Montana Health Insurance: Key Facts
- Medicaid Status Expanded (HELP Act 2016)
- Exchange Type Federal (Healthcare.gov)
- Open Enrollment November 1, 2024 - January 15, 2025
- Medicaid Income Limit 138% FPL (~$20,783/year single)
Montana provides multiple pathways to health coverage for its residents. The state expanded Medicaid in 2016 through the HELP Act, which has since provided coverage to tens of thousands of Montanans. For marketplace coverage, Montana uses the federal Healthcare.gov platform.
Medicaid in Montana
Montana Medicaid expansion provides comprehensive health coverage to adults who previously fell into the coverage gap. The program has been particularly impactful in Montana's rural communities, where access to healthcare can be challenging.
Who Qualifies for Montana Medicaid?
- Adults 19-64: Household income up to 138% of the Federal Poverty Level (approximately $20,783/year for an individual)
- Children: Up to 261% FPL through the Healthy Montana Kids (CHIP) program
- Pregnant Women: Up to 157% FPL
- Seniors and Disabled: Various programs available with different income limits
What Does Montana Medicaid Cover?
- Doctor and specialist visits
- Hospital services (inpatient and outpatient)
- Prescription drugs
- Mental health and substance use disorder services
- Preventive care and wellness visits
- Lab tests, X-rays, and imaging
- Emergency services
- Dental services (limited for adults)
Montana Health Insurance Marketplace
Montana uses the federal marketplace, Healthcare.gov, for individual and family health insurance enrollment. Residents can shop for ACA-compliant plans during Open Enrollment or during a Special Enrollment Period if they experience a qualifying life event.
How to Enroll Through Healthcare.gov
- Visit Healthcare.gov and create an account
- Complete your application with household and income information
- See if you qualify for Medicaid, CHIP, or premium subsidies
- Compare available plans and choose one that fits your needs
- Complete enrollment and pay your first premium
Insurance Companies in Montana
Montana residents have access to plans from several insurers, including:
- Blue Cross Blue Shield of Montana
- PacificSource Health Plans
- Montana Health CO-OP
Average Health Insurance Costs in Montana
Montana's health insurance costs can be higher than the national average due to its rural nature and limited competition. However, premium subsidies help make coverage affordable for most residents.
| Metal Tier | Average Monthly Premium | Typical Deductible |
|---|---|---|
| Bronze | $400 - $500 | $7,500 - $9,000 |
| Silver | $550 - $650 | $5,000 - $6,500 |
| Gold | $680 - $780 | $1,500 - $3,000 |
Important Enrollment Dates
- Open Enrollment: November 1, 2024 - January 15, 2025 (for 2025 coverage)
- Coverage Effective Date: January 1, 2025 (if enrolled by December 15) or February 1, 2025 (if enrolled by January 15)
- Medicaid: Apply year-round; no enrollment period
Frequently Asked Questions
Does Montana have Medicaid expansion?
Yes, Montana expanded Medicaid in 2016 under the HELP Act (Health and Economic Livelihood Partnership). The program, known as Montana Medicaid Expansion, covers adults aged 19-64 with incomes up to 138% of the federal poverty level.
Where do Montana residents enroll in marketplace health insurance?
Montana uses the federal marketplace at Healthcare.gov for health insurance enrollment. Residents can compare plans, apply for subsidies, and enroll in coverage through the federal platform during Open Enrollment or a Special Enrollment Period.
When is Montana's health insurance open enrollment period?
Montana's Open Enrollment for 2025 coverage runs from November 1, 2024 through January 15, 2025. The federal marketplace offers an extended enrollment window compared to some state-based exchanges.
How much does health insurance cost in Montana?
The average monthly premium for a benchmark Silver plan in Montana is approximately $550-$650 before subsidies. Montana's rural geography can affect premiums, but most residents qualify for subsidies that significantly reduce costs.
Need Help Finding Coverage in Montana?
Our licensed agents can help you navigate Healthcare.gov, check your Medicaid eligibility, and find the best plan for your needs and budget.
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