Montana Medicaid provides free or low-cost health coverage to eligible residents, including low-income adults, children, pregnant women, seniors, and people with disabilities. The program is administered by the Montana Department of Public Health and Human Services (DPHHS) and covers a wide range of services from doctor visits and hospital stays to prescriptions and mental health care. If you are a Montana resident wondering whether you qualify and how to get started, this guide walks you through every step of the process.
Not sure if Medicaid is right for you? Check your eligibility for multiple programs in minutes using our free screening tool, or visit our Montana Benefits Overview for a full list of assistance programs available in the state.
Who Is Eligible for Montana Medicaid?
Montana expanded its Medicaid program in 2016 under the HELP (Health and Economic Livelihood Partnership) Act, extending coverage to more low-income adults. Eligibility depends on several factors including your income, household size, age, disability status, and whether you are pregnant or caring for children.
The main eligibility groups include:
- Low-income adults (ages 19 to 64) with household income at or below 138% of the Federal Poverty Level (FPL)
- Children (under 19) in families with income meeting CHIP or Medicaid thresholds
- Pregnant women with income at or below 157% of FPL
- Seniors (65 and older) who meet income and asset requirements
- People with disabilities who meet Social Security or state disability criteria
- Parents and caretaker relatives with dependent children
To qualify, you must also be a resident of Montana and a U.S. citizen or qualified immigrant.
Montana Medicaid Income Limits
Income limits for Montana Medicaid are based on a percentage of the Federal Poverty Level, which is updated each year. The table below shows approximate monthly income limits for common eligibility groups. These figures are estimates based on federal poverty guidelines and may vary slightly depending on the specific program category.
Adults and Children (Modified Adjusted Gross Income)
| Household Size | 138% FPL (Adults) | 157% FPL (Pregnant Women) |
|---|---|---|
| 1 | Approximately $1,800/month | Approximately $2,050/month |
| 2 | Approximately $2,450/month | Approximately $2,790/month |
| 3 | Approximately $3,080/month | Approximately $3,510/month |
| 4 | Approximately $3,720/month | Approximately $4,240/month |
| 5 | Approximately $4,360/month | Approximately $4,960/month |
Note: These are approximate figures. Exact thresholds are updated annually when new Federal Poverty Level guidelines are published. The numbers shown reflect estimates based on recent FPL data. Contact DPHHS or use our free screener for a personalized check.
Seniors and People with Disabilities (Aged, Blind, and Disabled Category)
For seniors aged 65 and older and individuals with disabilities, Montana uses different income and asset rules:
- Single applicant: Approximately $994/month income limit with a $2,000 asset limit
- Married couple (both applying): Approximately $1,491/month with a $3,000 asset limit
These limits apply to the Regular Medicaid / Aged, Blind, and Disabled category. Nursing home Medicaid and Home and Community Based Services waivers have their own specific rules. Individuals receiving Supplemental Security Income (SSI) are automatically eligible for Montana Medicaid.
What Documents Do You Need?
Before you start your application, gather the following documents to avoid delays:
- Proof of identity: Driver's license, state ID, passport, or birth certificate
- Social Security numbers for everyone in your household applying for coverage
- Proof of income: Recent pay stubs, W-2 forms, tax returns, self-employment records, or a letter from your employer
- Proof of Montana residency: Utility bill, lease agreement, or other mail showing your Montana address
- Proof of citizenship or immigration status: Birth certificate, U.S. passport, or immigration documents
- Information about current health insurance (if any)
- Information about other benefits you currently receive (such as SNAP, TANF, or SSI)
- Rent, mortgage, and utility payment amounts (may be requested)
If you do not have all documents available when you apply, submit your application anyway. DPHHS will let you know if anything else is needed.
How to Apply for Medicaid in Montana: Step by Step
Montana offers several ways to apply for Medicaid. You can apply at any time during the year since there is no limited enrollment period for Medicaid.
Step 1: Choose Your Application Method
You have four options:
- Apply online at apply.mt.gov (recommended for fastest processing)
- Apply through HealthCare.gov (the federal Health Insurance Marketplace)
- Apply in person at a local Office of Public Assistance
- Apply by phone by calling the DPHHS helpline at 1-888-706-1535
Step 2: Create an Account (Online Applications)
If applying through apply.mt.gov:
- Visit apply.mt.gov and select the option to create a new account
- Provide your name, email address, and create a password
- Verify your email and log in to begin your application
If applying through HealthCare.gov:
- Visit HealthCare.gov and create a Marketplace account
- Complete the application with your household and income information
- If you appear to qualify for Medicaid, your information will be forwarded to Montana DPHHS automatically
Step 3: Complete the Application
Whether online or on paper, you will need to provide:
- Personal details for each household member (name, date of birth, Social Security number)
- Household income information
- Current employment details
- Any existing health coverage
- Information about your living situation
Be as accurate as possible. Providing incorrect information can delay your application or result in a denial.
Step 4: Submit Required Documentation
Upload or mail copies of your supporting documents. The online portal at apply.mt.gov allows you to upload documents digitally, which speeds up the process.
Step 5: Wait for a Decision
Montana DPHHS will review your application and make an eligibility determination. Federal rules generally require states to process Medicaid applications within 45 days (or 90 days for disability-related applications). You will receive a notice by mail with the decision.
Step 6: If Approved, Choose a Health Plan
Once approved, you may need to select a managed care plan or primary care provider depending on the coverage category. DPHHS will send you information about your options and your Medicaid card.
What Does Montana Medicaid Cover?
Montana Medicaid covers a comprehensive range of health services, including:
- Doctor and specialist visits
- Hospital inpatient and outpatient care
- Prescription medications
- Mental health and substance use disorder treatment
- Preventive care and screenings
- Laboratory and X-ray services
- Dental care (for children; limited for adults)
- Vision care
- Durable medical equipment
- Home health services
- Nursing home care (for those who qualify)
- Transportation to medical appointments
Children enrolled through Medicaid or the Healthy Montana Kids (CHIP) program receive additional benefits including dental, vision, and hearing services.
Applying In Person: Office of Public Assistance Locations
Montana has Offices of Public Assistance throughout the state where you can apply in person, ask questions, or get help with your application. Major locations include offices in Billings, Missoula, Great Falls, Helena, Butte, Bozeman, Kalispell, and other communities. To find the office nearest you, visit the DPHHS Office of Public Assistance directory.
You can also get free help from certified application counselors and navigators who can walk you through the process at no cost.
What to Do If Your Application Is Denied
If your Medicaid application is denied, you have the right to appeal. Here is what to do:
- Read the denial notice carefully. It will explain why you were denied and the deadline to appeal.
- Request a fair hearing within 90 days of the denial by contacting DPHHS.
- Gather additional documentation that supports your eligibility.
- Attend the hearing and present your case. You may bring a representative or advocate.
Common reasons for denial include income that exceeds the limits, missing documentation, or failure to respond to requests for information. In many cases, providing the missing information can resolve the issue.
If you are not eligible for Medicaid, you may still qualify for subsidized health insurance through the federal Marketplace at HealthCare.gov, or for other assistance programs. Use our free benefits screener to explore your options.
How to Renew Montana Medicaid
Montana reviews your Medicaid eligibility periodically, typically once a year. DPHHS will contact you by mail when it is time to renew. To keep your coverage:
- Respond promptly to any renewal notices
- Update your contact information with DPHHS if you move
- Report changes in income, household size, or living situation as they happen
- Complete the renewal process online at apply.mt.gov or by returning the form by mail
Failing to complete the renewal process on time can result in losing your coverage, even if you are still eligible.
Important Notes About Montana Medicaid Expansion
Montana first expanded Medicaid in 2016 under a federal waiver, extending coverage to adults with incomes up to 138% of the Federal Poverty Level. The expansion program has been reauthorized by the state legislature multiple times. As of early 2026, over 200,000 Montanans were enrolled in Medicaid and CHIP combined.
Because Medicaid expansion in Montana has historically required periodic legislative reauthorization, eligibility rules for the expansion population may be subject to change. Check with DPHHS or visit apply.mt.gov for the most current information on program availability and eligibility requirements.
Frequently Asked Questions
Can I apply for Montana Medicaid at any time?
Yes. Unlike private health insurance through the Marketplace, Medicaid has no open enrollment period. You can apply any time during the year.
How long does it take to get approved?
DPHHS typically processes applications within 45 days. Applications involving a disability determination may take up to 90 days. Applying online and submitting all documents promptly can speed up the process.
Can I apply if I already have insurance through my employer?
Yes. You can apply for Medicaid even if you have employer-sponsored insurance. If you qualify, Medicaid may cover costs that your employer plan does not, or you may choose to switch to Medicaid coverage.
What is Healthy Montana Kids (HMK)?
Healthy Montana Kids is Montana's Children's Health Insurance Program (CHIP). It provides free or low-cost health coverage for children under 19 whose families earn too much to qualify for Medicaid but cannot afford private insurance. You can apply through the same process at apply.mt.gov.
Do I need to be a U.S. citizen to apply?
You must be a U.S. citizen or a qualified immigrant to receive full Medicaid benefits. Some emergency Medicaid services may be available regardless of immigration status. Lawfully present immigrants may qualify after meeting specific residency requirements.
What happens if my income changes after I am approved?
You are required to report changes in income to DPHHS. If your income increases above the eligibility limit, you may lose Medicaid coverage but could qualify for subsidized Marketplace insurance. If your income decreases, you may qualify for additional benefits.
Is there a cost for Montana Medicaid?
Most Medicaid recipients in Montana pay no premiums or copays for covered services. Some eligibility categories may have small copayments for certain services, but no one can be denied care for inability to pay a copay.
Where can I get help with my application?
You can get free assistance from your local Office of Public Assistance, call the DPHHS helpline at 1-888-706-1535, or visit apply.mt.gov for online help. Community health centers and nonprofit organizations across Montana also offer free application assistance.
Next Steps
Applying for Medicaid in Montana does not have to be complicated. Start by gathering your documents, then visit apply.mt.gov to submit your application online. If you want to check whether you might qualify for Medicaid and other benefit programs before applying, try our free eligibility screener to get a quick estimate based on your situation.
For a complete overview of all benefits available to Montana residents, visit our Montana Benefits Overview page.
