What is Presumptive Eligibility?
Presumptive Eligibility is an easier way to apply for Medicaid benefits. If you qualify, you could start getting the important prenatal care you need sooner than the usual way of finding out if you are eligible for Medicaid.
Who decides if I am eligible?
A qualified provider - a person or persons in an office that's enrolled as a Wyoming Medicaid Provider - must decide. Johnson County Public Health is a qualified provider, and so are the local physicians.
What services will I receive if I am eligible for Presumptive Eligibility?
If you are eligible, you will receive outpatient prenatal care services from enrolled Medicaid providers. Covered services include physician visits, certified nurse midwife visits, laboratory or x-ray tests, emergency room visits, medical supplies, prescription drugs as prescribed by a physician, community mental health visits and rural health clinic visits.
What services are not covered?
Presumptive Eligibility does not cover payment for delivery of your baby. No coverage is available for inpatient care until you become eligible for regular Medicaid.
How can I apply for Presumptive Eligibility?
If you are pregnant, you can apply at Johnson County Public Health.
What do I need to apply?
Bring your Social Security card, birth certificate, and proof of gross monthly income to your appointment. You need to fill out a single-page form for review, and we'll let you know if you are eligible. You can then begin your prenatal care. Your application will be sent to the Department of Family Services where your eligibility for regular Medicaid is determined. If eligible, you will be financially covered for inpatient and outpatient services for your pregnancy and delivery.