All of the states are currently reviewing their existing insurance laws to come into compliance with the 2010 Patient Protection and Affordable Care Act, which is enacting health care reform on a progressive schedule toward full implementation in 2014. Currently, children may no longer be excluded from coverage based on pre-existing conditions, and they may remain on their parents’ health insurance up to age 26, regardless of their educational or marital status. Adults with pre-existing conditions may now draw on temporary high risk pools for insurance protection until the federally required health insurance exchanges become operational on January 1, 2014.
General Insurance Regulations
Insurers in the state of Wyoming must include a guarantee of renewability in their health policies. Currently, exclusions for pre-existing conditions may be in place for up to 12 months, with a six-month look-back period. Babies and adopted children are covered for a minimum of 31 days if dependents are already included in the policy. Health status can be used to set rate levels and to deny coverage, however a policy cannot be canceled due to illness.
Health Care Exchange
Currently Wyoming is studying its options for the creation of the federally required health care exchange, but no substantive action is expected in 2012. If action is not taken by January 1, 2013, the U.S. Department of Health and Human Services will take over responsibility for the exchange.
Pre-Existing Condition Insurance
The U.S. Department of Health and Human Services runs the Wyoming Pre-Existing Condition Insurance Plan to provide primary and specialty care, hospitalization, and prescription medication coverage. According to age and option, monthly premiums run from $126 to $542. Deductibles range from $1000 to $3000 with maximum annual out-of-pocket expenses capped at $7000.
Medicaid eligibility is based on income figured as a percentage of the Federal Poverty Level. In Wyoming, all children under age 5 are Medicaid qualified at 133% FPL. Those from 6-19 may draw benefits at 100%.
Pregnant women are eligible at 133% FPL, parents at 48%, and non-elderly disabled Social Security beneficiaries at 74%.
Approximately 14 percent of the population of Wyoming draws Medicare coverage, with more than 75,000 accessing prescription drug coverage.