Looking for Individual Wyoming Health Insurance Coverage

6. If you are looking for health insurance but can't get it through your job . . .

. . . you may have to look for an individual health insurance policy in the private market. Here are some tips to help you:

• Shop carefully before buying insurance on your own because coverage and costs vary from company to company. When shopping for insurance, keep the following terms in mind and ask questions like:
  • Covered Services: What medical services are covered?
  • Deductible: How much must I pay before the insurance starts to help pay for services?
  • Copayments: After I reach my deductible, how much do I pay for services, and how much does the insurance company pay?
  • Pre-existing Conditions: Does the plan cover health problems I already have? If it does not cover these problems right away, when would it begin covering them? (Also see "Your Rights under Federal Law".)Provider Network: Are the doctors I want to see covered in this policy? If not, would I have to pay extra to see any of my doctors because they are not "in the network"? Also, you may want to ask your doctor directly if he or she would accept this insurance for your care.
• Talk with a health insurance agent in your area to help you think about the right policy for the right price (agents are listed in the yellow pages phone book).
• Be careful about plans that don't offer insurance coverage but offer only discounts on the cost of health care services. Generally, these plans are not a good buy.
• Be sure to find out if the insurance company you are thinking about buying coverage from has been licensed in Wyoming and if there have been complaints about the company. For this information, contact the Wyoming Insurance Department at 1.800.438.5768.
• Know your rights. Because you may run into problems shopping for an individual policy, you should be aware of your rights and protections under federal and state law. One resource to learn more about these federal and state protections can be found at www.healthinsuranceinfo.net. This Web site has a separate guide for each state.

Your Rights under Federal Law

HIPAA (the Health Insurance Portability and Accountability Act) is a federal law that may give you the right to buy coverage and prohibits insurance companies from refusing to cover a health problem you already have ("pre-existing condition").

To be eligible for these protections, you must have:

1. had at least 18 months of group coverage (usually through a job),
2. used up any COBRA continuation coverage rights (see #1, above), and
3. had no gaps in coverage longer than 63 days, so you must act quickly.

If you qualify for HIPAA protection, in Wyoming, you have a right to coverage through the Wyoming Health Insurance Pool, the state's high-risk pool. See Section #5 for more information on high-risk pools.

Your Rights under Wyoming Law

Your state also has laws that control whether an insurance company must offer you a policy, what conditions must be covered, and how high the premiums can be for a policy. Because these rules are complex, call the Wyoming Insurance Department at 1.800.438.5768 to understand your rights to insurance coverage in the individual market.