Programs and Eligibility

You may qualify for one or more of the assistance programs available under Medicaid or Kid Care CHIP. Apply now and we will help you find the programs for which you are eligible.

What is a 1095-B and Why is it Important?

Form 1095-B is a tax document that includes information about the health coverage provided for one or more months during the year to you, your spouse and individuals you can claim as dependents.
This form relates only to coverage provided by state Medicaid and CHIP agencies.
The healthcare law requires health coverage providers, including state Medicaid and CHIP agencies, to provide these documents to the IRS and covered individuals.
Receipt of this form does not create a federal tax return filing requirement with the IRS. Please check IRS.gov and the Form 1040 instructions to determine if you have a federal income tax return filing requirement.
Keep Form 1095-B with your records. You do not need to attach the form to your income tax return.
For more information about Form 1095-B, and other health care tax documents, please visit IRS.gov/aca.

Children’s Programs

In order to build a healthier future for our state, the Wyoming Department of Health offers several programs to assist Wyoming’s youngest residents.

Kid Care CHIP

Kid Care CHIP provides affordable health coverage for the children of working parents in Wyoming. The program provides free preventive dental and health care. Other health services are available for a small co-pay.

Kid Care CHIP is available to the children of parents’ whose income lies below 200% of the federal poverty level and are not eligible for Medicaid.

Children

Wyoming Medicaid children’s programs provide health coverage for eligible children from birth through age 18.

Child MAGI
Foster care children in DFS custody
Former Foster Youth up to the age of 26 who were in DFS custody and on a federally funded Medicaid program at the age of 18
Children receiving an adoption subsidy
Newborns born to Medicaid-eligible mothers are automatically eligible for the first year

To qualify a child must be:

A Wyoming resident
U.S. citizens or lawful permanent residents who have lived in the U.S. for at least five years
A child ages 0-18
Income eligible for Child MAGI
Children ages 0-5 whose family income is at or below 154% of the Federal Poverty Level (FPL)
Children ages 6-18 whose family income is at or below 133% of the FPL

Children's Mental Health Waiver

What is the Children’s Mental Health Waiver?

The Children’s Mental Health Waiver is a short-term home and community-based program that uses an intensive care coordination model designed to provide a community-based alternative for youth with serious emotional disturbance who might otherwise be hospitalized and whose parents may be required to relinquish custody of their child for them to receive needed mental health treatment and services.

The Children’s Mental Health Waiver seeks to:

(1) prevent custody relinquishment for youth to receive mental health treatment

(2) prevent or reduce the length of costly psychiatric hospital stays

(3) provide a mechanism to offer mental health support services to youth with serious emotional disturbance and their families in identified service areas. The Children’s Mental Health Waiver is not a long-term care waiver.

Assistance Programs For Pregnant Women

Wyoming provides assistance to eligible women during pregnancy to provide a safe and healthy experience for the mother and giving the baby the best possible beginning to life.

Presumptive Eligibility For Pregnant Women

Presumptive Eligibility (PE) for Pregnant Women is a Medicaid option designed to improve an applicant’s access to temporary Medicaid while their eligibility for full Medicaid benefits is being determined. Eligible pregnant women are limited to outpatient services through a Medicaid provider for up to 60 days after completing an application for Medicaid.

To qualify a woman must be:

Pregnant
A U.S. citizen or lawfully present in the U.S
A Wyoming resident
Income eligible at or below 154% of the Federal Poverty Level.

To apply visit your local Public Health Nursing office.

Pregnant Women

Wyoming Medicaid’s Pregnant Women programs provide health coverage for eligible pregnant women for up to 12 months post-partum. Pregnant women with income below the family care income guidelines must cooperate with Child Support Enforcement once the baby is born to continue eligibility.

To be eligible a woman must be:

Pregnant
Income eligible at or below 154% of the FPL
A U.S. citizen or lawfully present in the U.S
A Wyoming resident.

Pregnant By Choice

The Pregnant by Choice program provides pregnancy planning services to women who have received Medicaid benefits through the Pregnant Women program.

To be eligible a woman must be:

In the 12 months post-partum period and on Wyoming Medicaid’s Pregnant Women program
Income eligible at or below 159% of the FPL
U.S. citizens or lawful permanent residents who have lived in the U.S. for at least five years
A Wyoming resident.

More information on the Pregnant by Choice program can be found HERE.

Assistance Programs For Aged, Blind or Disabled

Nursing Home/Swing Bed and Inpatient Hospital Care

The Institutional programs are an option for those individuals who are waiting for or need Long Term Care and are unable to continue to live in the community. This would include Nursing Home Care and Inpatient Hospital Care.

To qualify you must be:

A U.S. Citizen or a lawful permanent resident who has lived in the U.S. for at least five years
A Wyoming resident
Age 65 or older, blind or disabled
Medically eligible based on needs assessment completed by a public health nurse (nursing home only)
Hospitalized for 30 days (remain in an institution for at least 30 consecutive days) or verified as SSI eligible
Income at or below 300% of the Federal Benefit Rate (FBR) Income Standard
Resources must be within the Maximum Resource Standard

What do Institutional programs cost?
A client is responsible to contribute to the cost of his or her care. This payment, often referred to as a patient contribution, is payable to the facility. The patient contribution is calculated using the individual’s total income less the following allowable deductions:

$50.00 for personal needs
Court ordered garnished child support
Spousal maintenance allowance
Medical expenses not covered by Medicaid, Medicare, private insurance, or a third party
Medicare premium may be deducted for the first two months of eligibility
Health insurance premium

Medicare Savings Programs

The Qualified Medicare Beneficiary (QMB) and Specified Low-Income Medicare Beneficiary (SLMB) are Medicare Savings programs. These programs help income-qualifying Medicare beneficiaries pay Medicare premiums and in some instances Medicare co-insurance and deductibles.

To qualify you must be:

A U.S. citizen or a lawful permanent resident who has lived in the U.S. for at least five years
A Wyoming resident
Entitled to Part A and Part B Medicare Insurance
Income eligible at or below 135% of the FPL
Resources must be within the Maximum Resource Standard

Other Assistance Programs

Wyoming provides medical assistance through Medicaid to several other select populations.

Parents and Caretaker Relative

Family Care is a Medicaid program that provides health coverage for parents or relatives who are caring for a child under the age of 18.

To qualify you must be:

A Wyoming resident
A U.S. citizen or lawful permanent resident who has lived in the U.S. for at least five years
Income eligible at or below the Family Care income guidelines
The parent or caretaker relative of a Medicaid eligible child under the age of 18

Emergency Services

Wyoming Medicaid’s Emergency Services Program is emergency healthcare for Wyoming’s families and children who are either undocumented immigrants or ineligible immigrants. This is not a full medical assistance program. Only emergency services are covered.

Who is eligible?

Applicants must meet all eligibility factors for a Medicaid program, excluding U.S. citizenship, identity, and social security number requirements.

Supplemental Security Income (SSI)

If you are eligible for SSI, you are automatically eligible for Medicaid. If you have questions or would like to apply for SSI, visit the Social Security Administration’s website at: https://www.ssa.gov.

Developmental Disabilities Waiver (DD)

The Comprehensive and Support (DD) waivers are Medicaid Home and Community-Based Services (HCBS) waiver programs authorized under Section 1915(c) of the Social Security Act that support individuals with intellectual or developmental disabilities (IDD) as well as individuals with acquired brain injuries. These waiver programs provide individuals access to an array of community-based services. For more information about the DD waivers please visit the Home and Community Based Services page of our website. For more information, please contact the HCBS Section at (307)777-1531 and/or 1-855-203-2936.

Contact the Long-Term Care Eligibility Unit for more information on financial eligibility criteria at 1-855-203-2936.

Community Choices Waiver (CCW)

The Community Choices Waiver program is a Medicaid Home and Community-Based Services (HCBS) waiver program authorized under Section 1915(c) of the Social Security Act. The Community Choices Waiver (CCW) program provides eligible individuals an alternative to nursing facility care through access to an array of community-based services. For more information about the CCW please visit the Home and Community Based Services page of our website. For more information, please contact the HCBS Section at (307)777-1531 and/or 1-855-203-2936.