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Montana Medicaid

Montana Medicaid seeks to facilitate access to a set of basic health care benefits for all Montana citizens with a priority for those most in need and create an environment where all recipients take an active role in their health care.

Program Name Montana Medicaid
Expanded Medicaid Yes
Website dphhs.mt.gov
Phone 800-362-8312
Apply Online https://apply.mt.gov/
Appeal a Denial Office of Administrative Hearings
Find a Local Office Field Offices of Public Assistance

Eligibility Requirements

To be eligible for Montana Medicaid, you must be a resident of the state of Montana, a U.S. national, citizen, permanent resident, or legal alien, in need of health care/insurance assistance, whose financial situation would be characterized as low income or very low income.

You must also be one of the following:*

  • Pregnant
  • Be responsible for a child 18 years of age or younger
  • Blind
  • Have a disability or a family member in your household with a disability
  • Be 65 years of age or older

* ACA Medicaid expansion covers eligible low-income adults.

Annual Household Income Limits (before taxes)

Household Size* Maximum Income Level (Per Year)
1 $12,880
2 $17,420
3 $21,960
4 $26,500
5 $31,040
6 $35,580
7 $40,120
8 $44,660

*For households with more than eight people, add $4,540 per additional person.

Available Services Include:

Dental care Mental health
Eyeglasses/eyewear every two years Physician services
Family planning Prescription drugs
Home health services Rehabilitative services and supplies
Hospital services Speech therapy, audiology, and hearing aids
Laboratory and X-ray services Transportation to appointments
Maternity and newborn care Vision

Copayments

Instead of copayments, Montana Medicaid recipients pay a monthly premium which is due on the first of each month.

You are excluded from paying the monthly premium if one of the following applies:

  • Your income is under 100% of the FPL, which is approximately $1,005 a month for an individual, or $2,050 a month for a family of four
  • You have been discharged from the United States military service within the previous 12 months
  • You are enrolled for credit in any Montana University System unit, a tribal college, or any other accredited college within Montana offering at least an associate degree
  • You see a primary care provider who is part of primary care case management program
  • You are in a substance use treatment program
  • You are in a DPHHS approved Community Based Wellness Program administered by Chronic Disease Prevention and Health Promotion

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