- Wyoming laws affect who is eligible for different kinds of health insurance in the state.smiling doctor with paaper image by Pavel Losevsky from Fotolia.com
In Wyoming, as in other states, health insurance is regulated by both federal and state laws. State laws often build on the federal framework to provide additional protections, though the laws can vary significantly from state to state. Residents of Wyoming should pay particular attention to the state laws that regulate their health insurance options. - Federal law governs most aspects of group health insurance, including eligibility requirements, limits on exclusion for preexisting conditions, and the provision that an eligible member of a group cannot be denied coverage or charged more because of health status. However, some specific provisions fall under Wyoming law.
In Wyoming, newborns, adopted children and children placed for adoption are automatically covered under the parents’ health plan for the first 31 days, if the plan covers dependents. Wyoming law also allows a disabled child to be covered by a parent's health plan into adulthood if the child was disabled before the age at which dependent coverage ends for children. - Small employers--in general, those who employ two to 50 employees--may choose to offer group health insurance to their employees. Federal law for small group health plans stipulates that most small groups cannot be turned down for insurance and that insurance cannot be canceled because someone in the group gets sick.
Wyoming law offers some additional protections. Wyoming law limits how much premiums can vary because of the health status of the members of the group or because of the kind of work done by the company. There also are limits regarding how much an insurance company can raise premiums based on a small group's claim history when renewing the plan. - If you leave a job where you had health insurance through a group health plan, you may be eligible to keep that coverage for a period of time through a federal law called the Consolidated Omnibus Budget Reconciliation Act (COBRA). COBRA applies if you worked for a company with 20 or more employees.
Wyoming has a law similar to COBRA that allows people who worked for a company with fewer than 20 employees to keep their coverage for up to 12 months if that employer offers a group health plan. Wyoming law also requires the insurance company that provided the group plan to offer you the option to convert your group policy to an individual health insurance policy. This policy may not have the same level of coverage as your prior policy, and the insurer is likely to charge you more than you were paying for your group plan. - Wyoming law allows insurance companies that sell individual health policies in the state to deny coverage based on an applicant's health history or to offer a policy that has coverage restrictions. The policy also is allowed to feature an elimination rider, which permanently excludes coverage for a health condition or a body system associated with a health condition. The policy also may include a temporary exclusion period for a preexisting condition.
In Wyoming, a condition can be preexisting only if you received (or a doctor recommended you receive) a diagnosis, treatment or medical advice within the six months before the policy began. One year is the maximum amount of time coverage for a preexisting condition can be excluded, according to Wyoming law.
The law also requires an insurance carrier that offers a policy with a preexisting condition exclusion period to give credit for your previous insurance coverage if you have had continuous coverage with no more than a 90-day lapse.
Wyoming law stipulates than an insurance company cannot cancel your coverage because you get sick, but it does not prohibit insurance companies from raising the rate of your premium based on your health status. - The Wyoming Health Insurance Pool (WHIP) provides health insurance to people who cannot buy health insurance from private companies because they have preexisting health conditions. You are eligible for WHIP if an insurance company turned you down for an individual health insurance policy because of your health status. You also may be eligible if an insurance company offered you a policy with heavy restrictions or exclusions or if an insurance company offered you a policy that is more expensive than WHIP coverage (see Resources).
- Medicaid is a program the provides health insurance to low-income people who cannot afford to buy insurance. Medicaid is funded by both federal and state governments, but the states administer the program, and state law governs who is eligible and the services offered. Wyoming Medicaid, called EqualityCare, covers families with children, pregnant women, people with disabilities, and the elderly who meet the income requirements established by state law. You may be eligible even if you work as long as you meet the income standards (see Resources).
- Wyoming law requires that Kid Care covers eligible children even if they have a preexisting health condition.child image by saied shahinkiya from Fotolia.com
The Wyoming Kid Care (CHIP) Program provides health insurance to low-income children 18 years old or younger who are not eligible for Medicaid and who have no health insurance. The program provides comprehensive health coverage to eligible children, including doctor visits, hospital stays, prescriptions, mental health care, dentists, and vision and hearing services. A child is eligible for the program according to Wyoming law if her family has a household income up to 200 percent of the federal poverty level. For 2010, for a family of three, 200 percent of the poverty level was an annual income of up to $34,200 or gross monthly income of $2,767 (see Resources).
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