Wyoming residents seeking affordable healthcare coverage can explore several Medicaid programs based on age, income, family status, and medical condition. Here’s a comprehensive breakdown of who qualifies, income limits, and how to apply for Medicaid and other health coverage in the state.
General Eligibility Requirements
To qualify for Wyoming Medicaid, applicants must:
- Be a resident of Wyoming
- Be a U.S. citizen or have qualified immigration status
- Have or apply for a Social Security number (with some exceptions)
- Meet eligibility criteria for at least one Medicaid program
- Meet income and resource limits specific to the program
Note: Seniors (65+), people with disabilities, and those with certain medical conditions have separate eligibility rules not covered here.
Medicaid Eligibility Categories
1. Medicaid for Children
- Who Qualifies: Wyoming residents under age 19, U.S. citizens or qualified immigrants, meeting income guidelines
- Income Limits:
- Infants (up to age 1): Up to 154% FPL
- Children ages 1-5: Up to 154% FPL
- Children ages 6-18: Up to 133% FPL
Example Monthly Income Limits:
| Family Size | Infants (154% FPL) | Children 6-18 (133% FPL) |
|---|---|---|
| 2 | $2,715 | $2,345 |
| 3 | $3,420 | $2,954 |
| 4 | $4,126 | $3,563 |
2. Children’s Health Insurance Program (CHIP)
- Who Qualifies: Children under 19, family income above Medicaid limits but at or below 200% FPL, no other health insurance
- Income Limits: Above Medicaid limits, up to 200% FPL
3. Medicaid for Pregnant Women
- Who Qualifies: Pregnant individuals, Wyoming residents, meeting income and immigration guidelines
- Income Limit: 154% of FPL
- Coverage: Includes 12 months postpartum care
- Presumptive Eligibility: Temporary prenatal coverage while application is processed
4. Medicaid for Parents & Caretaker Relatives
- Who Qualifies: Parents or caretaker relatives of dependent children under age 19
- Income Limits: Approximately 41% of FPL
Example Monthly Income Limits:
| Family Size | Income Limit |
|---|---|
| 2 | $723 |
| 3 | $911 |
| 4 | $1,098 |
5. Medicaid for Non-Disabled, Non-Elderly Adults
- Wyoming has not expanded Medicaid under the Affordable Care Act
- Non-disabled adults without dependent children generally do not qualify, regardless of income
How Income is Counted
Eligibility is based on MAGI (Modified Adjusted Gross Income), which includes wages, self-employment income, Social Security benefits, and other income sources.
Other Health Coverage Options
If you don’t qualify for Medicaid:
- Marketplace Insurance: Available through the Health Insurance Marketplace
- Who Can Apply:
- U.S. citizens or lawfully present individuals
- Not incarcerated
- Not covered by Medicare
Premium Tax Credits: Help reduce insurance costs for those earning between 100% and 400% FPL.
The Coverage Gap in Wyoming
Due to the state not expanding Medicaid:
- Adults without dependent children and income below 100% FPL may not qualify for Medicaid or Marketplace subsidies
- Options for those in the gap:
- Check eligibility for other Medicaid categories
- Use community health centers with sliding fee scales
- Consider catastrophic plans (for those under 30 or with hardship exemptions)
When to Apply for Marketplace Coverage
- Annual Open Enrollment: Typically November through January
- Special Enrollment Periods: Within 60 days of qualifying life events (job loss, marriage, birth of a child, etc.)
