Wyoming Health Insurance Guide
Wyoming Health Insurance Information, Health Organizations and Resources and access to online health insurance quotes
When you live in Wyoming you can choose from a variety of private health insurance plans including plans for individuals and group plans provided by an employer. Depending on your income or employment status, you may also be eligible for Wyoming State-funded affordable health insurance for individuals and families, and federal programs such as Medicaid and COBRA.
Wyoming is not a guarantee issue state for individuals. Private insurance companies that sell individual policies can medically underwrite them and are not required to sell you an individual health insurance policy if you do not meet their criteria. You can be turned down for any number of reasons including your past or current health and lifestyle habits. In Wyoming, insurers are permitted a 12-month exclusionary period and a six-month look-back period for pre-existing conditions, unless you have proof of qualifying creditable coverage. Wyoming also permits health insurance providers to issue Elimination Riders that exclude coverage for specific health conditions. Insurers in Wyoming can base premiums for individual policies on your health, your age and lifestyle factors. There are no caps that limit what you can be charged. Wyoming does not require insurers to offer standardized policies for individuals.
Wyoming is a guarantee issue state for group health plans issued to small businesses. If your Wyoming health insurance is provided through your employer, your coverage cannot be denied because of your past or current health. The insurer can impose a 12-month exclusionary period and a six-month look-back period for pre-existing medical conditions, but must give credit for prior creditable coverage if there has been no more than a 63-day break in coverage. Your employer may impose a waiting period for eligibility for new hires, but it must be applied equally to all new hires. Premiums for small group health insurance may be underwritten and the insurer can charge a premium not to exceed 30% of its index rate if your group has a history of unfavorable health.
Wyoming is a guaranteed renewal state. Regardless of your health, your insurer must renew your individual health insurance policy as long as you’ve paid your premiums on time and haven’t defrauded the company, or in the case of some HMOs, as long as you haven’t moved out of the service area. However, your premiums can be increased to reflect your current health status. Your policy can be canceled if your insurer discontinues a plan or no longer sells insurance in the state.
Wyoming Mandated Health Benefits
Wyoming laws require private health insurance policies to cover several state-mandated benefits. These currently include:
- Breast Reconstruction
- Cervical Cancer and HPV Screening
- Colorectal Cancer Screening
- Diabetes Supplies and Self Management
- Maternity Stays and Prostate Cancer Screening
- Coverage for newborns under their parent's policy
- Coverage for adopted children under their parent's policy
- Coverage for handicapped dependents under their guardian’s policy
- Coverage for continuation/employees
- Coverage for conversion to non-group
Types Health Insurance Plans Available in Wyoming
The following major medical health insurance plans are generally available in Wyoming. Major medical plans cover illness and injury, hospitalization, prescription drugs and office visits, as well as the mandated services stated above.
Indemnity plans - Typically the most flexible and therefore highest priced choice, an indemnity plan lets you select your health providers and facilities. Depending on your plan, you will have to pay a deductible or co-insurance.
Preferred provider organization plans (PPOs) - You select from a network of preferred health care providers and facilities, and receive services at an agreed-upon discounted rate. You also have the option of going outside the network, but typically at a higher cost. You do not need a referral from a primary care physician to see a specialist. Premiums may be less than an indemnity plan but more than an HMO. You will have to pay a deductible or co-insurance.
Health maintenance organizations (HMOs) - HMOs plans require you to select a primary care physician from a prescribed network of providers, who must issue a referral before you can see a specialist. Services and covered costs are typically more comprehensive than those provided by a PPO. HMOs offer the advantage of affordable premiums and low out-of-pocket costs, with an emphasis on preventive care. Non-emergency services out of network are usually not reimbursed.
Point of Service plans (POS) - Similar to a PPO in that you will receive reimbursement for out-of-network care, but with an HMO’s requirement for a primary care physician who must provide referrals to specialists. Premiums, co-pays and co-insurance are typically higher than what you’d pay with an HMO.
Alternative Health Programs in Wyoming
Wyoming Health Insurance Pool
WHIP provides coverage for eligible residents who cannot obtain private health insurance because of a pre-existing condition. Other eligibility requirements apply. Two PPO plans offered. WHIP Brown has a $5,000 deductible and can be set up as a Health Savings Account. WHIP Gold has a $1,000 deductible, requires a 20% coinsurance for most covered services and has a maximum $2,000 out-of-pocket. Premiums are based on the plan you select, your age and sex, but are capped at 200% of the average rate charged for similar coverage in Wyoming. Enrollment is open. There may be a 12-month waiting period for pre-existing conditions, which may be fully or partially waived with proof of prior creditable coverage.
Kid Care CHIP Wyoming
This program provides comprehensive free or low-cost health care for resident children up to age 19, whose families meet income requirements and other eligibility requirements. One plan is available. There are no premiums or enrollment charges. Modest co-pays may be charged for some services, but most preventive services are free and co-pays are capped at $200 per year per family. There may be a 30-day waiting period if previous health insurance was voluntarily cancelled.. Enrollment is open but is subject to review and renewal every 12 months.
The Wyoming Insurance Department is responsible for regulating Wyoming’s health insurance industry.
Get access to Wyoming health insurance quotes from http://www.EINSURANCE.com/health-insurance/.
Wyoming Insurance Department
106 E 6th Ave
Cheyenne, WY 82002
(307) 777-7401 or (800) 438-5768
Kid Care CHIP Program
Wyoming Department of Health
(877) KIDSNOW ((877) 543-7669
(NAIC) National Association of Insurance Commissioners
The National Association of Insurance Commissioners (NAIC) is the organization of insurance regulators from the 50 states, the District of Columbia and the five U.S. territories. The NAIC provides a forum for the development of uniform policy when uniformity is appropriate. NAIC members are the elected or appointed state government officials who along with their departments and staff regulate the conduct of insurance companies and agents in their respective state or territory.
Insurance Information Institute (I.I.I)
The mission of the Insurance Information Institute (I.I.I.) is to improve public understanding of insurance -- what it does and how it works.
110 William Street
New York, NY 10038