Q: What is the difference between Medicare and Medicaid?
A: The federal government administers Medicare. Medicare is not based on financial need, but is generally linked to receiving Social Security benefits based on being age 65 or older, or have a disability. Each state administers their own Medicaid programs. Medicaid is based mainly on financial need.
Q: What services are covered?
A: Covered services vary by program. Call 855-294-2127 and choose option 1, and option 1. You can also go to this website for the Medicaid Handbook: https://wyomingmedicaid.com/portal/Medicaid_Handbook or sign up for the myHealthPortal: https://wyomingmedicaid.com/portal/MemberHome.
Q: Where do I apply for Wyoming Medicaid?
WDH Customer Service Center
3001 E. Pershing Blvd., Suite 125
Cheyenne, WY 82001
Q: How long does it take to process an application?
A: Applications have 45 days to approve or deny an application. This is extended to 60 days if more information is needed from you and 90 days if the application is pending a disability determination. You will receive a letter in the mail letting you know if you qualify.
Q: How will I be notified of my eligibility determination?
A: The eligibility determination notice will be sent in the mail.
Q: If I have other insurance, would I still be eligible for Medicaid?
A: Yes, with the exception of insurance through the Federally Facilitated Market Place. You cannot have both Medicaid and Market Place insurance. For other insurance, Medicaid pays amounts that are still owed after your primary insurance pays. If it is cost effective, you may be eligible to have your health insurance premiums reimbursed, if you have employer sponsored insurance or COBRA.
Q: I was on Medicaid in another state, can I transfer my Medicaid?
A: No. You cannot transfer Medicaid from one state to another. Each state’s Medicaid programs are different. You must submit a new application in Wyoming.
Q: What if I don’t have a Social Security Number?
A: If you do not have a Social Security Number leave that field blank. You will need to apply for a Social Security Number through the Social Security Administration.
Q: What if I already have medical bills?
A: If you have medical bills in the 3 months before you submit an application for Medicaid, you may be eligible for Medicaid to pay those bills. Your income from those months must have been within the Medicaid income limits and the medical services received must have been Medicaid covered service and must have been provided by a Medicaid enrolled provider.
Q: How long will my children or I be covered by these programs?
A: Under most programs, you will be approved for one year from the date your eligibility is determined.
Q: How do I keep my benefits?
A: You will be sent a renewal form in the mail prior to your one year anniversary. You will need to complete and return the renewal to the Customer Service Center or the Long Term Care Unit where they will re-determine eligibility for you and/or your children. If it is determined that you are no longer eligible, you will be notified by mail.
Q: Do I have to pay for Medicaid?
A: If you are eligible for Medicaid, you will receive Medicaid services at no cost to you with these exceptions:
- Adults over the age of 21 who are not pregnant may have a small co-payment for medical services or treatment not related to the pregnancy.
- The Employed Individuals with Disabilities (EID) program requires a monthly premium.
- If you are in a Long Term Care Facility, you will be responsible to contribute to the cost of your care.
- If you are in an Assisted Living Facility, you will be responsible to pay for your room and board.
Q: What if I am disabled?
A: If you feel that you are disabled, tell us on your application. You must qualify for disability programs using Social Security guidelines. Proof may involve obtaining medical records, tests, and other medical findings.
Q: What information do I need to know or take with me to apply?
A: For most programs you will need to bring verification of citizenship, DOB, SSN, identity, the last 30 days of income and sometimes resources (verifications depend on programs).
Q: What if my children do not qualify for Medicaid based on the household income?
A: Children under the age of 19 may still qualify for Kid Care CHIP. For more information visit their website at LINK
Q: I lost my Medicaid card, how do I get a new one?
A: Contact our Customer Service Center at 855-294-2127 or log into the website at https://wyomingmedicaid.com/portal/MemberHome. (Refer to the myHealthPortal User guide for instructions on ordering a new card).
Q: How do I change my information or report a birth of a child?
A: Contact the Customer Service Center at 855-294-2127 to make changes to your case.
Q: I am an adult with no income, can I qualify for Medicaid?
A: There is limited coverage through Medicaid for parents or qualified relatives of an eligible child under the age of 19 and aged, blind or disabled individuals. We would recommend that you contact our Customer Service Center for more information.
Q: I have self employment income, how can I verify my income?
A: If your current self employment income is the same as the previous year, turn in your previous year tax return. If your income is different, we will need a current business ledger showing income and expenses; here is an example of a business ledger that may be used.
Q: How are resources defined by Medicaid?
A: A resource is real or personal property that has economic value. Resources can include, but are not limited to, cash savings, checking and savings accounts, life insurance policies, investments, houses, land, vehicles, etc. The applicant’s resources are evaluated for ownership, accessibility, and equity value. All resources are countable unless specifically excluded by regulation.
Q: If I think that I am eligible for Medicaid, should I cancel any other health insurance I might already have?
A: No. You can still qualify for Medicaid and keep your current health insurance policy.
Q: How do I file a Medicaid complaint?
A: If you do not understand or if you disagree with a Medicaid decision, contact the Customer Service Center or the Long Term Care Unit. If you feel that policy was incorrectly followed, you may ask for an Administrative Hearing. You must request this within 30 days of being notified in writing of a decision regarding your Medicaid benefits. If you do not request a hearing within the 30 days, no hearing will be granted.
Q: If I am getting Social Security benefits, am I automatically eligible for Medicaid?
A: No. You are only automatically eligible for Medicaid if you are SSI medically eligible.
Q: What is Estate Recovery?
A: Estate recovery helps the State of Wyoming generate funds to pay medical care costs, through the Medicaid program, for the increasing number of people in need of care. The federal government requires state Medicaid programs to seek repayment from the estates of certain deceased clients who have benefited from the Medicaid program. The State will pursue recovery of medical care costs paid by the Medicaid program from the estate of a Medicaid recipient, age 55 years or older, when he/she received medical assistance, or if the person was an inpatient in a medical institution when he/she received medical assistance.
Q: Is there a link to access the Wyoming Eligibility Manual?
A: Yes., ecom.wyo.gov.