Medicaid Coverage and Costs in Wyoming

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Wyoming Medicaid coverage can have costs associated with enrolling in the program and receiving health care services. Depending on the types of Medicaid insurance beneficiaries in WY qualify for, expenses related to the program can be nominal or nonexistence. Medicaid cost estimates can vary based on the claimant’s Medicaid eligibility. If Medicaid beneficiaries understand the types of Medicaid insurance available, they will have a greater understanding of the costs associated. There are out-of-pocket costs that a beneficiary may encounter when he or she receive medical services like a copay or deductible. Certain Medicaid applicants may be exempt from paying anything for their medical services. Medicaid beneficiaries must also understand what services are covered by Medicaid and which are not, as payment for services not covered Medicaid will be the responsibility of the patient. Learn more about how much is Medicaid in Wyoming for approved claimants by reading the information below.

How much does Medicaid cost in Wyoming?

Wyoming Medicaid coverage costs are typically set for each beneficiary when they enroll in the state program. Once a type of Medicaid insurance is selected, the claimant will find out details about any premiums that are required to enroll. Prospective petitioners should keep in mind that all Medicaid costs are nominal, as the program is for low-income and medically needed residents. The cost for the state medical assistance program is either very low or nothing for the beneficiaries. Medicaid applicants should know that upon enrolling into the Medicaid program that required expenses can change.

Wyoming officials determine a beneficiary’s Medicaid cost estimates by looking at his or her total household income. This decision is based on the information furnished during the Medicaid application process. Depending on the amount, the state may choose to exempt the beneficiary from any out-of-pocket costs or set cost-share figures. Petitioners may be exempt from Medicaid expenses for a variety of reasons, although low earnings is often the key factor. If Wyoming Medicaid exempts a beneficiary from paying any copays for the medical services receive, he or she will be notified. Instances when people may be found to be exempt from costs for Medicaid coverage in WY include any enrollees who are pregnant, 18 years of age or younger or residing in a nursing home or long-term care facility. Native American Indians who show a letter of proof that they actively use Indian Health Services will also be exempt.

It is very important that any potential Medicaid beneficiary know that he or she could incur costs for medical procedures or situations where medical intervention is required. The beneficiary may have to pay these out-of-pocket costs at the time they receive services. These Medicaid cost estimates include any copays, which are partial amounts for a service rendered or product purchased. In Wyoming, if the Medicaid beneficiary has a copay for a medical service, there are laws that dictate the maximum copay amount. Once the program sets the maximum copay amount, any medical facility that accepts Medicaid coverage is not allowed to charge more than the set amount for services. However, the medical facility may choose to charge less than the maximum amount at its discretion.

There are services that Medicaid covers that do not require a copayment, regardless of the beneficiary’s status. These Medicaid covered services include emergency room visits, birth control and pregnancy-related appointments as well as a multitude of services for the elderly or disabled Medicaid beneficiaries.

Find out which health care services must be covered by Medicaid according to federal law in our comprehensive guide.

What services are covered by Medicaid in Wyoming?

Health care services covered by Wyoming Medicaid are categorized under federal or state requirements. Each government entity determines the Medicaid coverage that must be granted to beneficiaries. The federal government establishes core services while states are allowed to expand on this minimum. While Wyoming did not accept the Affordable Care Act expansion to the Medicaid program, the state has the ability to select covered services. To give potential applicants an idea of what the mandatory Medicaid benefits could entail, see the list provided below. While this is not a complete list of services covered by WY Medicaid, some of the mandatory benefits include:

  • Ambulance services and non-emergent transportation to and from any doctor appointments.
  • Hospital inpatient and outpatient services.
  • Mental health, substance abuse treatment, and behavioral health services.
  • Occupational or physical therapy, also known as rehabilitation services.
  • Primary physician appointments, screenings, and services.

Even if the medical services are deemed mandatory, there may still be a copay at the time of services. Whether the Medicaid beneficiary will have a copay depends on his or her type of enrollment in the program. For instance, children enrolled in Medicaid or the Children’s Health Insurance Program typically have more comprehensive Medicaid coverage than adults do.

What services does Medicaid not cover in Wyoming?

Knowing what does Medicaid not cover in Wyoming is as important as understanding what services Medicaid will cover. WY Medicaid coverage will not include medical professionals outside of the programs network. The program will also not cover any elective or cosmetic procedures. Alternative medicinal treatments like acupuncture and Infertility services including artificial insemination, counseling, and reverse sterilization will not be covered by the Medicaid insurance.

For details about the Medicaid program including how to sign up for coverage, download our free guide.