If you live in Montana and need health insurance, the Affordable Care Act (ACA) offers two main pathways to coverage in 2026: Medicaid for lower-income residents and subsidized Marketplace plans through HealthCare.gov for those with moderate incomes. Understanding which program fits your situation starts with knowing the income limits and eligibility rules that apply this year.
Montana has some good news heading into 2026. Governor Greg Gianforte signed House Bill 245 in March 2025, permanently lifting the sunset on Medicaid expansion in the state. That means roughly 76,000 Montanans who depend on expansion coverage can keep their insurance without worrying about another legislative deadline. For people shopping on the Marketplace, however, the picture has changed: the enhanced premium subsidies that were in place from 2021 through 2025 have expired, bringing back the 400% federal poverty level (FPL) income cap for subsidy eligibility.
This guide covers everything you need to know about Montana ACA eligibility in 2026, including current income thresholds, how subsidies work under the original ACA rules, and exactly how to apply.
Understanding Your Two Coverage Pathways
Montana residents looking for affordable health coverage through the ACA generally fall into one of two categories:
Montana Medicaid covers adults with household incomes up to 138% of the federal poverty level. Because Montana expanded Medicaid, there is no coverage gap for low-income adults. If your income falls below the Medicaid threshold, you will be directed to Medicaid rather than Marketplace coverage.
ACA Marketplace plans through HealthCare.gov are available to Montanans with incomes between 100% and 400% of FPL who want premium tax credits (subsidies). Three private insurance companies offer plans in Montana's Marketplace for 2026. Even without subsidies, anyone who is not incarcerated, lives in Montana, and is lawfully present in the U.S. can purchase a Marketplace plan.
Not sure which path is right for you? Check your eligibility in minutes with our free screening tool.
2026 Income Limits for Montana ACA Programs
All ACA eligibility is based on the 2026 Federal Poverty Level guidelines, published by the Department of Health and Human Services in January 2026. Here are the key income thresholds for Montana residents:
Montana Medicaid Income Limits (Up to 138% FPL)
| Household Size | Annual Income Limit | Monthly Income Limit |
|---|---|---|
| 1 | $22,025 | $1,835 |
| 2 | $29,863 | $2,489 |
| 3 | $37,702 | $3,142 |
| 4 | $45,540 | $3,795 |
| 5 | $53,378 | $4,448 |
| 6 | $61,217 | $5,101 |
If your income falls at or below these amounts, you likely qualify for Montana Medicaid. You can apply year-round through apply.mt.gov or by visiting your local Office of Public Assistance.
ACA Premium Subsidy Income Limits (100% to 400% FPL)
To qualify for premium tax credits on a Marketplace plan in 2026, your household income must be between 100% and 400% of FPL. Here are the upper limits (400% FPL) by household size:
| Household Size | Minimum Income (100% FPL) | Maximum for Subsidies (400% FPL) |
|---|---|---|
| 1 | $15,960 | $63,840 |
| 2 | $21,640 | $86,560 |
| 3 | $27,320 | $109,280 |
| 4 | $33,000 | $132,000 |
| 5 | $38,680 | $154,720 |
| 6 | $44,360 | $177,440 |
If your income exceeds 400% FPL, you can still buy a Marketplace plan, but you will pay the full premium with no federal subsidy. This is the so-called "subsidy cliff" that returned in 2026 after the enhanced subsidies expired at the end of 2025.
How Premium Subsidies Work in 2026
Premium tax credits (also called Advance Premium Tax Credits or APTC) reduce your monthly health insurance premium. The amount you receive depends on your income relative to the federal poverty level.
In 2026, the government expects you to pay a certain percentage of your income toward the cost of the second-lowest-cost Silver plan in your area. Your subsidy covers the difference. Here is the expected contribution schedule for 2026:
| Income Level (% of FPL) | Expected Premium Contribution (% of Income) |
|---|---|
| Below 133% FPL | 2.1% of income |
| 133% to 150% FPL | 3.14% to 4.19% of income |
| 150% to 200% FPL | 4.19% to 6.6% of income |
| 200% to 250% FPL | 6.6% to 8.44% of income |
| 250% to 300% FPL | 8.44% to 9.96% of income |
| 300% to 400% FPL | 9.96% of income |
| Above 400% FPL | No subsidy available |
These percentages are notably higher than the 2021 through 2025 enhanced rates. For example, a household earning below 150% FPL paid 0% of income toward premiums under the enhanced rules but will now pay between 2.1% and 4.19% in 2026.
Cost-Sharing Reductions
If your household income is between 100% and 250% of FPL, you may also qualify for cost-sharing reductions (CSR). These lower your deductible, copays, and maximum out-of-pocket costs when you choose a Silver-level plan. About one-third of Montana Marketplace enrollees received CSR benefits in recent years.
CSR benefits are only available on Silver plans, so if you qualify, selecting a Silver plan is usually the smartest financial move.
Montana Medicaid Expansion: What Changed
Montana first expanded Medicaid in 2016 under a federal waiver. The program faced a sunset date of June 30, 2025, which created uncertainty for the roughly 76,000 Montanans enrolled through expansion. In March 2025, Governor Gianforte signed House Bill 245, a bipartisan measure that permanently removed the sunset date.
Key facts about Montana Medicaid expansion in 2026:
- Adults aged 19 to 64 with incomes up to 138% FPL are eligible
- Children are eligible for Medicaid with household incomes up to 148% FPL
- Children above that level may qualify for Healthy Montana Kids (CHIP) at higher income thresholds
- Enrollment is open year-round
- The federal government covers 90% of expansion costs, with Montana paying 10%
- Apply online at apply.mt.gov or by calling 1-888-706-1535
For a full overview of all programs available in the state, visit our Montana Benefits Overview page.
Step-by-Step: How to Enroll in Montana ACA Coverage
For Marketplace Plans
Step 1: Gather your information. You will need Social Security numbers for everyone in your household, income documentation (pay stubs, W-2s, or tax returns), and information about any employer-sponsored coverage available to you.
Step 2: Visit HealthCare.gov. Montana uses the federally run Marketplace at HealthCare.gov. Create an account or log in to your existing one.
Step 3: Complete your application. Answer questions about your household size, income, and coverage needs. The system will determine whether you qualify for Medicaid, CHIP, or premium subsidies.
Step 4: Compare plans. Browse available plans from the three insurers operating in Montana's Marketplace for 2026. Compare monthly premiums, deductibles, provider networks, and out-of-pocket maximums.
Step 5: Enroll. Select your plan and confirm enrollment. If you qualify for APTC, your subsidy will be applied automatically to reduce your monthly premium.
Step 6: Pay your first premium. Your coverage begins once you pay your first monthly premium by the due date.
For Montana Medicaid
Step 1: Apply online at apply.mt.gov, or start your application through HealthCare.gov (you will be referred to Montana Medicaid if eligible).
Step 2: Apply by phone by calling 1-888-706-1535, or visit your local Office of Public Assistance in person.
Step 3: Provide required documentation. This includes proof of identity, residency, income, and household composition.
Step 4: Wait for a determination. Montana DPHHS will review your application and notify you of your eligibility status. Medicaid coverage can begin as early as the date of your application.
Getting Free Help
You do not have to navigate this process alone. Free assistance is available through:
- Cover Montana Help Line: 1-844-682-6837
- HealthCare.gov Call Center: 1-800-318-2596 (available 24/7 except holidays)
- Local navigators and certified application counselors: Find one at HealthCare.gov
- Licensed insurance brokers: Can help you enroll at no cost to you
Important Dates for 2026
The enrollment timeline has changed for the upcoming coverage year:
- Year-round: Montana Medicaid and Healthy Montana Kids (CHIP) enrollment is always open
- November 1 to December 15, 2026: Open enrollment for 2027 Marketplace coverage (this window is shorter than in recent years due to a federal rule change)
- Special Enrollment Periods: Available year-round if you experience a qualifying life event such as losing other coverage, getting married, having a baby, or moving to Montana
- American Indians and Alaska Natives: Can enroll in Marketplace plans at any time without a qualifying life event
What If Your Income Changes During the Year?
If your income increases or decreases during 2026, report the change to the Marketplace as soon as possible. This matters because:
- If your income drops below 138% FPL, you may qualify for Medicaid instead of a Marketplace plan
- If your income rises above 400% FPL, you could lose your premium subsidy and owe money when you file taxes
- Keeping your income information current helps you avoid a surprise tax bill or missed benefits
You can update your information at any time by logging into your HealthCare.gov account.
Frequently Asked Questions
Does Montana have Medicaid expansion in 2026?
Yes. Montana permanently extended Medicaid expansion in March 2025 when Governor Gianforte signed House Bill 245. Adults with incomes up to 138% of the federal poverty level ($22,025 per year for an individual in 2026) are eligible.
What is the income limit for ACA subsidies in Montana for 2026?
Your household income must be between 100% and 400% of the federal poverty level to qualify for premium tax credits. For a single person, that range is $15,960 to $63,840 per year. For a family of four, it is $33,000 to $132,000.
Did ACA subsidies change in 2026?
Yes. The enhanced premium subsidies that were available from 2021 through 2025 expired at the end of 2025. In 2026, the original ACA subsidy rules are back in effect, meaning higher expected premium contributions and a hard income cap at 400% FPL. People with incomes above 400% FPL no longer receive any subsidy.
How do I apply for health insurance in Montana?
For Marketplace plans, visit HealthCare.gov during open enrollment or a special enrollment period. For Medicaid, apply year-round at apply.mt.gov or call 1-888-706-1535.
What insurers offer Marketplace plans in Montana for 2026?
Three private insurance companies offer coverage through Montana's ACA Marketplace in 2026. You can compare all available plans and prices at HealthCare.gov by entering your ZIP code.
Can I get both premium subsidies and cost-sharing reductions?
Yes, if your income is between 100% and 250% of FPL and you choose a Silver-level plan. Premium subsidies can be used with any metal level, but cost-sharing reductions are only available on Silver plans.
What happens if I earn too much for Medicaid but cannot afford Marketplace premiums?
Because Montana expanded Medicaid, there is no coverage gap. If you earn more than 138% FPL, you transition to Marketplace coverage, where premium subsidies can help bring costs down. Use our free eligibility screener to see what programs and savings you may qualify for based on your specific situation.
Take the Next Step
Figuring out health insurance eligibility can feel overwhelming, especially with the subsidy changes in 2026. The good news is that Montana residents have strong options through both Medicaid and the ACA Marketplace.
The fastest way to find out what you qualify for is to use our free benefits screening tool. In just a few minutes, you will get a personalized report showing which programs you may be eligible for, including estimated savings amounts. It checks not just health insurance but also SNAP, LIHEAP, and other assistance programs you might be missing.
