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Wyoming Health Insurance

Overview of Medical Coverage in Wyoming

There are many health insurance options for the residents of Wyoming.  Even though 10 percent of the state’s residents have no insurance coverage, recent healthcare reform legislation may cause a hike in the figures of citizens covered by insurance in Wyoming.  Health coverage choices in the state can range in the variation of public programs along with group coverage through the workplace and individual coverage.

In the current healthcare climate, health insurance has become quite the topic of debate, but the information provided may change in the coming years ahead.  Despite the health status of residents in Wyoming, the information provided below represents the status of the general health of residents along with the medical coverage offered in the state of Wyoming currently.

Wyoming’s Health Care Issues
Among the 50 states in the U.S., Wyoming ranks at 25th in comparing the overall health of its citizens, which is right in the middle.  Wyoming’s ranking is somewhat in between all of the other states, but it has dropped significantly from 17th place in 2013.  The state has a variety of strengths and weaknesses, as discussed below:

Strengths:

  • Low prevalence of diabetes
  • Low percentage of children in poverty
  • Low levels of air pollution

Challenges:

  • Low immunization coverage among children
  • Low immunization coverage among adolescents
  • Limited availability of primary care physicians

Even with this information, it is hoped that new healthcare reform will cause Wyoming’s numbers to climb with regard to its population of covered residents.

Uninsured Residents of Wyoming
People between the ages of 19 to 64 are the largest demographic of uninsured residents in the state of Wyoming.  Studies have shown that there are 61 percent of the state’s population that consists of individuals who are covered under employer-provided health insurance plans.  In Wyoming, public programs cover 23 percent of the state’s residents.

Group Health Insurance Plans
In the state of Wyoming, employees can seek health insurance coverage through the workplace and this is the best option for obtaining health benefits.  In Wyoming, you may not be eligible for insurance coverage if you live outside of the HMO’s coverage area.  According to the law in the state of Wyoming, you cannot be discriminated against or denied insurance coverage because of a health condition.

When enrolling into a group plan for coverage, the insurance provider may seek information on your current health status.  They may wish to know whether or not you have a pre-existing condition.  If this is applicable, you may receive coverage with treatment for your condition excluded for a period of time.  Under health plans through the workplace, there are limitations in place for how long you can be made to wait for an exclusion period.

In Wyoming, the look back period is six months so that insurance companies can determine whether or not you have a pre-existing condition.  The maximum length of time for exclusion periods in Wyoming is 12 months.  Exclusion periods do not apply to dependents under the age of 19 and cannot be used against the receipt of genetic information in the absence of a diagnosis.

COBRA Coverage
COBRA coverage is available to residents who have recently lost their insurance status because of a job loss or divorce.  This allows the formerly covered person to receive extended benefits at the current group rate previously received.  This type of coverage can last as long as 12 months, but it can prove to be quite expensive.  Because there is no employer contributed portion of the premiums, the rates are higher for people to retain coverage under this plan.  To be eligible for coverage under COBRA, the original policy-issuing company must have had over 50 employees.

For companies with fewer than 20 workers, the individuals working there are covered by the Wyoming Continuation State Law.  Through this law, former employees can retain their medical benefits for a year’s time.  Along with COBRA coverage, continuation coverage of this sort can cost a lot of money because you are paying 100%  of the premiums along with an administration fee.
Individual Health Insurance Policies
According to statistics, individual policies cover 6% of the state’s residents.  In this state, your ability to get coverage under an individual policy can largely depend on your health status.  Companies who offer individual policies can reject applications for people with pre-existing conditions and they also have the ability to do extensive underwriting when crafting these policies.  When applying, you will be subjected to filling out a questionnaire regarding the state of your health.  Depending on your answers, you may get turned down for insurance coverage.

In the state of Wyoming, if you have an individual plan, it is required to cover newborns and adopted children (for 31 days) as long as the policy has allowances for dependents.  The law in Wyoming also calls for disabled children to remain dependents on their parents’ insurance policies until they reach adulthood.
Health Benefit Exchange in Wyoming
Wyoming’s health insurance exchange has defaulted to a federally managed exchange.  The health insurance exchange in Wyoming is managed with the aid of a federal grant of $1 million to Wyoming’s Department of Insurance.  In 2013, the federal government took control of the health insurance exchange in the state.

In the future, the state of Wyoming reserves the right to take charge of their health benefits marketplace should the need arise.  Now, through the marketplace on healthcare.gov, Wyoming residents are able to get coverage and compare their available options.

Wyoming State Health Insurance Programs
Individuals who choose to seek health insurance coverage through the state will be able to select the program that is best designed to suit their needs.  There are health insurance programs that are unique to the state of Wyoming and offer various benefits depending on age, gender, medical condition and other information.

Listed below are the programs in detail:

Wyoming Medicaid
Medicaid in the state of Wyoming offers many basic healthcare services that cover pregnant women, children and families who earn lower than average incomes.

To qualify, you must meet the following criteria:

  • Be a Wyoming resident
  • Have low or very low income
  • Be pregnant or a parent of a child or children under the age of 19
  • Be blind or disabled or have a family member that is
  • Be 65 years of age or older

Wyoming CHIP
This is Wyoming’s Children’s Health Insurance Program.  Under this program, kids in Wyoming can receive the following services:

  • Vision care
  • Dental care
  • Health care

Eligibility depends on income level and the covered child cannot have insurance through any other means.

Wyoming Breast and Cervical Cancer Early Detection Program

  • Women in Wyoming can apply for coverage under this program if they meet certain criteria:
  • Must be a resident of Wyoming
  • Must meet income guidelines
  • Must not have insurance coverage through any other means

Wyoming Prescription Drug Assistance Program
This program offers prescription drug assistance for people in the state of Wyoming who earn 100% of the Federal Poverty Level.  This program is funded through the Department of Health/Office of Healthcare Financing/Office of Pharmacy Services.  You may have to pay $10 co-payments and you are able to obtain 3 prescriptions per month.

Other Programs:

Wyoming Colorectal Cancer Screening Program
This program urges all residents of Wyoming to be screened for colorectal cancer and you can qualify for a free colonoscopy by filling out an application.  You must be over the age of 50 to qualify and not currently covered under Medicare or Medicaid.  To be eligible, you must earn below 250% of the Federal Poverty Level.

Wyoming Heart Disease and Stroke Prevention Program
In Wyoming, this program offers detection, prevention and monitoring services for residents at risk of developing heart disease or having a stroke.  Among the items addressed are nutrition guidelines, cholesterol levels and physical activity.

Best Beginnings for Wyoming Babies
This program is geared toward pregnant women and offers a variety of prenatal services to encourage the expectant mother to remain healthy.  Through this program, you can receive help with pregnancy counseling, breastfeeding education, smoking cessation, prenatal classes and more.  For women who are interested in this program, they should reach out to their Best Beginnings Coordinator at their local Public Health Office.
Maternal High Risk Program
Mothers who are determined to be at high risk and infants who are in need of intensive care services must be sent to hospitals that are out of state in order to receive the proper care and treatment.  This program aims to provide financial support to those mothers and infants who are said to be high risk so that they can access the care they need in out-of-state hospitals.  The Best Beginnings Coordinator at your local Public Health Office will have the most information on joining this program.

Wyoming Health Insurance Pool
WHIP is the state’s insurance program that offers coverage to people suffering from pre-existing medical conditions.  In order to qualify, you must be a resident of the state of Wyoming and meet only one of the following criteria:

  • Have been denied insurance benefits because of medical reasons
  • Have lost coverage through an employer or have exhausted COBRA benefits
  • Have involuntarily lost insurance coverage
  • Have been notified of the end date of your insurance plan
  • Have met the lifetime limits on your current health plan
  • Have group coverage through the workplace with abnormally high monthly premiums

If you have any of the following “presumptive” conditions, you will not need to send a letter showing proof of your denial for insurance benefits.  These conditions are: ALS, epilepsy, Alzheimer’s disease, HIV, Parkinson’s disease, Renal Failure or Cerebral Palsy.

Health Insurance Portability and Accountability Act
In the state of Wyoming, the protection of a person’s medical records and information is paramount.  As such, under the HIPAA legislation, regulations are provided to guard the information of individuals living in the state of Wyoming and nationwide.

Under HIPAA, residents can renew their health insurance coverage without regard for health conditions.  It also guarantees that residents covered under individual insurance plans can lose their coverage depending on certain circumstances.  The law also limits the length of time that insurance providers can use for exclusion periods and prohibits employers from denying coverage based on the presence of a pre-existing medical condition.

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