What You Need to Know
You can enroll in 2021 health insurance plans from November 1, 2020 through December 15, 2020.
One insurance carrier offers plan for individuals and families.
You could also get help paying for your health coverage, depending on your income, or apply for public programs like Medicaid.
Only one Wyoming health insurance company offers Affordable Care Act plans for 2021. Still, most enrollees get generous subsidies to save money on premiums. Many other forms of health insurance are available in the state.
Wyoming is the state with the smallest population in the U.S.: 560,300 people.1
Its population receives health insurance through employers, programs such as Medicaid, Children’s Health Insurance Program (CHIP), Medicare, Obamacare (ACA), or the private individual market.
Health insurance coverage in Wyoming breaks out as follows:2
- Employer: 55%
- Nongroup: 7% (individuals and families who bought or are covered as a dependent by nongroup insurance)
- Medicaid: 10%
- Medicare: 15%
- Military: 2%
- Uninsured: 11%
The 55% covered by employer insurance receive it through a current or former employer or union. About a third are children, and the rest are adults aged 19-64.3 In 2018, the average annual premium for employer-sponsored coverage for families was $19,374, and the deductible was $3,902.4
Obamacare enrolled about 4% of Wyoming’s population in 2019. Plans must include such essential health benefits as inpatient hospital care, prescription drug coverage, and free preventive care. The number of enrollees has been very stable over the past three years.5
Medicaid is another important source of insurance for its residents, although Wyoming did not opt for the ACA’s Medicaid expansion. (A Supreme Court ruling allowed states to opt out.)6 If it had, it would have covered nearly all nonelderly adults under 138% of the poverty level. That action would have added an extra 16,000 uninsured adults to its rolls.7
Read below for an overview of the Wyoming health insurance landscape and available coverage options.
Obamacare’s Impact in Wyoming
Under the Affordable Care Act, residents of Wyoming can buy nongroup coverage and may qualify for premium tax credit assistance through health insurance marketplaces. About 95% of its enrollees received an Advanced Premium Tax Credit (APTC) to help pay their premium, compared with a national average of 87%.8
In 2014 and 2015, two issuers participated in the Health Insurance Marketplaces accessible to residents of Wyoming. Since 2016, only one insurer has sold policies in the state,9 Blue Cross and Blue Shield of Wyoming.
About Wyoming’s Health Insurance Marketplace
The Open Enrollment Period for 2021 coverage runs from November 1, 2020 to December 15, 2020. Coverage begins January 1, 2021. It is important to re-enroll during each open enrollment to avoid a break in coverage.
If you miss the Open Enrollment Period, you will have to wait for the next year unless you experience a qualifying life event. Any event that leaves you uninsured or changes the size of your family (such as loss of a job or insured spouse, marriage, birth, or adoption of a child) triggers a special enrollment period. The qualifying life event opens a short window again for you to obtain your insurance. This is also known as a Special Enrollment Period.
COVID Special Enrollment Period
Wyoming residents who didn’t purchase health insurance during open enrollment can do so during a COVID Special Enrollment Period. The federal government reopened sign ups from February 15, 2021 to August 15, 2021 due to the coronavirus.
The Marketplace in Wyoming is a federally-facilitated marketplace, which means the Department of Health and Human Services (HHS) performs all marketplace functions. Wyoming consumers apply for and enroll in coverage through healthcare.gov.10 In 2019, 22,890 residents enrolled through the marketplace for the 2020 insurance year.11
For individuals and families, Obamacare may be the best low-cost health insurance thanks to subsidies that can significantly lower your monthly premiums in Wyoming. If you are self-employed with no employees, your health insurance options are the same as for individuals and families.
Individual Health Insurance Companies in Wyoming
Residents can also call Wyoming 2-1-1 (which partners with Enroll Wyoming) for help enrolling or getting answers about the ACA. For assistance, in Wyoming, dial 2-1-1 or (888) 425-7138.13
Wyoming Health Insurance Premiums
Qualified plans available on and off the Marketplace are organized in metal tiers or levels of cost-sharing.
Wyoming health insurance premiums on metal plans have increased gradually for the past three open enrollment seasons (2018-2020).14 Below is the average monthly cost for a 40 year old for bronze, silver, and gold plans sold in Wyoming’s Marketplace.
|Average Premiums for Wyoming Marketplace Plans||2018 Plan Year||2019 Plan Year||2020 Plan Year|
|Average Lowest Cost Bronze Premium||$580||$577||$590|
|Average Lowest Cost Silver Premium||$864||$858||$875|
|Average Lowest Cost Gold Premium||$714||$716||$732|
The “benchmark” silver plan is used to calculate subsidies and represents the second-lowest cost silver premium for a 40 year old.15 This benchmark has increased in 2020 after holding steady during the 2018 and 2019 open enrollment seasons.
|Average Benchmark Premiums for Wyoming Marketplace Plans||2018 Plan Year||2019 Plan Year||2020 Plan Year|
|Average “Benchmark” Silver Plan (second-lowest silver premium)||$865||$865||$881|
Wyoming Marketplace Subsidies
If you earn between 100% and 400% of the federal poverty level (FLP), you can get a subsidy to help you pay for any metal plan. To qualify, for example, a family of three must earn between $21,720 and $86,880 in 2020. Subsidies can only be obtained through plans purchased on the Marketplace.
The average monthly subsidy received by Wyoming Marketplace enrollees in 2019 was $898. That is considerably higher than the U.S. average of $514.17
Just So You Know
You can only qualify for subsidies if you enroll in a plan through the Health Insurance Marketplace.
Here are some examples of cost savings with subsidies
A 28 year old in Cheyenne, Wyo., who earns $24,000 a year could get a 2020 silver plan for $122 per month after subsidies. The same policy would cost $690 per month without the premium tax credits that cover 82% of the cost.
A family of three in Casper, Wyo., that earns $50,000 a year could pay $322 a month after subsidies for a 2020 silver plan. This policy would cost $1,454 per month without the premium tax credits that cover 78% of the cost.
If you receive premium tax credits and have income up to 250% of FPL, you may also be eligible for Cost-Sharing Reductions (CSRs) if you are enrolled in a silver plan in the Marketplace. The CSRs lower the out-of-pocket costs you face.
In 2019, 26% of the people enrolled in Wyoming Marketplace plans received the CSR subsidies. This figure was down considerably from 56% in 2017 because CSRs were discontinued in October 2017 for new enrollees.18
Wyoming Low-Cost and Free Coverage Through Medicaid and CHIP
Slightly more than one in four of Wyoming’s residents earn less than twice the federal poverty level. That group represents 149,500 people.19 Of those aged 19-64, 40% are insured by employers, 10% by individual insurance, 16% by Medicaid, 5% by other public programs, and 29% are uninsured.20
In November 2019, 49,700 people were enrolled in Medicaid and 4,200 in CHIP in Wyoming.21 They represent about 10% of the population.
Income eligibility for Medicaid and CHIP varies for different groups. For instance, the federal poverty level for a family of three in 2020 is $21,720. Eligibility limits by percentage of the federal poverty level are:22
- Parents: 54%
- Pregnant women: 159%
- Children: 205%
- Seniors or Disabled: 74%
Wyoming’s combined Medicaid/CHIP enrollment dropped about 20% since the first Marketplace open enrollment period (pre-ACA) in late 2013. During the same period, the enrollment for the nation increased by 24%.23
You may qualify for low- or no-cost Medicaid coverage, if you are younger than 19, in foster care, a parent or other caretaker relative, pregnant, aged, blind, or have a disability. Qualification will depend on your income.24
Wyoming opted not to expand Medicaid. As a result, 16,000 adults are in what is called the “coverage gap.” Their income is higher than the current Medicaid eligibility, but lower than the lower limit for Marketplace premium credits. Most of these are adults without dependent children.25
If you are pregnant, support is available for you and your baby. In Wyoming, one third of births in 2018 were financed by Medicaid. While the Medicaid and CHIP income eligibility for pregnant women is 159% of the federal poverty level (FPL), for parents to maintain Medicaid eligibility after pregnancy coverage ends, their income must be below 54% of the FPL. The state has not enacted a paid family leave law.26
Eligible pregnant women receive health coverage for up to 60 days postpartum. If your income is below the family care income guidelines, to continue eligibility you must cooperate with Child Support Enforcement once your baby is born. Newborns born to Medicaid-eligible mothers are automatically eligible for the first year of life.27
Low-income children 18 and younger have access to health insurance in Wyoming. Kid Care CHIP provides affordable health coverage for the children of working parents, including free preventive dental and health care. For a small copay, other health services are also available.
Kid Care CHIP covers children from birth through age 18. Their parents must not be eligible for Medicaid and must earn below 200% of the FPL. (That’s $51,500 per year for a family of four.)28
Wyoming Medicare Plans For Seniors and Disabled Individuals
If you are over age 65, are younger with long-term disabilities, or have end-stage renal disease, Medicare is a federal program that helps you cover health costs. Nearly one-fifth of Wyoming’s population is enrolled in Medicare.
Nine percent of Medicare beneficiaries have incomes below the poverty level, and 11% are also enrolled in Medicaid. Of those people on Medicare with Part D prescription drug coverage, about 1 out of 7 receive low-income premium and cost-sharing subsidies.
Compared with other states, only 2.5% get their benefits through the private Medicare Advantage plans instead of Original Medicare.30 In both plans, enrollees receive Part A hospital and Part B medical insurance that include emergency room care and doctor’s visits.
Medicare Advantage (or Part C) offers additional benefits. Most plans include Part D prescription coverage whereas, under Original Medicare, you would have to purchase a standalone Medicare Part D plan separately. Three companies provide Medicare Advantage plans in Wyoming: Aetna Medicare, Lasso Healthcare, and United Healthcare.31
If you have Original Medicare, you can add Medicare Supplement insurance (Medigap) to your benefits to pay the portion Medicare does not pay. The 10 available Medigap plans are standardized. The benefits remain the same for all, but the premiums may vary by company. For 2020, Wyoming lists 28 companies that offer Medigap plans.34
The Wyoming State Health Insurance Information Program (WSHIIP) is a federally funded program with volunteer counselors to help you with any Medicare problems or questions. The one-on-one service is free and confidential. WSHIIP can be reached at (800) 856-4398 or (307) 856-6880.
If you are a Medicare beneficiary having difficulty paying Medicare premiums plus, in some cases, Medicare coinsurance and deductibles, Wyoming participates in two Medicare savings programs: the Qualified Medicare Beneficiary (QMB) and Specified Low-Income Medicare Beneficiary (SLMB).35
If you are under age 65 and on Medicare due to disability, the Wyoming Health insurance Pool (WHIP) offers coverage similar to a Medicare Supplement insurance plan covering Medicare Part A and Part B deductibles. The lifetime maximum paid for the Brown and Catastrophic Plan is $750,000; for the Gold Plan it is $1,250,000.
Income guidelines are 250% of the federal poverty limit (FPL), or $31,900 per year for an individual.36 Eligibility levels (Level 1 or 2) are based on Adjusted Gross Income and Filing Status. Level 1 premiums range from $56 to $140 per month; Level 2 rates run from $37 to $112. Contact WHIP at (800) 442-2376 for more information.
Buying Short-Term Health Insurance in Wyoming
Wyoming does not have state-specific regulations for short-term health insurance, but defaults to the federal rules. Plans can have initial durations of up to 364 days with renewals up to a total of 36 months.37
Short-term health insurance can be useful to fill temporary insurance gaps. These could be periods between jobs, waiting for employer-sponsored coverage, aging off your parent’s health insurance when you turn 26, after missing the Affordable Care Act enrollment window, or retiring before qualifying for Medicare.
Short-term, limited-duration plans are not the same as the comprehensive health coverage of ACA-qualified plans. Policies can exclude covering pre-existing conditions or preventive care. Be sure you read and understand what coverage is guaranteed by whatever policy you consider.