Medicare in Wyoming

Nearly all Wyoming Medicare beneficiaries opt for Original Medicare – only 16,558 people had Medicare Advantage coverage as of July 2023, which amounts to about 13% of Wyoming’s Medicare population enrolled in Medicare Advantage plans¹ (although that’s up from just 6% in 2021).¹¹ Nationwide, nearly 49% of Medicare enrollees were enrolled in Medicare Advantage plans¹⁰, but Original Medicare enrollment in Wyoming is much more popular.

That’s due in large part to the fact that much of Wyoming simply didn’t have many Medicare Advantage plans available for purchase. Prior to 2019, there were no Medicare Advantage plans in 15 of the state’s 23 counties²

But starting in 2019, one carrier began offering Medicare Savings Account plans (a type of Medicare Advantage plan) statewide in Wyoming.¹² And other Medicare insurers have joined the state’s market since then; as of 2022, there are just eight counties in Wyoming that only have plans available from the carrier.⁵

Medicare Advantage plan availability in Wyoming in 2023 ranges from two plans in Sublette and Park counties, to 11 plans in Lincoln County.⁴

Medicare Advantage plans provide all of the benefits of Original Medicare (Part A, hospital coverage, and Part B, outpatient/medical coverage), although out-of-pocket costs and provider network access can differ considerably. Medicare Advantage plans also tend to include additional benefits, including Medicare Part D prescription drug coverage for drugs, nurse hotlines, fitness, and covered dental and vision services.

Medicare Advantage plan enrollment is available when a person is first eligible for Medicare, and there’s the Medicare Annual Open Enrollment Period (October 15 to December 7) when beneficiaries can switch to or from Medicare Advantage, or pick a different Medicare Advantage plan. There is also a window at the start of the year (January 1 to March 31) when people who are already enrolled in Medicare Advantage plans can switch to a different Medicare Advantage plan or switch to Original Medicare instead.

• Learn more about the Medicare Annual Enrollment Period (Oct. 15-Dec. 7)
• Questions to ask when you’re deciding between Medicare Advantage and Medigap + Part D.
• Learn how Wyoming Medicaid provides assistance to Medicare beneficiaries with limited income and assets.

Original Medicare does not have a cap on out-of-pocket costs (the deductible, copay and coinsurance the people pay when they need medical care), so most beneficiaries rely on some sort of supplemental insurance coverage. Many have Medicare supplement insurance coverage from a current or former employer, or from Medicaid. But for those who don’t, Medigap plans provide supplemental insurance coverage that pays some or all of the out-of-pocket expenses Original Medicare beneficiaries would otherwise have to pay on their own.

The Wyoming Department of Insurance publishes an annual buyer’s guide for Medigap coverage (here’s the 2022 guide) with helpful state-specific information related to Medicare plans. The guide notes that people under age 65 who have Medicare eligibility in Wyoming due to a disability are not guaranteed access to a Medigap plan, and that insurers can use medical underwriting to determine eligibility for people under 65 — all of whom have at least one significant pre-existing condition.

There are no federal rules to ensure access to Medigap plans for people under age 65. Many states have taken action to address this, but Wyoming has not.

According to Medicare’s plan finder tool, only one insurer offers Medigap coverage to Wyoming applicants under 65 in 2023. They offer only Plan B and high-deductible Plan F for these enrollees, and at much higher premiums than the standard rates (under federal rules, any version of Plan F can only be purchased by someone who became eligible for Medicare prior to 2020).⁶

However, the Wyoming Health Insurance Pool provides guaranteed-issue coverage for applicants who are unable to obtain Medigap coverage due to medical underwriting.

Wyoming is one of several states where state-run high-risk pools are still operational, with supplemental insurance coverage available to Medicare beneficiaries who are unable to obtain Medigap insurance policies.⁷ Wyoming enacted legislation in 2019 that extends the operation of the Wyoming Health Insurance Pool through 2030.¹³

For people who are age 65 or older, there were 30 insurance companies offering Medigap plans in Wyoming as of 2022.⁵ The state’s annual buyer’s guide includes sample prices for a 65-year-old for each plan offered by each insurer (Medigap plans are standardized at the federal level, with ten different plan options available, but not all insurers offer all plan options).⁵

Unlike other Medicare plan coverage options (ie, Medicare Advantage and Medicare Part D prescription drug plans), there is no annual open enrollment period for Medigap insurance policies. Coverage is guaranteed-issue during the first six months that a person is at least 65 and also enrolled in Medicare Part A and Medicare Part B. After that, in most circumstances, insurers can use medical underwriting if a person applies for a Medigap policy.

Original Medicare does not cover outpatient prescription drugs. But Medicare beneficiaries can get coverage for prescription drugs via a Medicare Advantage plan, an employer-sponsored plan (offered by a current or former employer), or a stand-alone Medicare Part D prescription drug plan. In areas where Medicare Advantage plan enrollment is lower, Medicare Part D prescription drug plan enrollment for stand-alone plans tends to be higher.¹

As of June 2023, more than 66% of Wyoming Original Medicare beneficiaries were enrolled in stand-alone Medicare Part D prescription drug plans.¹ For 2023 coverage, Medicare Part D prescription drug plan availability in Wyoming includes 22 plans with premiums starting at fifty cents per month.⁸

Medicare Part D prescription drug enrollment is available when a person is first eligible for Medicare, and the same fall Annual Enrollment Period that applies to Medicare plans is also used for Medicare Part D prescription drug plans: Beneficiaries can enroll in a Medicare Part D prescription drug plan or switch to a different plan between October 15 and December 7, with coverage effective the first of the following year.

It’s recommended that beneficiaries use Medicare’s plan finder tool each year to actively compare the available options and see how each plan will cover their prescription drugs in the coming year; plans change from one year to the next, and so do beneficiaries’ medication needs. A more costly plan in terms of monthly premiums might work out to be the best option, due to lower out-of-pocket costs when the enrollee fills prescriptions throughout the year.

Many Medicare beneficiaries receive financial assistance through Medicaid with the cost of Medicare premiums and services Medicare doesn’t cover – such as long-term care.

Our guide to financial assistance for Medicare enrollees in Wyoming includes overviews of these benefits, including Medicare Savings Programs, long-term care coverage, and eligibility guidelines for assistance.

If you have questions about Medicare eligibility in Wyoming or need help with Medicare coverage enrollment in Wyoming, you can reach out to the Wyoming Insurance Department. They have a page devoted to health coverage for Medicare beneficiaries, which includes information about Wyoming’s State Health Insurance Information Program.

The Medicare Rights Center is a nationwide service, with a website and call center, that can provide information and assistance with a variety of Medicare-related questions.

This guide to how Wyoming Medicaid can provide assistance to Medicare beneficiaries with limited financial means is a useful resource for Medicare beneficiaries in Wyoming and their caregivers.