Eligibility Online Manual

M401 Applying For Benefits

Purpose: This section will provide information about applying for Medicaid benefits.

Current Policy Effective Date: September 1, 2019

Date Last Reviewed: August 26, 2019

Previous Policy: September 1, 2018


1. Applicants Must Complete An Application

Below is the Medicaid Application:

Health Coverage Application, use for all Medicaid programs.

Health Coverage Application, (Spanish version), use for all Medicaid programs.

2. Medicare Part D Low-Income Subsidy (LIS) Data Exchange

The Medicare Part D, Low-Income (LIS) Data Exchange is transmitted to the states from the Social Security Administration. The Medicaid Eligibility Unit will distribute necessary information on a spreadsheet referred to as the MIPPA file to the Wyoming Department of Health Customer Service Center to process as an application for the Medicare Savings Programs.

3. Methods To Obtain A Paper Application

Applicants may pick up an application at any Department of Family Services field office; print one from the Wyoming Department of Health web site or contact the Wyoming Department of Health (WDH) Customer Service Center at 855-294-2127 to request one be mailed or faxed.

Paper applications can be mailed or delivered to:

WDH Customer Service Center

3001 E Pershing Blvd., Suite 125

Cheyenne, WY 82001

WDH Long Term Care unit

122 W 25th St, West 4th Floor

Cheyenne, WY 82002

Faxed to:

    • The WDH Customer Service Center at 855-329-5205

    • The WDH Long Term Care Unit at 307-777-8399

Emailed to:

    • wesapplications@wyo.gov

4. Other Ways To Apply

Individuals can apply:

    • Over the phone through the WDH Customer Service Center at 855-294-2127

    • Over the phone through the WDH Long Term Care Unit at 855-203-2936, when applying for Long Term Care Services

    • Online at www.wesystem.wyo.gov

5. Not Required To Complete Application

The following applicants are not required to complete an application:

    • Applicant takes the appropriate action within 60 days from denial and 90 days from closure.

    • Individuals eligible for Supplemental Security Income (SSI).

    • Newborns of a Medicaid eligible mother.


Defining Requirement: 42 CFR 435.905 – 912

Clarifying Information:

Worker Responsibilities:


    1. Upon receipt of a MIPPA file, the WDH LTC Unit Consultant copies and pastes the information transmitted from the Social Security Administration into an Excel spreadsheet, formats and sends to the Customer Service center.

    2. Customer Service Center (CSC) processes the MIPPA file and registers the application in WES.

    3. CSC enters the Social Security income and uses collateral contact for verification.

      • If there is a spouse, the Social Security income of the couple is combined.

      • Enter the total Social Security income under the applicant and $0.00 for the spouse. This will trigger the BENDEX interface to obtain individual income for each spouse.

    4. No other verifications are required unless there is conflicting information.

    5. Client's must be periodically reviewed every 12 months under the Medicare Savings Program. Refer to Section M1403 for information on reviewing eligibility.