Wyoming Medicaid Definition
Medicaid in Wyoming is administered by the Wyoming Department of Health.
Medicaid is a wide-ranging health insurance program for low-income individuals of all ages. Jointly funded by the state and federal government, it provides health coverage for various groups of Wyoming residents, including pregnant women, parents and caretaker relatives, adults with no dependent children, employed and unemployed individuals with disabilities, and seniors. However, the focus of this webpage is strictly on Medicaid eligibility for Wyoming elders, aged 65 and over, and specifically for long term care, whether that be at home, in a nursing home, or in an assisted living facility. Specifically, long term care is covered. In addition to nursing home care and assisted living services, Wyoming Medicaid pays for many non-medical support services that help frail seniors remain living in their homes.
Income & Asset Limits for Eligibility
There are several different Medicaid long-term care programs for which Wyoming seniors may be eligible. These programs have varying financial and medical (functional) eligibility requirements, as well as benefits. Further complicating eligibility is that the requirements vary with marital status and that Wyoming offers several pathways towards Medicaid eligibility.
1) Institutional / Nursing Home Medicaid – This is an entitlement program; Anyone who meets the requirements will receive assistance. Benefits are provided only in nursing home facilities.
2) Medicaid Waivers / Home and Community Based Services (HCBS) – This is not an entitlement program; There are a limited number of participant slots and wait lists may exist. Intended to delay the need for nursing home care, benefits are provided at home, adult day care, or in assisted living. More about Waivers.
3) Regular Medicaid / Aged, Blind, and Disabled – This is an entitlement program; All eligible applicants are able to receive services. Various long-term care benefits, such as personal care assistance or adult day care, may be available.
The table below provides a quick reference to allow seniors to determine if they might be immediately eligible for long term care from a Wyoming Medicaid program. Alternatively, one can take the Medicaid Eligibility Test. IMPORTANT: Not meeting all the criteria does not mean one is ineligible or cannot become eligible for WY Medicaid. More.
|2022 Wyoming Medicaid Long Term Care Eligibility for Seniors|
|Type of Medicaid||Single||Married (both spouses applying)||Married (one spouse applying)|
|Income Limit||Asset Limit||Level of Care Required||Income Limit||Asset Limit||Level of Care Required||Income Limit||Asset Limit||Level of Care Required|
|Institutional / Nursing Home Medicaid||$2,523 / month*||$2,000||Nursing Home||$5,046 / month ($2,523 / month per spouse)*||$3,000||Nursing Home||$2,523 / month for applicant*||$2,000 for applicant & $137,400 for non-applicant||Nursing Home|
|Medicaid Waivers / Home and Community Based Services||$2,523 / month||$2,000||Nursing Home||$5,046 / month ($2,523 / month per spouse)||$3,000||Nursing Home||$2,523 / month for applicant||$2,000 for applicant & $137,400 for non-applicant||Nursing Home|
|Regular Medicaid / Aged Blind and Disabled||$841 / month||$2,000||Help with ADLs||$1,261 / month||$3,000||Help with ADLs||$1,261 / month||$3,000||Help with ADLs|
What Defines “Income”
Any income that a Medicaid applicant receives is counted. To clarify, this income can come from any source. Examples include employment wages, alimony payments, Veteran’s benefits, pension payments, Social Security Disability Income, Social Security Income, Supplemental Security Income, IRA withdrawals, and stock dividends. Holocaust restitution payments and Covid-19 stimulus checks are not considered income and do not impact Medicaid eligibility.
When only one spouse of a married couple applies for nursing home Medicaid or a Medicaid Waiver, only the income of the applicant is counted. This means the income of the non-applicant spouse is disregarded and does not impact the applicant spouse’s eligibility. The non-applicant spouse, however, may be entitled to a Minimum Monthly Maintenance Needs Allowance (MMMNA) from the applicant spouse to prevent spousal impoverishment. In 2022, the MMMNA in WY is $3,435 / month. If a non-applicant spouse has monthly income under this amount, income can be transferred from the applicant spouse to the non-applicant spouse to bring their monthly income up to this level. A non-applicant spouse who has $3,435 / month or more in income is not entitled to a MMMNA / spousal income allowance.
Income is counted differently when only one spouse applies for Regular Medicaid; The income of both the applicant spouse and non-applicant spouse is calculated towards the applicant’s income eligibility. Learn more about how Medicaid counts income.
What Defines “Assets”
Countable assets, also called resources, include cash, stocks, bonds, investments, promissory notes, certificates of deposit, credit union, savings, checking accounts, and real estate in which one does not reside. There are also many assets that are not counted towards Medicaid’s asset limit. These exempt assets include personal belongings, such as clothing and wedding rings, household furnishings and appliances, an automobile, a burial plot, burial funds (up to $1,500), life insurance policies (up to $1,500 in cash surrender value) and generally one’s primary home. For home exemption, the Medicaid applicant must live in the home or have intent to return, and their home equity interest must be under $636,000 (in 2022). Equity interest is the amount of the home’s value, minus any outstanding home debt, that is owned by the applicant. The home is also exempt, regardless of any other factors, if a non-applicant spouse resides there.
The assets of a married couple are considered to be jointly owned regardless of the long-term care Medicaid program for which one is applying. However, the non-applicant spouse of a nursing home Medicaid or Medicaid Waiver applicant is permitted a Community Spouse Resource Allowance (CSRA). In 2022, this spousal impoverishment rule allows the community spouse (the non-applicant spouse) to keep up to $137,400 of the couple’s assets, as the chart shows above.
Wyoming has a 60 month (5 year) Medicaid Look-Back Period that immediately precedes the date of one’s Medicaid application. During this period, the Medicaid agency checks all past asset transfers to ensure none were gifted or sold for less than fair market value. This includes transfers one’s non-applicant spouse has made. If one has violated the “look back”, it is assumed it was done to meet Medicaid’s asset limit and they will be penalized with a period of Medicaid ineligibility.
Qualifying When Over the Limits
For elderly Wyoming residents (aged 65 and over) who do not meet the eligibility requirements in the table above, there are other ways to qualify for Medicaid.
1) Qualified Income Trusts (QIT’s) – Also called Miller Trusts, and specifically Irrevocable Income Trusts in Wyoming, these special trusts offer a way for individuals over the Medicaid income limit to still qualify for nursing home Medicaid or a Medicaid Waiver. Money deposited into a QIT does not count towards Medicaid’s income limit. In simple terms, one’s excess income (over the Medicaid income limit) is directly deposited into the irrevocable trust, in which a trustee is named, giving that individual legal control of the money. Irrevocable means the terms of the trust cannot be changed or canceled. The trust funds can only be used for very specific purposes, such as paying long term care services / medical expenses accrued by the Medicaid enrollee. The state of Wyoming must be listed as the remainder beneficiary.
2) Asset Spend Down – Persons who have assets over Medicaid’s limit can “spend down” assets and become asset eligible. This can be done by spending “excess” assets on non-countable ones. Examples include home modifications and additions (wheelchair ramps, roll-in showers, stair lifts, and adding first floor bedrooms), home improvements (replacing faulty electrical wiring, updating plumbing, and replacing old water heaters), vehicle modifications (wheelchair lifts, adaptive control devices, and floor modifications to allow one to drive from a wheelchair), prepaying funeral and burial expenses, and paying off debt. One must be cautious when “spending down” asset to avoid violating Medicaid’s look back rule. It is recommended one keep documentation of how assets were spent as proof this rule was not violated.
3) Medicaid Planning – The majority of persons considering Medicaid are “over-income” or “over-asset” or both, but still cannot afford their cost of care. For these persons, Medicaid planning exists. By working with a Medicaid planning professional, families can employ a variety of strategies to help them become Medicaid eligible as well as to protect their home from Medicaid estate recovery. Read more or connect with a Medicaid planner.
Specific Wyoming Medicaid Programs
Community Choices Waiver (CCW) – This HCBS Medicaid Waiver provides assistance for those who require a nursing home level of care, but choose to remain living at home, the home of a family member, or in an assisted living facility. Benefits include adult day care, meal delivery, personal emergency response systems, respite care, skilled nursing, and non-medical transportation. Personal care attendants are also an available benefit, and via the In-Home Participant Directed Option, program participants are able to hire the caregiver of their choosing, including select relatives.
How to Apply for Wyoming Medicaid
Seniors can apply for Medicaid benefits online at WES (Wyoming Eligibility System), by filling out and submitting the paper application, “Application for Health Coverage & Help Paying Costs”, or apply via phone by calling the Customer Service Center at 1-855-294-2127. One’s local Area Agency on Aging office might be helpful in answering questions or providing application assistance. Once an application is submitted, it may take as long as 45 days for Medicaid to determine if one is eligible.
When submitting an application for long-term care Medicaid in Wyoming, it is vital that applicants are certain that they meet all eligibility criteria (in detail above). Elderly applicants who have income and / or assets over the limit(s) should consider Medicaid planning for the best chance of acceptance into a Medicaid program. While the application process can be confusing and lengthy, seniors can learn more about the process here.