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Current Policy Effective Date: September 1, 2019
Date Last Reviewed: August 26, 2019
Previous Policy: September 1, 2018
POL M401: APPLYING FOR BENEFITS
1. Applicants Must Complete An Application
Below is the Medicaid Application:
Health Coverage Application , use for all Medicaid programs.
Health Coverage Application, (Spanish version) , use for all Medicaid programs.
2. Medicare Part D Low-Income Subsidy (LIS) Data Exchange
The Medicare Part D, Low-Income (LIS) Data Exchange is transmitted to the states from the Social Security Administration. The Medicaid Eligibility Unit will distribute necessary information on a spreadsheet referred to as the MIPPA file to the Wyoming Department of Health Customer Service Center to process as an application for the Medicare Savings Programs.
3. Methods To Obtain A Paper Application
Applicants may pick up an application at any Department of Family Services field office; print one from the Wyoming Department of Health web site or contact the Wyoming Department of Health (WDH) Customer Service Center at 855-294-2127 to request one be mailed or faxed.
Paper applications can be mailed or delivered to:
WDH Customer Service Center
3001 E Pershing Blvd., Suite 125
Cheyenne, WY 82001
WDH Long Term Care unit
122 W 25th St, West 4th Floor
Cheyenne, WY 82002
Faxed to:
The WDH Customer Service Center at 855-329-5205 The WDH Long Term Care Unit at 307-777-8399
Emailed to:
wesapplications@wyo.gov
4. Other Ways To Apply
Individuals can apply:
Over the phone through the WDH Customer Service Center at 855-294-2127 Over the phone through the WDH Long Term Care Unit at 855-203-2936, when applying for Long Term Care Services Online at www.wesystem.wyo.gov
5. Not Required To Complete Application
The following applicants are not required to complete an application:
Applicant takes the appropriate action within 60 days from denial and 90 days from closure. Individuals eligible for Supplemental Security Income (SSI). Newborns of a Medicaid eligible mother.