Medicaid Eligibility in Wyoming: Income Limits & How to Apply
Medicaid Eligibility in Wyoming
As of 2026, Wyoming has opted not to expand Medicaid. EqualityCare / Wyoming Medicaid serves a limited population: children, pregnant women, seniors, people with disabilities, and some very low-income parents. Most childless adults below the poverty line cannot qualify.
Coverage gap in Wyoming: Adults earning below $15,650 per year (100% FPL for an individual) may fall into the coverage gap — too much income for traditional Medicaid but too little to qualify for ACA marketplace subsidies. An estimated hundreds of thousands of Wyoming residents are affected.
Without Medicaid expansion, coverage in Wyoming is generally limited to:
- Children in families with income up to 200-300% FPL (via CHIP)
- Pregnant women with income up to 185-200% FPL
- Parents with very low incomes (often well below 50% FPL)
- Seniors and people with disabilities meeting strict income/asset limits
- Adults in the coverage gap have limited options: community health centers, hospital charity care, and free clinics
About EqualityCare / Wyoming Medicaid
In Wyoming, most adults will not qualify for EqualityCare, the state's Medicaid program, because the state has not expanded its Medicaid eligibility. This means there's a "coverage gap" for many low-income adults. You can qualify for EqualityCare if you are a child (ages 0-5 with household incomes up to 159% of the federal poverty level (FPL), or ages 6-18 with household incomes up to 138% FPL), a pregnant woman (up to 159% FPL), a parent with dependent children (with household income up to about 43% FPL, which is around $873 per month for a family of three as of 2024/early 2025), or if you are aged, blind, or disabled. For example, a single applicant for nursing home Medicaid in 2026 must have an income under $2,982 per month and assets under $2,000. If you are a childless adult with an income below 100% FPL, you will likely fall into this coverage gap and not qualify for either Medicaid or marketplace subsidies.
If your income is close to the Medicaid cutoff, you might transition between EqualityCare and marketplace coverage on HealthCare.gov. It's crucial to report any changes in your income or household size to ensure you receive the correct assistance. If your income is above the Medicaid limits but still relatively low, you may qualify for subsidies on HealthCare.gov to help pay for a marketplace plan. Keep in mind that Wyoming's benchmark Silver plan is around $678 per month, which is higher than the national average. If your income rises above 100% FPL, you become eligible for these marketplace subsidies. During the recent "unwinding" period, many people lost Medicaid coverage, and if you were one of them, you can reapply at any time if your situation has changed or if you believe you were incorrectly denied.
EqualityCare (Wyoming Medicaid) covers essential health services such as visits to healthcare providers, inpatient and outpatient hospital services, lab tests, X-rays, medical transportation, nursing home care, home health services, and family planning. For those who qualify, EqualityCare generally has no cost-sharing. Wyoming has also extended Medicaid coverage for mothers for 12 months postpartum. As of November 2024, approximately 68,773 people were enrolled in Medicaid and CHIP in Wyoming, with children making up the largest group of enrollees.
If you find yourself in the coverage gap, meaning your income is too high for EqualityCare but too low for marketplace subsidies, there are still options for accessing care. Wyoming has an uninsured rate of about 10.5%, higher than the national average of around 8.2%, with approximately 9,000 adults in the coverage gap. Community health centers across Wyoming offer services on a sliding-scale fee structure based on your income and family size, regardless of your insurance status or ability to pay. Hospitals like Banner Health and Cheyenne Regional Medical Center also offer financial assistance or charity care programs, often with sliding scales for those with incomes up to 400% FPL. Additionally, free clinics such as the Lander Free Medical Clinic and the Heart Mountain Volunteer Medical Clinic provide free primary care to uninsured, low-income residents in their service areas. Remember to recheck your eligibility for marketplace subsidies if your income increases above 100% FPL, as your options for affordable coverage will expand significantly.
Wyoming Medicaid Income Limits 2026
The following table shows the key income thresholds for Wyoming in 2026:
| Household Size | 100% FPL | 138% FPL | 400% FPL (Subsidy Limit) |
|---|---|---|---|
| 1 | $15,650 | N/A | $62,600 |
| 2 | $21,150 | N/A | $84,600 |
| 3 | $26,650 | N/A | $106,600 |
| 4 | $32,150 | N/A | $128,600 |
| 5 | $37,650 | N/A | $150,600 |
| 6 | $43,150 | N/A | $172,600 |
Because Wyoming has not expanded Medicaid, the 138% FPL threshold does not apply for adult eligibility. Adults earning between 0-100% FPL may fall into the coverage gap. Those earning between 100-400% FPL can access marketplace subsidies.
Wyoming has some of the highest marketplace premiums in the country, with the benchmark Silver plan averaging $678/month. The upside: higher premiums mean larger subsidies for eligible residents, so out-of-pocket costs after credits may be similar to cheaper states.
Marketplace Insurance in Wyoming
Wyoming residents who do not qualify for Medicaid can purchase private health insurance through the federal marketplace at HealthCare.gov. The average benchmark (second-lowest cost Silver) plan in Wyoming costs approximately $678/month for a 40-year-old in 2026.
Premium tax credits (subsidies) are available for households with income between 100% and 400% FPL. Here is what a 40-year-old individual in Wyoming might pay after subsidies:
| Income Level | Annual Income | Expected Contribution | Estimated Monthly Premium |
|---|---|---|---|
| 150% FPL | $23,475 | 4.01% of income | ~$78/mo |
| 200% FPL | $31,300 | 6.52% of income | ~$170/mo |
| 250% FPL | $39,125 | 8.33% of income | ~$272/mo |
| 300% FPL | $46,950 | 9.83% of income | ~$385/mo |
| 400% FPL | $62,600 | 9.83% of income | ~$513/mo |
These are estimates for an individual. Actual premiums depend on your age, household size, tobacco use, and the specific plan you choose. Households with income between 100-250% FPL also qualify for cost-sharing reductions (CSR) on Silver plans, which lower deductibles and copays.
Residents of Wyoming shop for marketplace insurance through HealthCare.gov, the federal exchange. The application process screens for Medicaid eligibility first, so you'll be directed to Wyoming's program if you qualify.
The lack of Medicaid expansion in Wyoming leaves a gap in the safety net. Residents in the coverage gap — too much income for traditional EqualityCare / Wyoming Medicaid but too little for marketplace subsidies — rely on community health resources and uncompensated care.
How to Get Coverage in Wyoming
Since Wyoming has not expanded Medicaid, your path to coverage depends on your income level:
- Income above 100% FPL ($15,650+ for an individual): Apply through HealthCare.gov during open enrollment (November 1 - January 15) or after a qualifying life event. You will qualify for premium subsidies.
- Income below 100% FPL: Check if you qualify for traditional Medicaid categories (children, pregnant women, disabled). If not, look into community health centers, hospital financial assistance, and free clinics in your area.
- Children: Wyoming's CHIP program covers children in families with income up to 200-300% FPL regardless of expansion status.
Calculate Your Subsidy in Wyoming
Enter your income, age, and household size to see if you qualify for Medicaid or marketplace subsidies in Wyoming.
Check Your Eligibility →Frequently Asked Questions
What are Wyoming's Medicaid eligibility requirements?
Wyoming has not expanded Medicaid, so there is no standard income limit for adults. Traditional Medicaid covers specific groups (children, pregnant women, disabled, very low-income parents). Income limits for these groups vary. Children are generally covered up to 200-300% FPL through CHIP.
Does Wyoming have Medicaid expansion?
No, Wyoming has not expanded Medicaid. This creates a coverage gap for adults earning below 100% FPL who do not qualify for traditional Medicaid categories.
Can I get ACA subsidies in Wyoming?
Yes. Wyoming residents with household income between 100% and 400% FPL ($15,650 to $62,600 for an individual in 2026) qualify for premium tax credits that reduce the cost of marketplace health insurance. Apply through HealthCare.gov.
What is the name of Wyoming's Medicaid program?
Wyoming's Medicaid program is known as EqualityCare / Wyoming Medicaid. It provides health coverage for eligible low-income residents including children, pregnant women, seniors, and certain other qualifying groups.
How do I keep my health insurance if I lose Medicaid in Wyoming?
If your EqualityCare / Wyoming Medicaid coverage ends due to income changes or redetermination, you qualify for a Special Enrollment Period on the marketplace. This gives you 60 days to sign up for a private plan through HealthCare.gov. If your income is between 100-400% FPL, you'll likely qualify for subsidies to help cover the cost.
I don't qualify for Medicaid or subsidies in Wyoming — what can I do?
If you're in the coverage gap (earning below $15,650/year but not qualifying for traditional Medicaid), look into community health centers in Wyoming that offer sliding-scale fees based on income. Many hospitals have charity care programs for uninsured patients. Free clinics and the 211 helpline can connect you with local resources. If your income changes, reapply — even small income increases could qualify you for marketplace subsidies.
Will Wyoming ever expand Medicaid?
Medicaid expansion has been a politically contentious issue in Wyoming. The state legislature has not passed expansion legislation, leaving an estimated coverage gap for adults earning below 100% FPL. Advocacy groups continue to push for expansion, and several neighboring states have recently adopted it. Check with Wyoming's legislative updates for the latest status.
Medicaid Eligibility in Nearby States
- Colorado Medicaid Eligibility — Expansion state
- Idaho Medicaid Eligibility — Expansion state
- Montana Medicaid Eligibility — Expansion state
- Nebraska Medicaid Eligibility — Expansion state