Medicaid is a healthcare assistance program that covers medical services for various groups, including children, pregnant women, families with children, as well as older adults, and individuals who are blind or have disabilities.

Eligibility for this program hinges on factors such as citizenship status, state residency, household income, and, in some instances, assets and specific healthcare requirements. Additionally, individuals who are not citizens may still qualify for Medicaid for emergency healthcare services.

Wyoming's Kid Care CHIP, the state's iteration of the Children's Health Insurance Program, aims to provide healthcare coverage encompassing health, vision, and dental care for the state's youth up until 18. Eligibility for this program is determined based on whether the child is uninsured and if they meet certain income and eligibility criteria.

• ‍Ambulance Services: Emergency and some non-emergency transportation.
• ‍Ambulatory Surgical Center Services: Outpatient surgery in a free-standing facility.
• ‍Care Management Entity: Services for Medicaid-eligible children and young adults under 21 with complex behavioral health needs.
• ‍Children's Mental Health Waiver
• Community Choices Waiver: Home and community-based services for older adults and adults with physical disabilities.
• ‍Dental Services: Comprehensive services for children and young adults under 21; limited services for adults.
• ‍Developmental Center Services: Assessments and therapy for children under 5.
• ‍Developmental Disability Waiver Services: Supportive services for all ages with disabilities.
• ‍Dietitian Services: Services by licensed dieticians, limited to 20 visits per year without additional authorization.
• ‍Durable Medical Equipment: Medically necessary equipment if ordered by a physician.
• ‍Emergency Services: Coverage for emergency care, including out-of-state services.
• ‍End-Stage Renal Disease Services: Outpatient dialysis for kidney disease.
• ‍Family Planning Services: Services provided to individuals of childbearing age.
• ‍Health Check Exams: Comprehensive screening and treatment for children and young adults under 21.
• ‍Hearing Services: Audiologist services and hearing aids.
• ‍Home Health Services: Skilled medical services under a physician's plan.
• ‍Hospice Services: Care for terminally ill members in the last months of life.
• ‍Hospital Services: Inpatient and outpatient services with some co-payment requirements.
• ‍ICF-ID Services: Long-term care for intellectually disabled members.
• ‍Interpretation Services: Verbal or sign language interpretation per national standards.
• ‍Laboratory and X-ray Services: Radiology, ultrasound, and screening services.
• ‍Mental Health and Substance Abuse Services: Various services by mental health professionals.
• ‍Nurse Practitioner and Nurse Midwife Services: Services as permitted by state statutes.
• ‍Nursing Facility Services: Care for members with medical needs who cannot live independently.
• ‍Organ Transplant Services: Limited and require prior authorization.
• ‍Occupational, Physical, and Speech Therapy Services: Rehabilitative therapy under a physician's orders.
• ‍Physician Services: Medically necessary services by or under the supervision of a physician.
• ‍Prescription Drugs: Coverage for most prescriptions and some over-the-counter drugs.
• ‍Prosthetics and Orthotics: Some cases require prior authorization.
• ‍Psychiatric Hospital Services: Acute psychiatric stabilization; prior authorization required.
• ‍Rehabilitation Services: Restoring functions after illness or injury.
• ‍Surgical Services: Necessary procedures; some require prior authorization.
• ‍Transportation Services: Reimbursement for medically necessary travel to appointments.
• ‍Vision Services: Comprehensive services for members under 21; limited services for adults.
• ‍Well-Baby and Well-Child Visits and Immunizations: Routine immunizations and visits with no co-pay.

The basic eligibility requirements for Medicaid in Wyoming involve several criteria that vary depending on the specific program and the individual's circumstances. Here's a general overview:

1. Residency and Citizenship: Applicants must be Wyoming residents and either U.S. citizens or lawful permanent residents. For specific programs, lawful permanent residents must have lived in the U.S. for at least five years.
2. Age and Special Groups: Some programs target specific groups such as the elderly, blind, disabled, pregnant women, and children. For instance, children's programs cover eligible individuals from birth through age 18, and specific programs for pregnant women provide coverage for up to 12 months postpartum.
3. Income Level: Eligibility is often based on the applicant's income level, which must fall within certain limits. These limits are typically set as a percentage of the Federal Poverty Level (FPL) and vary by program. For example, children's and pregnant women's programs have their income eligibility set at specific percentages of the FPL.
4. Medical Needs: Some programs, like Nursing Home/Swing Bed and Inpatient Hospital Care, require medical eligibility based on needs assessment.
5. Program-Specific Requirements: Different Medicaid programs have specific eligibility requirements. For example, the Emergency Services Program is for certain undocumented or ineligible immigrants and only covers emergency services.
6. Family Composition and Care Requirements: Programs for parents and caretaker relatives have eligibility criteria for family composition and the care of a child under 18.
7. Supplemental Security Income (SSI) Eligibility: Individuals eligible for SSI are automatically eligible for Medicaid in Wyoming.

Find more information about income limits and specific programs here.

Apply online at www.wesystem.wyo.gov or contact the Wyoming Department of Health Customer Service Center at 855-294-2127 to apply over the phone.

Pregnant women may also apply for the Presumptive Eligibility Program through a Qualified Provider to receive up to 60 days of coverage for outpatient services (if approved). Find a list of Qualified Provider locations here.

Members must renew their Medicaid coverage every year. Members will receive a renewal in the mail a few months before coverage is due to end.

Once the member has received the renewal, the member will need to review the information on the renewal, update any changed information, sign and date the renewal, and then return the renewal and verification documents by the due date.

Members who remain eligible will receive a letter showing the renewal was approved.Renewals can be completed online at www.wesystem.wyo.gov or submitted over the phone, through email, by faxing the renewal back per the contact information listed above.