Presumptive Eligibility (PE) is a Medicaid option designed to improve an applicant’s access to temporary Medicaid while their eligibility for full Medicaid benefits is being determined. If determined eligible for PE, a client will received full Medicaid benefits (Pregnant Women are limited to outpatient services) through a Medicaid provider until a determination is made on the full Medicaid application or the last day of the next month if a full Medicaid application is not received.
Please click here for a list of Qualified Providers/Hospitals.
There are five Presumptive Eligibility Medicaid groups:
- Pregnant Women – (Pregnant Women are limited to ambulatory outpatient services)
To qualify, a women must be:- Pregnant
- Be lawfully present in the U.S.
- A Wyoming Resident
- Income eligible at or below 154% of the FPL
- Children
To qualify, a child must be:- A U.S. Citizen or lawful permanent resident who has been living in the U.S. for at least five years
- A Wyoming Resident
- Income Eligible:
- Parents and Caretaker Relatives – (Caretaker Relatives are adult relatives who provide a home for and take care of the day-to-day needs of the Medicaid eligible child)
To qualify, the adult must be:- A U.S. Citizen or lawful permanent resident who has been living in the U.S. for at least five years
- A Wyoming Resident
- Income eligible at or below the Family MAGI income guidelines
- Breast and Cervical Cancer
To qualify, a women must be:- A U.S. Citizen or lawful permanent resident who has been living in the U.S. for at least five years
- A Wyoming Resident
- Enrolled in the Breast and Cervical Cancer Early Detection Program and diagnosed with breast or cervical cancer
- Income eligible at or below 250% of the FPL
- Former Foster Youth
To qualify, an applicant must be:- A U.S. Citizen or lawful permanent resident who has been living in the U.S. for at least five years
- A Wyoming Resident
- Have been in Wyoming DFS or Tribal Foster Care custody and enrolled in a Federally Funded Medicaid Program on their 18th birthday
How do I apply to be a Qualified Provider or Qualified Hospital?
Wyoming Medicaid enrolled providers can apply to become a Qualified Provider and Wyoming Medicaid Enrolled Hospitals can apply to become a Qualified Hospital. Fill out the application and appropriate agreement below, and email a copy to eceligibilityunit@wyo.gov to begin.
PE Qualified Provider and Qualified Hospital Application