Health Insurance Marketplace in Wyoming
If you live in Wyoming, you’ll use this website, HealthCare.gov, to apply for coverage, compare plans, and enroll. Specific plans and prices are available now and coverage can start as soon as January 1, 2014.
Spanish language speakers can contact cuidadodesalud.gov.
Choosing the Right Health Insurance Plan
There are 5 categories of Marketplace insurance plans: Bronze, Silver, Gold, Platinum, and Catastrophic.
Plans range from bare bones “bronze” plans which cover 60% of pocket medical costs to “platinum” plans which have greater coverage but come with higher premiums. In general higher premiums mean lower out-of-pocket costs and a wider insurer network of doctors and hospitals.The plans are as listed below:
NOTE: All cost sharing is of out of pocket costs. Please see ObamaCare health benefits for services that are covered at no out of pocket charge on all plans. The maximum out-of-pocket costs for any Marketplace plan for 2014 are $6,350 for an individual plan and $12,700 for a family plan.
Bronze Plan: The bronze plan is the lowest cost plan available. It has the lowest premiums and in exchange has the lowest actuarial value. The actuarial value of a bronze plan is 60%. This means that 60% of medical costs are paid for by the insurance company, leaving the other 40% to be paid by you.
Silver Plan: The Silver plan is the second lowest cost plan, it has an actuarial value of 70%. This means that 70% of medical costs are paid for by the insurance company, leaving the other 30% to be paid by you. The Silver plan is the standard choice for most reasonably healthy families who historically use medical services.
Gold Plan: The Gold plan is the second most expensive plan, it has an actuarial value of 80%. This means that 80% of medical costs are paid for by the insurance company, leaving the other 20% to be paid by you.
Platinum Plan: The Platinum plan is the plan with the highest premiums offered on the insurance exchange. The Platinum plan as an actuarial value of 90%. This means that 90% of medical costs are paid for by the insurance company, leaving the other 10% to be paid by you. This plan is suggested to those with high incomes and those in poor health. Although coverage is more expensive up front the 90% coverage of costs will help those who use medical services frequently.
Catastrophic plans – which have very high deductibles and essentially provide protection from worst-case scenarios, like a serious accident or extended illness — are available to people under 30 years old and to people who have hardship exemptions from the fee that most people without health coverage must pay.
Wyoming has not chosen to expand its Medicaid program at this time. Read “What if my state isn’t expanding Medicaid?” to learn more. You can find out whether you qualify for Medicaid under Wyoming’s current rules 2 ways: Contact your state Medicaid agency right now or fill out an application for coverage in the Health Insurance Marketplace.
Who can help you (the Navigators)
Memorial Hospital of Laramie will help lead “Enroll Wyoming,” a statewide effort to reach out to the uninsured in Wyoming. They plan on reaching out to the uninsured population through hospitals, safety-net providers, and others to inform people of their coverage options and facilitate enrollment.
Wyoming Senior Citizens, Inc. is a non-profit that is working to provide eligible citizens with information about programs that can help them enroll in health care. Counselors from the group will provide public information at libraries, senior centers, town halls, etc., and focus on eligible populations in the rural, frontier, and farming communities in Fremont, Hot Springs, Washakie, Big Horn, Carbon, Natrona, Converse, Goshen, and Laramie Counties.
Who you can contact for more help
If you need more detailed analysis, identification of issues, solutions, and implementation of your health insurance plan please let us know with the form below and we’ll get right back to you.
Accountable Care Organizations in Wyoming
ACOs are profit-driven health innovators primarily serving Medicare patients who are financially rewarded by the government and private insurance companies for delivering medical services that lead to better health outcomes for less money.
- Healthlinknow, Inc. WY – Health Care Innovation Award
- Memorial Hospital Of Laramie County Dba Cheyenne Regional WY – Health Care Innovation Award
Health care facilities where Innovation Models are being tested
- Wyoming Medical Center Casper, WY – BPCI Initiative: Model 2
- Conwell Clinic Casper, WY – Federally Qualified Health Center Advanced Primary Care Practice Demonstration
- Phyllis Sherard MPA Cheyenne, WY – Innovation Advisors Program
The Insurance Exchange/Marketplace
What has been done, not been done, or left up to the federal government to do.
Establishing the Exchange in Wyoming
On November 14, 2012, Governor Matt Mead (R) acknowledged Wyoming would default to a federally-operated health insurance exchange for 2014, with the possibility of moving to a state-run exchange in the future.1
Governor Mead had signed HB 0050 into law in 2011 establishing the Wyoming Health Insurance Exchange Steering Committee to study the feasibility of creating a health insurance exchange in the state.2 The Steering Committee was comprised of four members from the Legislature and 17 appointees, including representatives of businesses, insurers, providers, hospitals, consumers, and state agencies.3 The Steering Committee received approval for an extension to continue researching exchange implementation until 2013; however, in March 2012, the Committee voted unanimously not to file an extension for federal funds.4 Exchange planning was suspended despite Governor Mead’s support for Wyoming continuing to pursue establishment of “some components of a state-run benefit exchange.”5 The Governor also indicated that the exchange should be established by the Legislature, and not through an executive order, as had been discussed by the Committee.6 Since Wyoming’s 2012 legislative session was a budget session, requiring a two-thirds majority vote, exchange legislation would not have been possible until the 2013 General Session.
Information Technology (IT): In June 2012, the Wyoming Department of Health released a Request for Proposals (RFP) soliciting subcontractors to upgrade the state’s Medicaid and Children’s Health Insurance Program (CHIP) eligibility and enrollment system which will integrate with an exchange.7 Wyoming has received approval from the Centers for Medicare and Medicaid Services (CMS) for an enhanced federal match to assist with financing IT upgrades of the state’s Medicaid and CHIP eligibility systems.8
Essential Health Benefits (EHB): The ACA requires that all non-grandfathered individual and small-group plans sold in a state, including those offered through the Exchange, cover certain defined health benefits. Since Wyoming has not put forward a recommendation, the state’s benchmark EHB plan will default to the largest small-group plan in the state, Blue Cross Blue Shield of Wyoming- Blue Choice Business, PPO.
In September 2010, the Wyoming Department of Insurance received a federal Exchange Planning grant of $800,000. Additionally, HB 0050 appropriated $145,000 from the General Fund for any portions of the study not paid for by the federal grant. In his 2013 budget proposal to the Legislature, Governor Mead included a request for $100,000 to assist in the state in evaluating exchange options beyond 2014.9
Expansion of Medicaid
From 2014 to 2017, the federal government will pay for 100% of the difference between a state’s current Medicaid eligibility level and the ACA minimum. Federal contributions to the expansion will drop to 95% in 2017 and remain at 90% after 2020, according to the ACA.
As the ACA was originally written, states would lose all Medicaid funding if they refused to expand their program to the ACA minimum.
However, the Supreme Court in June 2012 ruled that the federal government could not withhold Medicaid funding for states that chose not to expand their programs. The decision effectively allowed state officials to opt out of the expansion, and some have said they will do just that.
Wyoming will not participate in Medicaid expansion.
The federal government will assume full responsibility for running a health insurance exchange in Wyoming beginning in 2014.
1. Brown, Trevor. “Feds to control Wyoming health care.” November 14, 2012. WyomingNews.http://www.wyomingnews.com/articles/2012/11/14/news/01top_11-14-12.txt
2. HB 0050. Wyoming act to study a state health insurance exchange. Signed March 10, 2011.http://legisweb.state.wy.us/2011/Enroll/HB0050.pdf
3. Wolfson, J. “Wyoming’s Insurance Exchange Committee Members.” Casper Star-Tribune. July 1, 2011. http://trib.com/news/opinion/blogs/wolfjammies/article_66b88eb8-c1cc-5426-bad4-f8febf79bbed.html
4. Bleizeffer, Dustin. “Lawmakers put the brakes on health insurance exchange effort.” WyoFile. April 3, 2012. http://wyofile.com/2012/04/health-on-hold-lawmakers-put-the-brakes-on-health-insurance-exchange-effort/
5. Wolfson J. “Wyoming Gov. Mead Supports State Health Exchange Recommendations.” Casper Star-Tribune. October 10, 2011. http://trib.com/news/state-and-regional/wyoming-gov-mead-supports-state-health-exchange-recommendation/article_3f3d6b73-af00-5a86-8193-bc34eb10e31d.html
6. Brown T. “Health Insurance Exchange Could Bypass Legislature.” Wyoming Tribune Eagle. October 5, 2011. http://www.wyomingnews.com/articles/2011/10/05/news/19local_10-05-11.txt
7. White, T. “Wyoming Making Moves on Health Insurance Exchange Efforts.” GovWin from Deltek. May 9, 2012. http://iq.govwin.com/index.cfm?fractal=blogTool.dsp.blog&blogname=public&alias=Wyoming-making-moves-on-health-insurance-exchange-efforts.
8. Performing Under Pressure: Annual Findings of a 50-state survey of Eligibility, Enrollment, Renewal, and cost-sharing policies in Medicaid and CHIP. January 2012. Kaiser Family Foundation. http://www.kff.org/medicaid/upload/8272.pdf
9. Governor Matt Mead. 2013-2014 Supplemental Budget Letter. November 30, 2012.http://governor.wy.gov/Documents/2013-14%20Supplemental%20Budget%20Letter%20and%20Message.pdf
Also of interest
Provided by the Henry J. Kaiser Family Foundation