WHEN DO INDIVIDUAL HEALTH INSURERS HAVE TO SELL ME A POLICY? 

In Wyoming, your ability to buy an individual health insurance policy may depend on your health status. 

• In general, companies that sell individual health insurance in Wyoming are free to turn you down because of your health status and other factors. When applying for an individual health insurance policy, you may be asked questions about health conditions you have now or have had in the past. Depending on your health status, insurers might refuse to sell you coverage or offer to sell you a policy that has special limitations on what it covers. If you are turned down or offered a policy with reductions or restrictions, you may be eligible for the High Risk Pool.
• Under Wyoming law, newborns, adopted children, and children placed for adoption are automatically covered under the parents’ individual health insurance policy for the first 31 days, if the plan covers dependents. The insurer may require that the parent enroll the child within the 31 days in order to continue coverage beyond the 31 days.
• Under Wyoming law, your disabled child can remain covered as a dependent under your individual health insurance policy into adulthood. This applies if your dependent was already disabled and covered under the health plan before he or she reached the limiting age for dependent coverage. You will be required to submit proof of your child’s continued incapacity and dependency within 31 days following the date that your child reaches the limiting age and annually thereafter. Subsequently, if you change health plans, you might not be able to cover your disabled son or daughter as a dependent under the new health plan.

WHAT WILL MY INDIVIDUAL HEALTH INSURANCE POLICY COVER?

• It depends on what you buy. Wyoming does not require health insurers in the individual market to sell standardized individual health insurance policies. Health plans can design different policies and you will have to read and compare them carefully. However, Wyoming does require all health plans to cover certain benefits, such as diabetes care. Check with the Wyoming Department of Insurance for more information about mandated benefits.

WHAT ABOUT COVERAGE FOR MY PRE-EXISTING CONDITIONS?

• There are different ways that an individual health insurance plan can exclude a pre-existing condition.

The plan can impose an elimination rider, which is an amendment to your health insurance contract that permanently excludes coverage for a health condition, body part, or body system. Or a plan can apply a temporary exclusion period on any pre-existing condition.

Individual plans can count as preexisting conditions only those for which you actually received (or were recommended to receive) a diagnosis, treatment or medical advice within 6 months before individual coverage begins.  The maximum exclusion period that can be imposed is 12 months.

• Individual health insurers that apply a pre-existing exclusion period have to give credit for your prior coverage as long as your coverage has been continuous with no more than a 90-day lapse.
• In Wyoming, pregnancy and genetic information can be considered a pre-existing condition in all individual health insurance policies.

WHAT CAN I BE CHARGED FOR AN INDIVIDUAL HEALTH INSURANCE POLICY?

• Generally, in Wyoming, there are no limits on how much individual premiums can vary due to age, gender, health status, family size, and other factors.

CAN MY INDIVIDUAL HEALTH INSURANCE POLICY BE CANCELED?

• Your coverage cannot be canceled because you get sick. This is called guaranteed renewability. You have this protection provided that you pay the premiums, do not defraud the company, and, in the case of managed care plans, continue to live in the plan service area. However, guaranteed renewability does not protect you from having your premiums go up at renewal.
• Some insurance companies sell temporary health insurance policies. Temporary policies are not guaranteed renewable. They will only cover you for a limited time, such as 6 months. If you want to renew coverage under a temporary policy after it expires, you will have to reapply and there is no guarantee that coverage will be re- issued at the same price or at all.