Health Insurance Coverage in Montana
Montana Health Insurance Database
One of the biggest obstacles in reducing health insurance costs os the lack of information about the varying costs of medical services. The Montana Commissioner of Securities & Insurance (http://www.csi.mt.gov/) has formed a database of health care costs to increase communication between Montana residents and Montana health insurance companies.
Over recent years, they have collected health insurance claim information from a number of sources.
This health insurance database, called All-Payer Claims Databases (APCDs) will help to answer questions such as:
Where is public health improving?
How far do people travel for services? Which services?
The database will improve the transparency of medical services and costs, treatment methods, outcomes, and more across Montana communities.
Insure Montana Program: Health Insurance for Small Businesses
The Insure Montana program began in 2005 as an initiative to help small businesses provide better health insurance benefits to their employees, and if they don’t have health insurance, make it more affordable to acquire a plan.
Small businesses in Montana with 2-9 employees are eligible for the program and may be eligible to apply for a refundable state tax credit.
Small businesses that currently do not offer group health insurance plans to their employees can apply for the Purchasing Pool program which offers subsidies to reduce premium payments.
Montana Health Care Exchange: Comprehensive Health Association (MCHA)
The MCHA (http://www.mthealth.org/) us a program offering individual health insurance policies to Montana residents who are otherwise considered uninsurable due to medical reasons. It is sometimes referred to as Montana’s high-risk pool, and the health insurance plans are administered by the Blue Cross Blue Shield of Montana for over 3,000 Montanans.
The MCHA has a number of health insurance plans that will help Montana resident secure affordable health insurance. Pre-existing conditions are excluded from consideration when determining premiums, and no payment shall be made for treatment of a pre-existing condition until the person has been covered by MCHA for at least twelve months.
Montana Health Insurance for Kids
Health Montana Kids (http://hmk.mt.gov/) is a free or low-cost health insurance plan that provides health coverage to eligible children and teenager up to age 19 in Montana. There are no pre-existing condition limitations.
Some parents will be required to share in some payments when their child receives care, but HMK ensures that this will not exceed $215 per family per year.
Eligibility Requirements:
Montana residents
Household meets income guidelines for household size
Household and income requirements:
| Household Size (Children and Adults) |
Household Income |
| Family of 2 | $36,775 | Family of 3 | $46,325 | Family of 4 | $55,875 | Family of 5 | $65,425 | Family of 6 | $74,975 | Family of 7 | $84,525 | Family of 8 | $94,075 |
Some employment-related and child care deductions apply.
HMK health insurance plans’ list of covered services includes:
- Office and clinic visits
- Emergency visits
- Hospital services
- Prescription drugs
- Lab and x-ray services
- Mental health services
- Physicals
- Anaestheseia services
- Ambulance
- Dental services
- Vision exams and eyeglasses
- Hearing exams
- …and more.
For more information about the Healthy Montana Kids program, call the HMK family health line at 1-877-KidsNow.
