What is the Wyoming Health Insurance Pool?

As of 2010, all 50 states in the United States offer some kind of insurance pool to their residents. Most administer their own plans, but some states let the federal government run the pool. These insurance pools are designed mainly for people who have been denied health insurance from private companies because of pre-existing conditions. The Wyoming Health Insurance Pool (WHIP) was created in 1990 and is run by the state insurance department.

Eligibility

• Residents of Wyoming who want to enroll in WHIP must first meet certain conditions. You must have been refused health insurance because of a medical condition, or have used up your maximum lifetime benefits with your existing plan. You may also join WHIP if you are younger than 65, are not eligible for group health insurance and receive Medicare. If you were a member of WHIP in the past and have already been paid the maximum amount of benefits, however, you cannot enroll again. You cannot enroll if you are currently a hospital inpatient or incarcerated.

Presumptive Conditions

• Most people who apply for WHIP must show proof of refusal of health coverage before they can join the program. However, if you are currently being treated for one or more of specific health conditions, this requirement is waived. The state provides a full list of all presumptive conditions on the Insurance Department website. As of 2011, presumptive conditions include AIDS, obesity, metastatic cancer, Parkinson's disease, paraplegia and quadriplegia, leukemia, HIV, epilepsy, renal failure and insulin-dependent diabetes.

Plans

• Wyoming offers three plans through the health insurance pool: the Brown Plan, the Gold Plan and the Catastrophic Plan. The Brown Plan has a higher yearly deductible and out-of-pocket expenses than the Gold Plan, but the pool pays 100 percent after these are met. The Brown Plan also qualifies as a high-deductible policy that can work with medical savings accounts. The Gold Plan has a lower deductible and out-of-pocket costs but pays only 80 percent after these are reached. The Catastrophic Plan is available only to people with an annual adjusted gross income below 400 percent of the federal poverty level and has the highest calendar deductible, though benefits are eventually paid at 100 percent.

Benefits

• All three WHIP plans have benefits in common. Home health services, chemotherapy, hospice, ambulance services, diabetes education, bone marrow transplants, prescription drug coverage, maternity care and hospital treatment are all automatically included no matter which WHIP policy you receive. The details regarding these benefits vary, however. Prescription drugs on the Brown Plan are subject to the $5,000 deductible, while with the Gold Plan you only pay coinsurance and co-payment amounts. Lifetime benefits for the Brown and Catastrophic plans are capped at $500,000, but lifetime benefits for the Gold Plan are $750,000.