Wyoming health insurance Marketplace guide

To qualify for health coverage through the Marketplace in Wyoming, you must:³

• Live in Wyoming
• Be lawfully present in the United States
• Not be incarcerated
• Not be enrolled in Medicare

Eligibility for financial assistance in the form of premium subsidies and cost-sharing reductions (CSR) depends on your income and how it compares with the cost of the second-lowest-cost Silver plan in your area – which depends on your age and location. (See more details below about premium subsidies and CSR benefits.). In addition, to qualify for financial assistance with your ACA plan you must:

• Not have access to affordable health coverage through your employer. If your employer offers coverage but you feel it’s too expensive, you can use our Employer Health Plan Affordability Calculator to see if you might qualify for premium subsidies in the Marketplace.
• Not be eligible for Medicaid or CHIP.
• Not be eligible for premium-free Medicare Part A.⁴
• If married, file a joint tax return with your spouse.⁵
• Not be able to be claimed by someone else as a tax dependent.⁵

In Wyoming, you can sign up for an ACA-compliant individual or family health plan from November 1 to January 15, which is the annual open enrollment period.⁶

If you need your coverage to start on January 1, you must apply by December 15. If you apply between December 16 and January 15, your coverage will begin on February 1.⁶

Outside of open enrollment, a special enrollment period is necessary to enroll or make changes to your coverage.

Most special enrollment periods are triggered by a qualifying life event, such as giving birth or losing other health coverage. But some special enrollment periods don’t require a specific qualifying life event.

If you have questions about open enrollment, you can learn more in our comprehensive guide to open enrollment. We also have a comprehensive guide to special enrollment periods.

To enroll in an ACA Marketplace plan in Wyoming, you can:

• Visit HealthCare.gov – the federally run health insurance Marketplace that’s used in Wyoming. Here you will find an online platform to compare plans, determine whether you’re eligible for financial assistance, and enroll in the plan that best meets your needs.
• Purchase individual and family health coverage with the help of an insurance agent or broker, a Navigator or certified application counselor, or an approved enhanced direct enrollment entity.⁷

You can also call HealthCare.gov’s contact center by dialing 1-800-318-2596 (TTY: 1-855-889-4325). The call center is available 24 hours a day, seven days a week, but it’s closed on holidays.

Wyoming residents can use the federally run enrollment platform – HealthCare.gov – to shop for individual and family health plans.

As of early 2024, about 96% of the people enrolled in plans through the Wyoming Marketplace were saving money on their premiums as a result of premium subsidies. The average subsidy savings was $864/month, which brought the average net premium — including the 4% of enrollees who paid full price — down to just $108/month.²

In addition to the premium subsidies, Marketplace enrollees with household incomes up to 250%of the federal poverty level also qualify for cost-sharing reductions (CSR) that reduce the out-of-pocket expenses on Silver-level plans.⁸

Between the premium subsidies and cost-sharing reductions, you may find that an ACA plan is the cheapest health insurance option for you.

Source: CMS.gov⁹

Wyoming has not yet expanded Medicaid eligibility under the ACA. The state legislature has considered Medicaid expansion numerous times over the years, but the legislation has never been successful. As a result, there is a coverage gap in the state: Non-disabled adults under age 65 who don’t have children are ineligible for both Medicaid and Marketplace subsidies if their income is below the poverty level.

Three insurers offer 2025 exchange (Marketplace) plans in Wyoming.¹⁰ Two of them already offered coverage in 2024, and they’re joined by UnitedHealthcare for 2025.¹

In most Wyoming counties, residents can choose from among plans offered by all three insurers for 2025, but three counties along the western edge of the state have just two participating Marketplace insurers,¹⁰ as UnitedHealthcare doesn’t offer coverage in those counties.

Wyoming’s Marketplace insurers have proposed the following average rate changes for 2025, before subsidies were applied:¹¹

Source: RateReview.HealthCare.gov¹²

Wyoming is one of three states that does not have an effective rate review program, so the proposed rates and plans are reviewed by the federal government (CMS) instead of state regulators.¹³ Rates will be finalized before open enrollment begins in November 2024.

When we talk about overall average rate changes, however, keep in mind that they only reflect how full-price premiums change from one year to the next. They don’t account for subsidies or for the fact that a person’s rates will increase each year based on their age, even if their insurer doesn’t change its average premiums at all.

Most enrollees in Wyoming’s exchange receive premium subsidies, which offset the majority of the cost of their coverage.²

Here’s a summary of how average pre-subsidy premiums have changed over the years in Wyoming’s individual/family health insurance market (note that these numbers are unweighted averages for years with multiple carriers, as enrollment numbers were often redacted):

• 2015: Average increase of 5%¹⁴
• 2016: Average increase of 6%¹⁵ (only one participating insurer)
• 2017: Average increase of 7.4%¹⁶
• 2018: Average increase of 55%¹⁷ (Largely due to elimination of federal funding for CSR)
• 2019: Average decrease of 0.25%¹⁸
• 2020: Average increase of 1.6%¹⁹
• 2021: Average decrease of 10%²⁰ (second insurer joined the exchange)
• 2022: Average decrease of 4%²¹
• 2023: Average increase of 18.5%²²
• 2024: Average increase of 0.3%²³

In the open enrollment period for 2024 coverage, 42,293 people enrolled in a health plan through the Wyoming ACA Marketplace.²⁴ This marked the fourth year in a row the Wyoming Marketplace reached record-high Marketplace enrollment (see chart below).

The surge in enrollment during these years was due in part to the American Rescue Plan (ARP) which made ACA’s premium subsidies more substantial. Under the ARP’s rules – extended through 2025 by the Inflation Reduction Act – subsidies are larger and more widely available than they used to be.²⁵

The enrollment increase in 2024 was also driven partly by the “unwinding” of the pandemic-era Medicaid continuous coverage rule. By April 2024, CMS reported that 5,864 Wyoming residents had transitioned from Medicaid to a Marketplace plan since the unwinding process began in the spring of 2023.

Source: 2014,²⁶ 2015,²⁷ 2016,²⁸ 2017,²⁹ 2018,³⁰ 2019,³¹ 2020,³² 2021,³³ 2022,³⁴ 2023,³⁵ 2024³⁶

HealthCare.gov
800-318-2596

Wyoming Insurance Department
Provides consumer protection and support to Wyoming residents by investigating consumer complaints and resolving issues on insurance matters.
(307) 777-7401 / Toll Free: 1-800-438-5768 / [email protected]

State Exchange Profile: Wyoming
The Henry J. Kaiser Family Foundation overview of Wyoming’s progress toward creating a state health insurance exchange.