- Member FAQs
Q: How do I apply for Medicaid Benefits? How do I know if I qualify for Medicaid?
A: To apply for benefits and/or to determine if you qualify, you can either contact the Customer Service Center (CSC) at 1-855-294-2127 and select the “benefit or eligibility” option, or you can apply online at www.wesystem.wyo.gov/.
Q: I need to change my address, income information, and/or end Medicaid benefits. How can I do this?
A: For all changes to your Medicaid benefits/demographics, you will need to contact the Customer Service Center (CSC) at 1-855-294-2127 and select the “benefit or eligibility” option.
Q: What are my Wyoming Medicaid benefits?
A: There are many Wyoming Medicaid benefit plans which are all different. To find out about your benefits, you may visit the Medicaid website at www.wyomingmedicaid.com/ to review the Wyoming Medicaid Handbook.
You may also register and login to the secure Member Portal, called myHealthPortal, for benefit plan information, or you may contact your physician, dentist, or other provider to determine if a specific procedure is covered under your specific benefit plan.
Note: Member Services cannot determine if a specific service or procedure will be covered.
Q: What happens when I go to a doctor that is not in Wyoming? Am I covered?
A: If the doctor is enrolled, and in an active enrollment status with Wyoming Medicaid, and the services being provided are covered by Wyoming Medicaid, then the services will be covered. This policy is not limited to doctors, but applies to all types of providers including hospitals, ambulances, dentists, and more.
Q: My doctor does not take Wyoming Medicaid. Do I have to change doctors?
A: Wyoming Medicaid is not able to pay a provider (doctor, dentist, hospital, clinic, etc.), if they are not enrolled with Wyoming Medicaid. You may ask your provider to enroll with Wyoming Medicaid. If the provider does not enroll and you continue to go to him/her, you will be responsible for the medical bills.
Q: I am getting billed. What do I do?
A: First, you must contact the provider (doctor, dentist, hospital, clinic, etc.) who is billing you and make sure they have your correct Wyoming Medicaid Member ID number. Find out why the doctor is billing you, write down the person you are speaking to, the date, and the dates of service.
If they tell you the medical claims that they are billing are denying, and they have your Member ID number correct, please have the provider call Provider Services at (888) WYO-MCAD, for billing assistance. Also, you should contact the Customer Service Center (CSC) at 1-855-294-2127 and select “you received a bill from a provider” option to be transferred to Member Services.
Q: Wyoming Medicaid has changed my eligibility date. It now covers past months and I have medical bills. Do I still have to pay these bills?
A: You must contact your providers (doctor, dentist, hospital, clinic, etc.) and notify them that your Wyoming Medicaid eligibility dates have changed. It is up to the provider if they choose to bill Wyoming Medicaid for these claims or not. If the provider chooses not to bill Wyoming Medicaid for your services, you will be responsible for the services.
Q: Who can receive information regarding my Wyoming Medicaid benefits or payment of claims?
A: Member Services can only give information to you (the member) or a legal guardian of the member. Member Services follows strict verification rules to ensure that Protected Health Information (PHI) is not provided to persons not authorized on the case established by the Customer Service Center (CSC).
Q: How do I request travel reimbursement for my medical appointments?
A: There are two options to request reimbursement for Medicaid travel. You may request reimbursement through the secure Member Portal, called myHealthPortal. After you have registered and logged into the portal, choose the “Travel Request” option. The second option is to call Member Services at 855-294-2127.
Note: If you are requesting Airline/Bus travel, Emergency Funds, or Taxi/Shuttle requests, you must call Member Services.
Q: How long will it take before I receive reimbursement for travel?
A: Once your W9 has been processed, it may take up to 30 days to receive reimbursement for Medicaid travel. If you have not previously filled out a W9, or if you need to update your address and receive reimbursement by paper check, it may take longer than 30 days.
Q: Can I get a ride to the pharmacy or grocery store?
A: No, you may not receive reimbursement for receiving a ride to the pharmacy to pick up prescriptions or to the grocery store. Reimbursement is based on medical necessity and is to only be used for medical transport (i.e., medical, dental, vision, physical therapy).
Q: My pharmacy hasn’t received my prescription who can assist me?
A: To follow up on the status of your prescription, you must contact the provider. The provider will know the status and can contact the pharmacy if necessary. The provider will know if a prescription requires a Prior Authorization (PA), will know the status of an authorization, and will also contact the pharmacy, if necessary, on a PA.