Wyoming Health Insurance: Key Facts
- Medicaid Status Not Expanded (Coverage Gap Exists)
- Exchange Type Federal (Healthcare.gov)
- Open Enrollment November 1, 2024 - January 15, 2025
- Traditional Medicaid Limit Very limited adult eligibility
Wyoming is one of the few remaining states that has not expanded Medicaid under the Affordable Care Act. This creates significant challenges for some low-income residents who fall into the "coverage gap." However, the federal marketplace at Healthcare.gov still provides options for many Wyomingites, especially those who earn at least 100% of the federal poverty level.
Understanding Wyoming's Coverage Gap
Because Wyoming has not expanded Medicaid, approximately 20,000 Wyomingites fall into this coverage gap. Traditional Wyoming Medicaid has very strict eligibility requirements, covering only specific populations like pregnant women, children, and people with disabilities who meet income guidelines.
Who is Affected by the Coverage Gap?
- Working adults without children who earn below 100% FPL
- Parents earning above traditional Medicaid limits but below 100% FPL
- Part-time workers and those in low-wage jobs without employer coverage
- Self-employed individuals with very low income
Options if You're in the Coverage Gap
While options are limited, some resources may help:
- Community Health Centers: Federally Qualified Health Centers provide care on a sliding fee scale based on income
- Hospital Charity Care: Many hospitals offer financial assistance programs
- Short-Term Health Insurance: Not ACA-compliant but may provide temporary coverage (use caution - limited benefits)
- EqualityHealth Wyoming: Some local programs may offer assistance
Traditional Medicaid in Wyoming
Wyoming Medicaid provides coverage to specific populations, but eligibility is much more limited than in expansion states.
Who Qualifies for Wyoming Medicaid?
- Children: Up to 200% FPL through Kid Care CHIP
- Pregnant Women: Up to 154% FPL
- Parents/Caretaker Relatives: Very low income thresholds (approximately 55% FPL)
- Seniors 65+: With limited income and assets
- People with Disabilities: Meeting specific criteria
- Adults without children: Generally NOT eligible for Medicaid in Wyoming
What Does Wyoming Medicaid Cover?
- Doctor and specialist visits
- Hospital services
- Prescription drugs
- Mental health services
- Preventive care
- Lab tests and X-rays
- Dental services (limited for adults)
- Vision services (limited for adults)
Health Insurance Marketplace in Wyoming
Wyoming uses the federal marketplace at Healthcare.gov for individual and family health insurance. While premiums tend to be higher than the national average, subsidies help make coverage affordable for those who qualify.
How to Enroll Through Healthcare.gov
- Visit Healthcare.gov and create an account
- Complete your application with household and income information
- See if you qualify for Medicaid, CHIP, or premium tax credits
- Compare available plans (typically Bronze, Silver, and Gold tiers)
- Select a plan and complete enrollment
- Pay your first premium to activate coverage
Insurance Companies in Wyoming
Wyoming's marketplace typically includes:
- Blue Cross Blue Shield of Wyoming
- Occasionally other insurers depending on the year
Average Health Insurance Costs in Wyoming
Wyoming has some of the highest health insurance premiums in the nation due to its rural geography, sparse population, and limited insurer competition. However, premium tax credits can substantially reduce costs.
| Metal Tier | Average Monthly Premium | Typical Deductible |
|---|---|---|
| Bronze | $500 - $600 | $7,500 - $9,000 |
| Silver | $650 - $780 | $5,000 - $7,000 |
| Gold | $800 - $950 | $1,500 - $3,000 |
Important Enrollment Dates
- Open Enrollment: November 1, 2024 - January 15, 2025 (for 2025 coverage)
- December 15 Deadline: Enroll by this date for coverage starting January 1
- January 15 Deadline: Final deadline for coverage starting February 1
- Wyoming Medicaid: Apply year-round for those who qualify under traditional rules
Frequently Asked Questions
Does Wyoming have Medicaid expansion?
No, Wyoming has not expanded Medicaid. The state legislature has considered expansion multiple times but has not passed it. This means there is a "coverage gap" where some low-income adults earn too much for traditional Medicaid but too little to qualify for marketplace subsidies.
What is the coverage gap in Wyoming?
The coverage gap affects adults in Wyoming who earn between 0-100% of the federal poverty level. They don't qualify for traditional Medicaid (which has very limited eligibility for adults) and don't qualify for marketplace subsidies, which start at 100% FPL. This leaves roughly 20,000 Wyomingites without affordable coverage options.
When is Wyoming's health insurance open enrollment period?
Wyoming's Open Enrollment for 2025 coverage runs from November 1, 2024 through January 15, 2025 on Healthcare.gov. Wyoming Medicaid applications (for those who qualify under traditional rules) are accepted year-round.
How much does health insurance cost in Wyoming?
The average monthly premium for a benchmark Silver plan in Wyoming is approximately $650-$780 before subsidies. Wyoming has some of the highest premiums in the nation due to its rural geography and limited insurer competition. However, most marketplace enrollees qualify for substantial subsidies.
Need Help Finding Coverage in Wyoming?
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