"Waiver" programs part of Wyoming Medicaid renewals

The Wyoming Department of Health (WDH) reminds participants, family members, providers and case managers the state’s efforts serving vulnerable groups through “waiver” programs are part of Wyoming Medicaid, which recently restarted its annual renewal process.

Medicaid is a joint federal/state insurance program that pays for the medical and long-term care of low-income and medically needy individuals and families. Wyoming Medicaid offers three waiver programs with rules and practices that differ from traditional Medicaid:

Community Choices Waiver– serves individuals aged 65 and older, or individuals aged 19–64 who have a verified, qualifying disability.

Supports Waiver – provides supportive services to eligible individuals of all ages who have an intellectual or developmental disability, or an acquired brain injury.

Comprehensive Waiver – provides comprehensive services to eligible individuals of all ages who have an intellectual or developmental disability, or an acquired brain injury. Individuals must meet emergency and eligibility criteria, to receive services.

“Because our waivers serve distinct groups of people and do not operate in the same way as traditional Medicaid, we believe many people do not recognize they are actually part of our state’s Medicaid program,” says Elizabeth Forslund, administrator of the Home and Community-Based Services Section with WDH.

“With Wyoming’s renewal process underway, we are concerned some people may not recognize that waiver program participants are included in the renewal requirements. Some people may no longer be eligible, but we do not want those who are to lose their Medicaid coverage because their forms weren’t completed on time.”

In the pandemic’s early stages, the federal government stopped states from reviewing Medicaid eligibility in exchange for temporarily increased federal funding. A change in federal law now requires states to return to renewal plans after a pause of roughly three years.

“It appears some waiver participants who have so far been sent renewal packets have not returned the needed forms and information. This can result in those individuals losing their Medicaid coverage and potentially their waiver services,” Forslund said.

Forslund noted family members, providers and case managers play key roles with many vulnerable waiver participants because these individuals may be unable to manage the renewal process for themselves.

Not all clients will receive their renewal notices at the same time.

The department recommends participants check whether Wyoming Medicaid has their current contact information so they do not miss the renewal notice. For those who have received packets, it is critical for forms to be completed as required to avoid loss of Medicaid coverage.

Wyoming Medicaid enrollees can update their contact information or go through the renewal process online at www.wesystem.wyo.gov or by calling 1-855-294-2127.

A low income does not automatically qualify people for Wyoming Medicaid. While most people on Medicaid are indeed low-income, people must also fall into certain categories based on age or health status.

Waivers are designed for eligible participants who prefer to get long-term care services and supports in their home or community, rather than in an institutional setting. More information about Wyoming’s waiver programs can be found at https://health.wyo.gov/healthcarefin/hcbs/.