Assisted living facilities primarily help residents with non-medical needs. Although minor and infrequent medical services, such as first-aid for a wound, can sometimes be met on-site by nurses. These communities may sometimes also be called ALFs, residential care facilities, retirement homes, or long-term care facilities.
The financial options available to help pay for senior care is dependent on, among other things, the type of care that is required. If you are just beginning the research process on how to pay for long-term care, it is helpful to have an idea about the type of care you or your loved one currently requires, as well as to anticipate future needs. In addition, it is important to be familiar with the associated eldercare terminology.
Can using home care technology help your family save money caring for an aging loved one? The answer is most certainly “Yes”. Our goal is not to provide a comprehensive list, but rather to make sense of those that are available on the market today and can reduce the care hours required by elderly persons. As such, they can reduce a family’s out-of-pocket care costs or reduce the hours they spend providing care themselves.
Medicare Advantage (Part C), a privately offered alternative to Original Medicare (Parts A and B), has grown in popularity over the years. Despite the growing popularity of Medicare Advantage, some seniors face obstacles that prevent them from truly understanding how it works and who it benefits. Common mistakes about Medicare Advantage include misunderstanding its differences from Original Medicare, getting it confused with other forms of private Medicare insurance (like Medigap or Part D), or not understanding how to look up or evaluate plans.
Medicare Advantage or Medicare Part C is a private health insurance option that combines the benefits of Medicare Parts A and B, also known as Original Medicare. Many Medicare Advantage plans provide coverage for additional benefits such as vision, dental, prescription drug coverage, transportation to medical appointments and senior wellness programs. About 42% of all Medicare beneficiaries were enrolled in a Medicare Advantage plan nationwide in 2021, and experts project this to increase to 51% by 2030.
Medicare Advantage providers must follow the rules established by the Centers for Medicare & Medicaid services and must provide the same level of care as Original Medicare. Aside from these stipulations, Medicare Advantage providers are free to set their own policies regarding eligibility, out-of-pocket costs and whether enrollees must choose a primary physician and obtain referrals for specialty services.
Medicare beneficiaries make up 19% of Wyoming’s total population. In 2020, Wyoming had 112,742 people enrolled in Original Medicare, and 3,526 enrolled in Medicare Advantage plans. In 2021, Medicare Advantage plan enrollees represented 3.7% of Wyoming’s total Medicare beneficiaries, far below the national average of 42%. Wyoming has one of the lowest rates of Medicare Advantage enrollees in the country, second only to Alaska. This low penetration rate is since Medicare Advantage plans were unavailable in most of Wyoming before 2019.
Now that Medicare Advantage plans are available statewide, beneficiaries in Wyoming can choose between a variety of plan options. This guide will cover information about the top Medicare Advantage plans in Wyoming, along with information residents can use to determine eligibility, compare coverage options and enroll in a plan.
The Top 3 Medicare Advantage Plans in Wyoming
While Medicare Advantage remains significantly less popular than Original Medicare in Wyoming, several insurance companies offer plan options for eligible beneficiaries looking to expand their coverage beyond Medicare Parts A and B. The table below includes the top plan providers in terms of total enrollment numbers, along with their monthly costs. There’s also information about the types of plans offered by each provider. Since most companies provide more than one plan, the table displays costs as a range instead of an overall average price.
All plan information included below is accurate as of April 2022. Medicare.gov has the most up-to-date information about which plans are available throughout Wyoming.
Name
Total Enrollment
Star Rating
Min Cost
Max Cost
Plan Types
UnitedHealthcare
5,940
3.5
$0
$74
PPO, PFFS
Aetna Medicare
1,150
3.5
$49
$65
HMO, PPO
Humana
173
0
$0
$0
PPO
How Medicare Advantage Plans Work in Wyoming
Medicare Advantage plans in Wyoming include four main types: Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), Private Fee-for-Service (PFFS) and Special Needs Plan (SNP). Some plan types restrict eligibility to only certain beneficiaries. For example, special needs plans are only available to people with specific chronic and disabling conditions like diabetes or End-Stage Renal Disease (ESRD).
Plans also differ when it comes to things like requiring referrals for specialty care, in-network versus out-of-network coverage and prescription drug coverage. Seniors can find descriptions of each plan type below.
What Medicare Advantage Plans Cover in Wyoming
Medicare Advantage plans cover the same services as Original Medicare, ranging from hospital stays and lab tests to preventative screenings and durable medical equipment (DME). The only exception is hospice care, which Medicare Part A covers but is not mandatory for Medicare Advantage providers to cover.
Along with all original Medicare Services, Medicare Advantage plans generally include extra coverage for dental, vision, hearing aids and prescription drugs. The exact benefits can differ from plan to plan, so beneficiaries should carefully review plan documents to know exactly what’s covered.
Coverage Available With Medicare Parts A & B?
Coverage Available With Medicare Advantage?
Preventive Screenings
Yes
Yes
Hospital Care
Yes
Yes
Durable Medical Equipment
Yes
Yes
Prescription Drugs
No
Yes**
Vision Care
No
Yes*
Dental Care
No
Yes*
Hearing Aids
No
Yes*
*Select plans offer this coverage
** Most plans offer this coverage
Eligibility for Medicare Advantage in Wyoming
There are a few key factors that determine eligibility for Medicare Advantage in Wyoming. Most importantly, Medicare Advantage eligibility requires Original Medicare enrollment. That means applicants must be older than age 65 or have a qualifying disability for Medicare coverage at a younger age. Applicants must also live within a plan’s service area and be a citizen or lawful immigrant.
Medicare Advantage has limited enrollment periods, and it’s generally not possible to enroll in a plan or change coverage outside of an enrollment period. Certain circumstances and events qualify as Special Enrollment Periods, but these are limited exceptions. To avoid missing their window for obtaining coverage, seniors should take note of the enrollment timing information below.
Initial Coverage Election Period: This is the initial 7-month period, coinciding with one’s 65th birthday, during which everyone is eligible to enroll in a Medicare Advantage plan.
Annual Election Period (AEP): Also referred to as the Open Enrollment Period, this the time of year when anyone over 65 can enroll in Medicare Advantage for the first time or change to a new plan.
Medicare Advantage Open Enrollment Period: During this period, those who are already enrolled in Medicare Advantage can switch to a different plan or switch back to Original Medicare.
Start Date
End Date
Initial Coverage Election Period
3 Months Before One’s 65th Birth Month
3 Months After One’s 65th Birth Month
Annual Election Period (AEP)
October 15th
December 7th
Medicare Advantage Open Enrollment Period
January 1st
March 31st
Additionally, Medicare Advantage plan participants can change their plan outside of these enrollment periods under certain qualifying circumstances, such as moving to a new state.
How to Find & Choose a Medicare Advantage Plan in Wyoming
Navigating the many intricacies of Medicare Advantage plan types, insurers, and the specific plan options available by region can be a difficult and time-consuming task. Below are several resources we’ve created to help you through the process.
First is a downloadable PDF that you can use as a guide to help you compare plans as you research. Finally, we have listed a number of organizations that you can contact with experts that will help you determine whether Medicare Advantage is right for you and what plans you should consider.
Wyoming State Health Insurance Information Program (WSHIIP)
This federally mandated and state-run program is specifically focused on helping seniors (and other Medicare recipients) understand the ins and outs of Medicare coverage, to understand what they’re entitled to, and to answer their questions. WSHIIP maintains a team of dozens of volunteer counselors statewide to advise beneficiaries and help solve problems free of charge. These volunteers are required to attend annual training to ensure their knowledge and counsel is up to date.
To get further information, and to get in touch with the program’s volunteers, WSHIIP can be reached on a toll-free line at (800) 856-4398. Further information and a directory of WSHIIP representatives can be found at the program’s website.
Senior Medicare Patrols are funded by federal grants toward the objective of empowering senior Medicare beneficiaries, providing outreach and education to help people report complaints about abuse, fraud or substandard care. They present to groups and exhibit at events in the community and also work one-on-one with Medicare beneficiaries. Much like their cousin program WSHIIP, SMPs are a volunteer-powered initiative.
The Wyoming Insurance Department is tasked with the impartial enforcement of the state’s insurance regulations and laws, with maintaining a healthy marketplace and with the promotion of needed change. It hosts a number of resources for those seeking information about Medicare and Medicare Advantage, including downloads of informative handbooks that provide initial guidance for those researching plans and trying to work out what the different kinds of Medicare plans provide. The department also provides information on Medicaid, Medicare Supplement Plans and long-term insurance.
The Wyoming Department of Insurance maintains an online contact portal at its website. It also maintains a staff directory at the same location and can be reached by phone for general inquiries at (307) 777-7401.
The American Association of Retired Persons (AARP) has been America’s most influential advocacy organization for seniors for over six decades. It supports a wide range of programs focused on helping Americans age with choice and dignity and played a prominent role in the formation of Medicare, for which the organization hosts a detailed online resource center. State branches such as AARP Wyoming are active in disseminating information, staging events and seminars, and providing education and webinars about how to interact with programs such as Medicare and Medicare Advantage.
A judicial branch organization affiliated with the Wyoming Supreme Court, Equal Justice Wyoming is dedicated to providing statewide assistance to low-income citizens in accessing legal counsel and civil justice. It provides free legal aid for individuals meeting certain qualifications, as well as Self-Help research and preparation facilities accessible to anyone. Among the many areas of the legal system for which it provides guidance and assistance is health care, including legal aid when navigating the health insurance marketplace.
Equal Justice Wyoming can be contacted by phone, toll-free, at 877-432-9955. Help in engaging with the office’s website can be accessed through its online contact portal.
Based out of the University of Wyoming, WIND is a unit in the College of Health Sciences that works to provide community services, individual and family supports, education, training and early intervention for people with disabilities, in particular developmental disabilities. Among the many programs and services that WIND provides is a TeleHealth network (WyTN). This is of potential interest to senior recipients of Medicare as it connects providers with the public and has informative webinars, education and training and informative documents at its resource center, many of them directly touching on Medicare and Medicare Advantage.
WIND can be reached at a toll-free line at (888) 989-9463or on its direct local line at (307) 766-2761.The program can also be reached by e-mail at [email protected].
