(a) The following individuals are eligible for Medicaid: - (i) Children born to a Medicaid eligible woman are deemed to have applied for medical assistance and to have been found eligible on the date of birth and to remain eligible for a period of 13 months, as specified in 42 C.F.R. § 435.117.
- (ii) Children birth through age five (5), whose countable family income does not exceed one hundred fifty-four percent (154%) of the Federal Poverty Level (FPL), are eligible for Medicaid as specified in 42 C.F.R. § 435.118.
- (iii) Children age six (6) through age eighteen (18), whose countable family income does not exceed one hundred thirty-three percent (133%) of the FPL are eligible for Medicaid as specified in 42 C.F.R. § 435.118.
- (iv) Foster care children are eligible for Medicaid under Title IV-E of the Social Security Act.
- (v) Foster care children who are not eligible under Title IV-E of the Social Security Act and are in the custody of the Department of Family Services (DFS) are eligible for Medicaid, as specified in 42 C.F.R. § 435.222.
- (vi) Adopted children who live in Wyoming and are under a Wyoming Subsidized Adoption Agreement remain eligible for Medicaid until age twenty-one (21), as specified in 42 C.F.R. § 435.145, 42 C.F.R. § 435.222 and Section 1902(a)(10)(A)(ii) (VIII) of the Social Security Act.
- (vii) Children who were in DFS custody at the time of their eighteenth (18th) birthday and are released from custody at that time or later, as specified in Sections 1902(a)(10)(A)(ii) (XVII) and 1905(w)(1) of the Social Security Act, are eligible for Medicaid until age twenty-six one (21).
- (viii) Children who were in DFS custody at the time of their eighteenth (18th) birthday and were receiving Medicaid benefits under the State Plan at that time or later, as specified in 42 C.F.R. § 435.150, shall be eligible for Medicaid until age twenty-six (26 )
- (ix) Poverty-Level Pregnant Women. A woman who is pregnant and whose family income does not exceed one hundred fifty-four percent (154%) of the FPL is eligible for Medicaid during the pregnancy and through a sixty (60) day period beginning on the last day of the pregnancy, as specified in 42 C.F.R. § 435.116.
- (x) Qualified Pregnant Women. A woman who is pregnant and whose family income does not exceed the income eligibility levels specified in the Medicaid State Plan under Title XIX of the Social Security Act shall be eligible for Medicaid during the pregnancy and through a sixty (60) day period beginning on the last day of the pregnancy, as specified in 42 C.F.R. § 435.116, and Sections 1902(a)(10)(A)(i)(III) and 1905(n)(l) of the Social Security Act. Qualified Pregnant Women shall cooperate in establishing paternity, and obtaining medical support during the sixty (60) day postpartum period, as specified in 42 C.F.R. § 433.147
- (xi) Family Planning Waiver. A woman who is age nineteen (19) but under the age of forty-five (45), whose family income does not exceed one hundred fifty-nine percent (159%) of FPL and is transitioning from the Pregnant Women Program shall be eligible for Medicaid coverage for certain family planning services as specified in 42 C.F.R. § 435.214 and Section 1115(a) of the Social Security Act.
- (xii) Family Care. Caretaker relatives of a dependent child, as specified in 42 C.F.R. 435.110, whose family income does not exceed the income eligibility levels specified in the Medicaid State Plan shall be eligible for Medicaid. Adults must cooperate in establishing paternity and obtaining medical support, as specified in 42 C.F.R. § 433.147 and Section 1931 of the Social Security Act.
- (xiii) Four (4) Month Extended Medicaid. Caretaker relatives of a dependent child under the age of nineteen (19) whose family income exceeds the Family Care income eligibility levels due to the receipt of spousal support, and who have received Family Care benefits for three (3) of the last six (6) months shall be eligible for an extension of Medicaid benefits for four (4) months, as specified in 42 C.F.R. § 435.115.
- (xiv) Twelve (12) Month Extended Medicaid. Caretaker relatives of a dependent child under the age of nineteen (19) whose family income exceeds the Family Care income eligibility levels due to an increase in earning of the caretaker, and who have received Family Care benefits for three (3) of the last six (6) months shall be eligible for Medicaid for an extended period of time, as specified in 42 C.F.R. § 435.112.
- (xv) Tuberculosis Assistance Program. Medicaid benefits shall be available to individuals who are infected with tuberculosis, as specified in 42 C.F.R. § 435.215.
(b) Treatment of Income. - (i) For all eligibility categories described in Section 6(a) of this Chapter which include an income requirement, income shall be calculated using the modified adjusted gross income of the household, as specified in 42 C.F.R. § 435.603 and the State Plan.
(c) Treatment of Resources. A resource test does not apply to any of the groups described in Section 6(a).
(d) Reporting Changes. Clients shall immediately report changes in any of the following circumstances to the Department: - (ii) Household composition;
- (iii) Health insurance; and
048-18 Wyo. Code R. § 18-6