Medicaid Costs and Coverage in Wyoming

“How much does Medicaid cost in Wyoming?” is a question that a beneficiary may ask after being approved for the program. To determine how much is Medicaid in Wyoming, enrollees must know that the cost of Medicaid depends on the health care service and if a copayment is required. It is important to note that beneficiaries who have Medicaid coverage are responsible for paying copayments, or a small fee, for certain services. Medicaid cost estimates will also depend on if the program covers the service. A covered Medicaid service is when a Medicaid reimbursement is made available after all of the guidelines are met. In Wyoming, services that are covered by Medicaid range from dental and vision screenings, family planning and hospice care. If Medicaid does not cover a service, then the beneficiary will be responsible for payment.

How does Wyoming Medicaid work?

In Wyoming, Medicaid coverage is a joint state and federal program that pays for the medical care of low-income and medically needy beneficiaries. Under Medicaid coverage, payment for medical care will not be made to the beneficiary. Medicaid guidelines state that payments are only made to the health care providers, which include doctors, hospitals and pharmacies that are enrolled in the Medicaid program. Before you can make an appointment to see a doctor, you must be sure that the provider accepts Medicaid. If Wyoming Medicaid coverage does not cover the service, then you will be responsible for payment.

Medicaid coverage in WY states that if Medicaid beneficiaries already have medical bills in the three months before they apply for Wyoming Medicaid, then they may be eligible to have Medicaid pay those bills. However, a beneficiary’s income from those months must have fallen within the Medicaid income limits and the medical services he or she received must have been a Medicaid-covered service. Wyoming Medicaid coverage requirements state that the service must have also been provided by a Medicaid enrolled provider.

How much does Medicaid cost in Wisconsin?

“How much is Medicaid in Wisconsin?” is a question a beneficiary may be wondering before he or she even receives coverage. Unlike private health care insurance, the different types of Medicaid insurance pay for both health care and long-term services, such as nursing home and home-health care of the elderly. It also covers community-based services for beneficiaries with intellectual and developmental disabilities (I/DD) and acquired brain injury (ABI). Home- and community-based services waivers under Medicaid coverage are an optional way for states to pay for long-term care and rehabilitative services in a home or community setting.

Medicaid costs vary depending on the Medicaid eligibility in Wyoming. If a beneficiary receives Medicaid coverage in Wyoming, then he or she qualifies for Medicaid services at no cost to them with the following exceptions:

  • Adults who are 21 years or older and not pregnant may be required to pay a copayment for medical services or treatment
  • Those enrolled in the Employed Individuals with Disabilities (EID) program are required to pay monthly premiums
  • If a beneficiary is in a long-term care facility, he or she will be responsible for contributing to the cost of care
  • If a beneficiary is in an assisted living facility, he or she will be responsible for paying for room and board

Coverage for Medicaid states that beneficiaries should not be charged for services that require prior approval that their health care provider did not obtain. Also, Medicaid costs requirements state that beneficiaries should not be billed for unnecessary medical services that they did not choose to receive. Download our comprehensive Medicaid guide for details about which medical services are mandatorily covered by the program for all beneficiaries.

What services are covered by Medicaid in Wyoming?

Medical services covered by Medicaid in WY include office visits, both outpatient and inpatient hospital and behavior health care. Medicaid coverage also includes prescription drugs and referrals for screenings and treatment. There is also extended coverage for dental and vision services for certain beneficiaries.

In Wyoming, Medicaid covers a variety of service for those enrolled in the program. Ambulance services covered under Medicaid include emergency transportation by basic life support ambulance, advanced life support ambulance or air ambulance. Also, some nonemergency ambulance transportation may be covered by Wyoming Medicaid if the beneficiary is in need of special care during the trip or if any other means of travel would put the beneficiary in danger.

What services are covered by Medicaidcan depend on the subgroup that the enrollee belongs to. For instance, Wyoming Medicaid coverage includes several types of dental services. Children younger than 21 years of age have comprehensive dental coverage and orthodontics for cases that directly impact function. However, Medicaid coverage requirements state that adults 21 years of age and older can receive preventative care, (cleanings and X-rays), restorative care (fillings), removable prosthetics (dentures) and emergency extractions.

Medicaid coverage in WY includes many additional services such as those for organ transplants, acquired brain injuries, adult’s and children’s developmental disabilities. Medicaid coverage is available at assisted living facilities and developmental centers. In addition to care management and services covered by Medicaid, prosthetics, orthotics and durable medical equipment, as well as occupational, physical and speech therapy services are included.

services covered by Medicaid in Wyoming include end-stage renal disease (ESD) services, health check exams, hearing, home health services, hospital services, vision services, surgical services, psychiatric hospital services and rehabilitation services. Medicaid coverage states that there is a limit on emergency room visits for non-emergency reasons for beneficiaries who are 21 years of age or older, and a copayment is required for non-emergency visits. Learn more about Medicaid coverage and specific costs by downloading our detailed national Medicaid guide here.

What does Medicaid not cover in Wyoming?

If a beneficiary is unsure of his or her Wyoming Medicaid coverage, then he or she can discuss it with a Medicaid health care provider before receiving any services. Generally, services not covered by Medicaid include those that are not considered medically necessary, such as cosmetic procedures and transsexual surgery including follow-up services and treatments. Acupuncture, autopsies, biofeedback therapies and equipment, canceled or missed appointments and chronic pain rehabilitation will also not be covered by the Medicaid program. Medicaid will not cover the cost of educational supplies and equipment either.

Although family planning services are covered by Medicaid, infertility services including reverse sterilization, counseling and artificial insemination are not. Likewise, Medicaid coverage does not include abortion, except as specified by federal law. Similarly, services not covered by Medicaid in Wyoming include those normally covered if they are performed by a provider who is not enrolled in Medicaid. Medicaid information about approved providers is furnished to enrollees so they may select one who is in the network.