Patient Advocate Services in Wyoming, Covered by Medicare

Yes. Since January 2024, Medicare pays for professional healthcare navigation through Principal Illness Navigation and Community Health Integration services. Medicare Part B covers about 80% of the cost, and a supplemental (Medigap) plan typically covers the rest. We check your coverage and tell you exactly what, if anything, you will owe before your first session.

Yes, all 23 counties, from Laramie County and Cheyenne in the southeast to Park County and Cody in the northwest, Teton County and Jackson in the west, and Niobrara County, the least populous county in the least populous state. The service is fully virtual, delivered by phone, video, and secure messaging, so it works the same in Casper, Gillette, and Laramie as it does on a ranch outside Lusk or Pinedale. In a state where the nearest specialist can be a day's round trip, an advocate you can reach without the drive is often the practical option, not the fallback.

Advocates work virtually and are matched to you, not to a zip code. What matters is that your advocate is the same person every time (One Advocate, For Life), knows Wyoming's rules like free WSHIIP counseling, the Medigap birthday rule, the Medicare Savings Programs, and Medicaid home care through the Community Choices Waiver, and gives you their direct phone, email, and text, so you never start over with a stranger in a call queue.

Yes, since June 4, 2025. If you have a Medigap policy, Wyoming's Medicare supplement regulation gives you a guaranteed issue period every year that starts on your birthday and lasts 63 days. During it you can switch to a comparable or lesser Medigap policy from any insurer, and the insurer cannot turn you down or price the policy on your health history. A comparable or lesser plan is one that adds no significant benefit your current plan lacks: someone with Plan G, for example, can move to another Plan G or to a plan with fewer benefits, but not up to a richer one. Wyoming does not community-rate Medigap, so insurers may price policies by age. Outside the birthday window and the federal guaranteed issue rights, insurers can use medical underwriting. Questions and complaints go to the Wyoming Department of Insurance at 1-800-438-5768.

Possibly, but Wyoming law does not guarantee it. Wyoming has no state rule requiring insurers to sell Medigap to people under 65 on Medicare because of a disability or end-stage renal disease, so it depends on whether an insurer chooses to offer a policy, and it can be medically underwritten. When you turn 65, you get the federal six-month Medigap open enrollment, when any insurer must sell you any plan it offers regardless of your health. Until then, a Medicare Advantage plan is often the main alternative. A free WSHIIP counselor at 1-800-856-4398 can walk you through the options.

Yes, and Wyoming's rules are specific. Wyoming has not expanded Medicaid, so in-home care through Medicaid usually means the Community Choices Waiver, for people 65 and older, or 19 to 64 with a disability, whom a county public health nurse's LT-101 assessment finds need a nursing home level of care, within Medicaid's income and resource limits. Through Participant-Direction, the waiver's self-directed option, a participant can hire their own caregiver; the rule bars anyone legally authorized to make financial decisions for the participant, such as a guardian or financial power of attorney, from being the paid worker, and a spouse can be hired only under those same conditions and when the circumstances make it necessary. For people who do not qualify for Medicaid, Wyoming Home Services, funded by the state, provides in-home help on a sliding fee scale through one provider in each county. Wyoming has no PACE program. To start, call the Department of Health's Home and Community-Based Services Section at 1-800-510-0280, or the Aging Division at 1-800-442-2766. Our advocacy is billed through Medicare, so we focus on the Medicare side: bills, appeals, appointments, coverage questions. For dual-eligible families that split works well: you manage the caregiving, and your parent's advocate handles the Medicare paperwork.

The Wyoming State Health Insurance Information Program (WSHIIP), run by Wyoming Senior Citizens, Inc. at 1-800-856-4398, offers free, unbiased Medicare counseling from trained counselors around the state, and it is excellent for one-off questions like comparing Part D or Medigap plans during Open Enrollment. Understood Care is different: a dedicated advocate who does the work itself, makes the calls, files the appeals, untangles the bills, and stays with you month after month, covered by Medicare. The two are complementary, and we often point our own members to WSHIIP counselors for enrollment-season plan comparisons.

In Wyoming we are in-network for Original Medicare (traditional fee-for-service Medicare). Together that covers roughly 82% of Wyoming's Medicare beneficiaries. Market-share data: 2024. Plan networks change, so we confirm exactly what your plan covers before any work begins.