans set lifetime or yearly dollar limits, don’t pay for preventive health care, and exclude many accidental injuries. The Commissioner also noted that short-term insurance does not cover preexisting conditions.

• Benefits.gov | Wyoming Medicaid | Last accessed January 2022
• Healthcare.gov | Cost-Sharing Reduction | Last accessed January 2022
• Healthcare.gov | Deductible | Last accessed January 2022
• Healthcare.gov | Preferred Provider Organization (PPO) | Last accessed January 2022
• Healthcare.gov | Premium Tax Credit | Last accessed January 2022
• Healthcare.gov | The ‘metal’ categories: Bronze, Silver, Gold & Platinum | Last accessed January 2022
• KFF | Health Insurance Coverage of the Total Population | Last accessed January 2022
• Medicare.gov | Medicare Advantage Plans | Last accessed January 2022
• MedicareInteractive.org | The Parts of Medicare (A, B, C, D) | Last accessed January 2022
• National Academy for State Health Policy | Wyoming CHIP Fact Sheet | Last accessed January 2022
• Wyoming Department of Health | Kids Care CHIP | Last accessed January 2022
• Your total costs for health care: Premium, deductible, and out-of-pocket costs | Last accessed January 2022