Wyoming Medicaid

Use our Online Web Portal to easily apply for or renew Medicaid or Kid Care Chip!

Eligibility Guidelines

Paper Application

Call 1 (855) 294-2127 to Apply or Renew

Pharmacy Claims Outage Issue

For Clients

The pharmacy claims processing system was brought back up on March 14. Your pharmacy should be able to process and fill your prescriptions as usual. No client should have to pay a copay for any prescription through June 30. If your pharmacy is having difficulty filling your prescription or is asking you to pay out-of-pocket, please call Wyoming Medicaid at 307-777-7531.

Change Healthcare Outage

For Providers

Wyoming Medicaid’s pharmacy claims and prior authorization vendor experienced a nationwide outage. You can learn more about our department’s response from our Pharmacy Services program.

Medicaid Renewals Continue

You may receive text messages and mail from the Wyoming Department of Health if it is time to renew Medicaid or Kid Care CHIP for yourself or for a family member:

• Do not ignore these important messages and forms!
• If you received a text message from WDH asking you to renew, please watch your mail for a Medicaid renewal form. This form must be completed, signed and returned. You can return renewals by completing online at https://www.wesystem.wyo.gov, mailing or dropping off using the address on the renewal notice, faxing it to 1-855-329-5205, emailing it to wesapplications@wyo.gov or calling to complete your renewal over the phone using the number on the notice.
• To prevent your case from closing for not completing your renewal, please don’t delay.

Information

Information

To apply for Medicaid/Kid Care CHIP or for Medicaid/Kid Care CHIP application status, please call 1-855-294-2127, or 1-855-329-5204 TTY/TDD.

WYhealth – This link directs you to Wyoming Medicaid’s Care Management program and includes helpful information for members, families, stakeholders, and providers.

Prior Authorization & Utilization Management – This link directs you to Utilization Management activities for Wyoming Medicaid. Helpful information for providers and stakeholders.

Eligibility – This link directs you to information on who may be eligible for Medicaid and how to apply.

Medicaid Provider/Client Portal – This link directs you to the Medicaid provider and client portal. Providers can check status of claims, benefits and services. Clients may check eligibility or benefits and request a replacement Medicaid ID card or transportation assistance.

Well Child Checkups! – This link directs you to our Well Child Checkup page with information on the importance of preventive screening for children and what to expect.

Home Care Services – This link directs you to a Medicaid program that provides nursing or therapy services to persons in their homes under a physician’s plan of care.

Partnership Access Line (PAL) – Resources for clinicians providing care to our children clients with developmental disabilities. Please click here for information about free consultation with a child/adolescent psychiatrist on any patient, and a valuable link to Resources for Wyoming providers in the Primary Care Principles for Child Mental Health.

Healthcare Provider

Healthcare Provider

• Enroll as a Wyoming Medicaid Provider
• Provider FAQ
• Accessing the IVR System
• Medicaid providers can use this email address to submit comments, concerns, complaints and compliments: HCFProviders@wyo.gov
• Submit a Psychiatric Rehabilitation Treatment Facility (PRTF) incident report – If you are a PRTF and need to report an incident.
• Pulse of CMS

Public Notices and Important Updates

The Wyoming Department of Health (WDH) provides public notice of a proposal meant to save state and federal dollars while also preventing or delaying nursing home stays for certain older Wyoming residents via an 1115 Waiver.

More information about the state’s proposal can be found at https://ltcexpansion.wyo.gov/.

• Applied Behavioral Analysis (ABA) Services Public and Tribal Notice – Posted 4/29/2024
• Medicaid Waiver Renewals for the Care Management Entity 1915(b) & (c) Waivers Public and Tribal Notice – Posted 4/2/2024
• Pregnant by Choice Public and Tribal Notice – Posted 2/2/2024
• Pregnant by Choice Public and Tribal Notice – Proposed Eligibility Change – Posted 3/31/2023
• Pregnant by Choice Public and Tribal Notice – Posted 2/1/2023
• SFY22_Magellan Statement of Work_Amendment One
• SFY22_Magellan Contract _Amendment _One
• Public Notice – Pregnant by Choice Public Feedback – posted 1/31/2022
• Required notice per 42 CFR§ 438.332(c) – Posted 11/21/21
• Public Notice – 1915(c) Children’s Mental Health Waiver
• Public Notice – Pregnant by Choice Public Feedback & Notice of Updated Public Forum Teleconference Info – posted 3/8/2021
• CME Facts & Figures – posted 02/03/2021
• Appendix B. EQR Protocol 1 Review Tool
• Appendix D. Operational Requirements Review Tool
• Appendix E. Outcome Measures Review Tool
• Appendix H. Network Adequacy Review Tool
• Care Management Entity Program
  SFY 2019 External Quality Review
  Technical Report
• WY CME Quality Review Strategy Draft-posted 10/5/20 – Draft QRS

Wyoming Provider Exclusion List – please contact 777-7531 or WDH-EXCLUSIONLIST@wyo.gov

Publications

Medicaid Publications

• 2024 Child Medicaid CAHPS Summary Report
• SFY 2023 Annual Report
• SFY2023 Benchmarking Report
  • Appendices A-K
    • Appendix A: Methodology and Data Sources
    • Appendix B.1: Comparison of Wyoming Medicaid Rates to Benchmarks, by Service Area
    • Appendix B.2: Total SFY 2023 Medicaid Expenditures for Top Procedures Used in Analysis, By Service Area
    • Appendix C: Hospital Cost Benchmarks
    • Appendix D: Medicare Reimbursement Methodology
    • Appendix E: Summary of Health Care Inflation Indices
    • Appendix F: Wyoming Medicaid Rate History
    • Appendix G: Glossary
    • Appendix H: Acronyms
    • Appendix I: Reimbursement Trends
    • Appendix J: Upper Payment Limit
    • Appendix K: Value Based Purchasing