Wyoming Medicaid for seniors and long-term care

Last verified: June 2026

Long-term care coverage in Wyoming Medicaid

Wyoming Medicaid covers nursing facility care and home and community-based services through two waiver programs for people who qualify financially and clinically. Wyoming has relatively limited nursing facility capacity compared to some states, and many residents use out-of-state facilities when appropriate local placement is unavailable.

• Skilled nursing facility care
• Community Choices Waiver (CCW) — HCBS alternative to nursing facility for eligible adults
• Comprehensive and Supports (DD) Waiver — for individuals with intellectual/developmental disabilities and acquired brain injuries
• Home health services (physician-ordered nursing or therapy in the home)
• Personal care services
• Employed Individuals with Disabilities (EID) program — allows working disabled adults to buy into Medicaid
• Hospice care
• Non-emergency medical transportation

Source: Wyoming Department of Health Programs and Eligibility page (health.wyo.gov/healthcarefin/medicaid/programs-and-eligibility/); HCBS Section (health.wyo.gov/healthcarefin/hcbs/).

Community Choices Waiver — HCBS for Wyoming seniors and adults with disabilities

The Community Choices Waiver (CCW) is Wyoming's primary HCBS alternative to nursing facility placement. The CCW provides an array of community-based services for eligible individuals who need nursing-facility-level care but choose to remain at home or in a community setting. Per WDH, information on the CCW and how to apply is available at health.wyo.gov/healthcarefin/hcbs/ or by calling 1-800-510-0280.

Financial eligibility for CCW waiver participation is determined by the Long-Term Care Eligibility Unit at 1-855-203-2936. Clinical eligibility requires a needs assessment by a public health nurse.

Financial eligibility for Wyoming long-term care Medicaid

Source: Wyoming Department of Health Programs and Eligibility page; see also income standard tables at ecom.wyo.gov/tables/table1a and resource tables at ecom.wyo.gov/tables/table7. Consult a Wyoming elder law attorney before making asset transfers if long-term care Medicaid may be needed.

Wyoming Medicaid estate recovery

Wyoming operates an estate recovery program. The Wyoming Medicaid Estate Recovery Brochure (available at health.wyo.gov) explains the program. WDH may seek reimbursement from the estates of members who received Medicaid-funded long-term care services at age 55 or older. The home is generally exempt while a surviving spouse or dependent child resides in it. Wyoming enforces the 60-month asset lookback period. Consult a Wyoming elder law attorney before making asset transfers if a family member may need LTC Medicaid.

Medicaid as the primary payer for long-term care

Medicare does not cover custodial nursing home care beyond 100 days following a qualifying hospital stay. Private long-term care insurance covers only those who purchased it. For the majority of Americans who need extended nursing home care, Medicaid ends up as the payer — after they have spent down their own assets to the program's limit.

Nationally, Medicaid pays for roughly two-thirds of all nursing home residents, per CMS data. Wyoming's share of that population is administered through Wyoming Medicaid. The rules that determine eligibility — income, assets, lookback periods, and exempt property — differ from the MAGI-based rules used for standard Medicaid.

Long-term care Medicaid also includes home and community-based services (HCBS), which allow people to receive care at home or in assisted living rather than a nursing facility. These programs operate through Section 1915(c) waivers and have waiting lists in most states.

Nursing facility coverage

Wyoming Medicaid covers skilled nursing facility care for seniors who meet clinical and financial criteria. Clinical eligibility requires a documented need for skilled nursing care — typically assessed through a standardized instrument. Financial eligibility means income and countable assets fall within the program's limits.

Once approved, Medicaid pays the nursing home directly. The resident contributes most of their monthly income toward the cost of care — typically all income minus a personal needs allowance (which varies by state but is often $30–$50 per month). Medicaid covers the gap.

If income exceeds the institutional Medicaid limit, Wyoming may use a "Miller Trust" (qualified income trust) arrangement to route excess income through a trust account, making the person financially eligible. Not all states allow this; verify whether Wyoming uses this approach with Wyoming Medicaid.

Home and community-based services (HCBS)

HCBS waivers let states cover long-term care services outside nursing facilities — in a person's home, adult day program, or assisted living. Section 1915(c) of the Social Security Act authorizes these waivers. Each state designs its own waiver programs, so what's available through Wyoming Medicaid differs from what's available in neighboring states.

Common HCBS services include personal care assistance, home health aide visits, adult day health care, respite care for family caregivers, and modifications to make a home accessible. Some states cap the number of waiver slots, creating waiting lists that can run for months or years.

Contact Wyoming Medicaid to ask which HCBS waiver programs are currently open for enrollment and whether there is a waiting list.

Asset limits for long-term care Medicaid

Unlike MAGI-based Medicaid, long-term care Medicaid has an asset test. Countable assets — bank accounts, investments, second vehicles, vacation property — must fall below the state's limit. The specific threshold varies by state and is updated periodically; it is not a figure this page can reliably publish.

Exempt assets are not counted. The primary home is exempt while the applicant lives there or intends to return, as well as when a spouse, minor child, or disabled adult child lives there. One vehicle is typically exempt. Personal belongings and a prepaid funeral arrangement are also generally exempt.

Medicaid has a 60-month (5-year) lookback period for asset transfers. Transfers of assets for less than fair market value within those 60 months can result in a penalty period during which Medicaid will not pay for care. Consult Wyoming Medicaid or a Medicaid planning attorney before transferring assets.

Spousal protections

When one spouse needs nursing home care, federal law protects the other spouse from complete impoverishment. The community spouse (the one still at home) is entitled to keep a minimum amount of assets — called the Community Spouse Resource Allowance (CSRA) — and a minimum monthly income.

The CSRA allows the community spouse to keep between a federal minimum and maximum, with the exact amount varying by state and updated annually. Wyoming's current CSRA is set by Wyoming Medicaid and published on their website.

The community spouse's own income is not counted toward the institutionalized spouse's Medicaid eligibility. If the community spouse has insufficient income, a portion of the institutionalized spouse's income may be allocated to them — the minimum monthly maintenance needs allowance (MMMNA).

What long-term care Medicaid typically covers

• Skilled nursing facility care — room, board, nursing services, and most medical care in the facility
• Physical, occupational, and speech therapy provided in a nursing home
• Personal care assistance with daily activities (bathing, dressing, eating) through HCBS waivers
• Home health aide visits for those receiving care at home
• Adult day health care programs
• Respite care to give family caregivers temporary relief
• Durable medical equipment prescribed by a physician
• Transportation to and from medical appointments