What Are Medicare Advantage Plans in Wyoming?

Medicare Advantage plans are an alternative to Original Medicare, offered by Medicare-approved private insurance companies. These plans include Part A (hospital coverage) and Part B (medical coverage), and most also include Part D (prescription drug coverage). Many plans offer additional benefits like vision, dental, hearing, fitness memberships, and telehealth services.

Medicare Eligibility

To enroll in a Medicare Advantage plan, you must first enroll in Original Medicare (Parts A and B). Most people become eligible for Medicare enrollment at age 65, though some may qualify earlier due to disability, ALS, or ESRD. Key enrollment periods include:

• Initial Enrollment
• General Enrollment
• Special Enrollment

Late enrollment may result in penalties or gaps in coverage.

What Types of Medicare Advantage Plans Are Available in Wyoming?

Wyoming offers a limited selection of MA plans:

• Health Maintenance Organizations (HMOs): Not currently available in Wyoming.
• Preferred Provider Organizations (PPOs): Not available in Wyoming.
• Private Fee-for-Service (PFFS) Plans: Available in six counties through UnitedHealthcare. These plans allow you to visit any Medicare-approved provider who accepts the plan’s terms.
• Special Needs Plans (SNPs): Not offered in Wyoming.
• Dual Eligible Special Needs Plans (D-SNPs): Not available in Wyoming.
• Medical Savings Accounts (MSAs): Offered statewide by Lasso Healthcare. These plans combine a high-deductible health plan with a medical savings account that the insurer funds for use toward qualified expenses.

What Are Your Prescription Drug Options with Medicare Advantage?

Most MA plans in Wyoming do not automatically include Part D drug coverage. Only one PFFS plan offers integrated drug coverage. If you choose an MSA or a PFFS plan without drug benefits, you may:

• Enroll in a separate standalone Part D plan
• Be subject to a late enrollment penalty if you delay and lack creditable coverage

How Do You Choose a Medicare Advantage Plan?

Understanding Medicare Advantage costs is essential when choosing a plan:

• Premiums:
  • MSA plans: $0 premium (excluding Part B premium)
  • PFFS plans: $40–$64 per month
• Deductibles, Coinsurance & Copays:
  • MSAs have high deductibles ($5,000–$8,000), partially offset by a deposit from the insurer ($2,000–$3,000).
  • PFFS plans may include fixed copays and coinsurance.
• Out-of-Pocket Maximums:
  • Capped to limit your annual medical expenses.
• Extra Benefits:
  • PFFS plans may include vision, hearing, telehealth, and even emergency coverage while traveling abroad.

When and How Do You Enroll in a Medicare Advantage Plan?

You can enroll in Medicare during these specific enrollment periods:

• Initial Enrollment: 3 months before through 3 months after your 65th birthday
• Annual Open Enrollment (Oct 15–Dec 7): Join, switch, or drop MA plans
• General Enrollment (Jan 1–Mar 31): For first-time Part B enrollees
• Medicare Advantage Open Enrollment (Jan 1–Mar 31): Switch or drop MA plans if already enrolled
• Special Enrollment Periods: For major life changes such as:
  • Moving out of your plan’s area
  • Losing Medicaid or employer coverage
  • Plan termination or eligibility for group coverage

What If You Want to Change Your Medicare Advantage Plan?

You can switch or disenroll from your MA plan during:

• Open Enrollment (Oct 15–Dec 7)
• Medicare Advantage Open Enrollment (Jan 1–Mar 31)

Understanding Medicare Advantage Star Ratings

The CMS star ratings system is how the Centers for Medicare & Medicaid Services (CMS) rates Medicare Advantage (MA) plans using a 5-star quality scale. These ratings help consumers compare the performance of different plans based on a standardized set of measures.

CMS Star Ratings Overview

• 1 star: Poor performance
• 2 stars: Below average
• 3 stars: Average
• 4 stars: Above average
• 5 stars: Excellent

These ratings are updated annually and reflect data collected from Medicare Advantage (Part C) and Medicare Advantage Prescription Drug Plans (Part D).

What Are Medicare Resources in Wyoming?

Wyoming provides several programs and contacts for Medicare assistance:

• Wyoming SHIP Program: Offers free Medicare counseling to help with plan selection and understanding coverage options.
• Wyoming SMP Program: Helps beneficiaries avoid Medicare fraud and abuse.
• Wyoming Department of Insurance: Handles Medicare-related complaints and helps with coverage disputes.
• For low-income residents, Wyoming Medicaid may offer assistance. Visit Wyoming Medicaid or call 1-855-294-2127. Learn more about the differences between Medicare and Medicaid.

Other Medicare Plan Options to Help with Out-of-Pocket Costs

Medicare Supplement Plans, also called Medigap, help cover out-of-pocket costs from Original Medicare, including deductibles, copays, and coinsurance.

• You must be enrolled in Medicare Parts A and B to buy a plan.
• The best time to enroll is during your six-month Medigap Open Enrollment Period.
• Medigap doesn’t include drug coverage—you’ll need a separate Part D plan.
• There are 10 standardized plans. Medicare Supplement Plan G is the most popular in recent years.
• Plan F is not available to new Medicare enrollees after 2020.
• Medigap offers predictable costs and nationwide provider access.

Learn more about Medicare Supplement plans in Wyoming.

Next Steps

If you’re considering a Medicare Advantage plan in Wyoming, compare available MSAs and PFFS options. Be sure to assess premiums, deductibles, drug coverage, and network acceptance. Choose the best fit and enroll during the proper period.