Montana Health Insurance: 2023 Coverage Guide

Montana Affordable Healthcare Insurance

Living in Montana means that you have several health insurance plans options but you should compare rates carefully before you buy a health plan. If you’re an individual or you’re buying coverage for a family, you can get the coverage you need for the best value by comparing your options with SmartFinancial. However, keep some important dates in mind because you can only buy health insurance during open enrollment, unless you are eligible for the Special Enrollment Period due to a qualifying event.

When Is Open Enrollment in Montana?

November 1, 2022 – January 15, 2023.

How to Get Health Insurance in Montana

Begin your search by doing some fact finding about your health care needs. Look at the past year and see how often you saw a care provider and what services you needed. Look at your current plan and see what you’ve been paying out-of-pocket, including copays and coinsurance. This way, you can choose wisely when you pick a coverage tier. The more care you need, the more sense it makes to buy a higher level tier. It may cost more monthly, but the overall cost may be less because you’ll pay lower copays and coinsurance.

What Types of Health Insurance Are Available in Montana?

HMOs, EPOs, PPOs and POS plans are most commonly available in Montana. You can also buy a catastrophic plan, which only covers emergency care but only partially. The most common tiers of coverage people choose in Montana are bronze (covers 60% of costs), silver (covers 70% of costs and gold (covers 80% of costs). The more care you need, the more economical it is to consider a higher-tier plan.

Does Health Insurance Cover Pre-existing Conditions?

The Affordable Care Act made it illegal for marketplace health plans to deny anyone health insurance coverage based on pre-existing conditions.

Do I Qualify for a Special Enrollment Period?

Common reasons people qualify for a special enrollment period:

• If you start a new business, lose a job, quit a job or change jobs where health insurance is not offered, you may buy a new health insurance plan.
• When you turn 26, you are no longer able to remain on your parent’s health insurance plan, but you may buy a new plan.
• Some insurance carriers only cover members in certain areas or states. If you move and become ineligible for coverage with your current carrier, you may buy a new health plan.
• If your Cobra extension reaches the deadline, you can buy a new health insurance policy.
• If you were married and shared a health plan with your spouse but you divorced, you can enroll in an individual health plan.
• Married people often share health insurance. If you were in this situation but you divorced, you can buy a new health plan.
• If you recently got married, you can buy a new plan as an individual or as a couple.
• New parents may buy a health insurance plan for the child.
• If you shared health insurance coverage with a spouse or partner and that person dies, you are eligible to buy a new plan.
• If you shared health insurance coverage with a spouse or partner and that person loses coverage for a qualifying reason, you can buy another plan together. You can also buy an individual plan if you prefer.

Is Health Insurance Required in Montana?

No, only California, Massachusetts, New Jersey, Vermont, Rhode Island, and DC still require health insurance. Otherwise, there is a tax penalty. Even though it’s not required in every state, buying health insurance is necessary to avoid medical bankruptcy.

How Much Is Health Insurance in Montana?

The average cost of health insurance in Montana for a 40 year old is about $448 a month. Health insurance is less expensive, the younger you are. Tobacco use increases health insurance rates.

How to Save on Health Insurance in Montana

The best way to save on health insurance in Montana is to compare rates based on the tier system. Beforehand, you’ll want to estimate your medical costs.

Compare Health Insurance Plans in Montana

Medicare in Montana

Medicare is health insurance coverage for Americans ages 65 years and older. The government also allows younger people with disabilities to enroll in the program. Individuals with End-Stage Renal Disease (a permanent kidney failure treated with dialysis or a transplant) can also sign up as can some individuals with severe mental health issues. Others who qualify for Medicare disability coverage are individuals with Amyotrophic Lateral Sclerosis (also called Lou Gehrig’s Disease). Most beneficiaries will receive Original Medicare (Parts A and B). Some people buy Medicare Advantage, which includes Part A and B as well as offering vision, dental and prescription drug coverage.

How Many People Are on Medicare in Montana?

21% of the residents of Montana are on Medicare.

How Much Is Medicare in Montana?

If you do not qualify for Medicare, you can buy it for $499 a month for Part A in 2022 and a standard monthly premium for Medicare Part B was $170.10, or even higher, depending on income.

Original Medicare vs Medicare Advantage: What’s the Difference?

Medicare is a government subsidized health plan that is available to qualified Americans age 65 and older. Medicare Advantage is sold through private health insurance companies, but these policies are also regulated by the government. Medicare Advantage plans offer the same benefits as Medicare Parts A and B. Medicare Advantage plans also offer more coverage for dental, vision, hearing and prescription drugs. Medicare Advantage plans have a maximum out-of-pocket limit. For 2022, it was $7,550 but many plans set their maximums at a much lower cost. That is why it’s important to compare companies. People who opt for original Medicare can buy Medicare Supplements to help with out-of-pocket costs. You cannot buy both Medicare Advantage and Medicare Supplements. If you enroll in a Medicare Advantage Plan during open enrollment, you will automatically be disenrolled from original Medicare.

How to Get Medicare Coverage in Montana

If you receive social security payments, you may automatically enroll in Medicare, but you may have to sign up if you do not receive payments. The easiest way to enroll in Medicare is by working with a trusted insurance agent to get the coverages you want. Just enter your zip code and answer a few simple questions.

Types of Medicare Plans Available

Original Medicare, Medicare Advantage, Medicare Cost Plans (only offered in certain areas), Demonstration/Pilot Programs (also called Research Studies; only offered in certain areas) and Programs of All-Inclusive Care for the Elderly (PACE).

How Do I Qualify for Medicare?

To qualify for Medicare you must be a citizen of the U.S. or have been a legal resident for at least five years. If you are age 65 or older and you/your spouse have worked for at least 10 years (40 quarters) or you have a disability, Amyotrophic Lateral Sclerosis (ALS) or end-stage renal disease (ESRD), you most likely qualify for Medicare.

How Can I Save on Medicare in Montana?

You can save on Medicare by signing up for Part B as soon as you’re eligible. People who enroll late must pay a penalty every year. If you’re interested in buying Medicare Advantage, you can shop and compare Medicare plans for the best value.

Find Affordable Health Insurance in Montana

Montana State Health System Ranking

Ever wonder how your state stacks up when it comes to quality healthcare? The Commonwealth Fund published a report in 2020 on State Health System Performance. They took into consideration the access to quality care, health outcomes, and disparities in all 50 states. The scores for the Montana Health System are listed below:

• Montana: Overall Ranking: 18 of 51
• Montana: Overall Performance: Below U.S. Average
• Montana: Access and Affordability: 30
• Montana: Prevention and Treatment: 34
• Montana: Avoidable Hospital Use and Cost: 7
• Montana: Healthy Lives: 12
• Montana: Health Care Disparities: 12

Montana Health Insurance Coverage

The people of Montana have different kinds of health insurance while some Montana residents are not insured at all. See the breakdown below:

• Private coverage: 49%
• Medicaid: 19%
• Medicare: 21%
• Uninsured: 11%

Report: America's Health Insurance Plans

Montana Health Insurance Companies

The following carriers offer health insurance and/or medicare in Montana.

• United HealthCare Services, Inc. (Montana)
• UnitedHealthcare Insurance Company (Montana)
• Cigna Health and Life Insurance Company (Montana/South Dakota)
• Connecticut General Life Insurance Company (Montana/South Dakota)
• PacificSource Health Plans (Montana)
• Aetna Life Insurance Company (Montana)
• Compass Rose Health Plan