Montana Medicaid covers over 290,000 residents across several eligibility categories, each with its own income threshold. Whether you are an adult under 65, a parent, a child, pregnant, or elderly with long-term care needs, the income limit that applies to you depends on your specific category. This guide covers the 2026 income limits for every major Montana Medicaid program, how income is counted, and how to apply.
Montana Medicaid Programs at a Glance
Montana operates multiple Medicaid coverage categories:
- HELP Program (Medicaid expansion for adults 19 to 64)
- Healthy Montana Kids (HMK) (Medicaid for children)
- HMK Plus (CHIP for children above Medicaid limits)
- Pregnant Women's Medicaid
- Traditional Medicaid for parents/caretakers
- Medicaid for Aged, Blind, and Disabled (ABD)
- Long-Term Care Medicaid (nursing home and waiver programs)
Montana expanded Medicaid in 2015 through the HELP Act. The program reached a sunset deadline in 2025, but Governor Greg Gianforte signed House Bill 245 in March 2025, permanently reauthorizing expansion and removing the sunset provision. The HELP Program remains active in 2026.
2026 Income Limits by Category
The tables below show Montana Medicaid income limits based on the 2026 Federal Poverty Level (FPL). The 2026 FPL for a single person is $15,960 per year ($1,330/month).
HELP Program (Adults 19 to 64)
Montana's Medicaid expansion covers adults between ages 19 and 64 with income at or below 138% FPL. There is no asset test for this category.
| Household Size | Monthly Income Limit | Annual Income Limit |
|---|
| 1 | $1,835 | $22,025 |
| 2 | $2,484 | $29,813 |
| 3 | $3,134 | $37,601 |
| 4 | $3,783 | $45,389 |
| 5 | $4,433 | $53,177 |
| 6 | $5,082 | $60,965 |
Limits based on 138% of the 2026 FPL for the 48 contiguous states. Add approximately $649/month for each additional person.
Healthy Montana Kids (HMK) - Children's Medicaid
Children up to age 19 qualify for free Medicaid coverage through Healthy Montana Kids at incomes up to 143% FPL.
| Household Size | Monthly Income Limit | Annual Income Limit |
|---|
| 1 | $1,902 | $22,827 |
| 2 | $2,575 | $30,901 |
| 3 | $3,248 | $38,975 |
| 4 | $3,921 | $47,049 |
| 5 | $4,594 | $55,123 |
| 6 | $5,267 | $63,197 |
Based on 143% FPL.
HMK Plus (CHIP for Children)
Children who exceed the Medicaid threshold may still qualify for HMK Plus (Montana's CHIP program) at reduced-cost coverage up to 261% FPL.
| Household Size | Monthly Income Limit | Annual Income Limit |
|---|
| 1 | $3,470 | $41,637 |
| 2 | $4,699 | $56,387 |
| 3 | $5,928 | $71,138 |
| 4 | $7,158 | $85,888 |
| 5 | $8,387 | $100,638 |
| 6 | $9,616 | $115,389 |
Based on 261% FPL.
Pregnant Women
Pregnant women qualify for Medicaid at income up to approximately 162% FPL. Montana also counts the unborn child as a household member, which raises the effective income threshold.
| Household Size (including unborn child) | Monthly Income Limit | Annual Income Limit |
|---|
| 2 | $2,153 | $25,834 |
| 3 | $2,717 | $32,600 |
| 4 | $3,281 | $39,367 |
| 5 | $3,844 | $46,134 |
| 6 | $4,408 | $52,900 |
Based on 162% FPL. Montana extended postpartum coverage to 12 months in 2023.
Traditional Medicaid for Parents and Caretakers
Parents and caretaker relatives who do not qualify under the expansion program face significantly lower income limits. Montana's traditional parent limit is approximately 25% FPL.
| Household Size | Monthly Income Limit |
|---|
| Family of 3 | approximately $333/month |
This category affects parents who may not qualify for the HELP Program expansion. Most low-income parents qualify through the HELP Program instead.
Medicaid for Aged, Blind, and Disabled (ABD)
Adults 65 and older, blind individuals, and people with disabilities who receive SSI or meet similar criteria.
| Category | Monthly Income Limit |
|---|
| Single | $994/month |
| Married couple | $1,491/month |
Asset limit: $2,000 for individuals, $3,000 for couples.
Long-Term Care Medicaid
Nursing Home Medicaid: Montana does not impose a fixed monthly income cap for nursing home care. Instead, income must be less than the monthly cost of nursing home care. Nearly all income goes toward the cost of care, with a small personal needs allowance retained.
Home and Community Based Services (HCBS) Waivers: For Montanans who need nursing-level care but prefer to remain at home.
| Category | Monthly Income Limit |
|---|
| Single applicant | $994/month |
| Married couple (combined) | $1,988/month |
Asset limit for long-term care programs: $2,000 for single applicants. For married couples where one spouse applies, the non-applicant spouse can retain up to approximately $162,660 (the Community Spouse Resource Allowance for 2026).
Home equity limit: $752,000 for 2026.
How Montana Counts Income
Montana uses Modified Adjusted Gross Income (MAGI) to determine eligibility for most Medicaid categories. MAGI-based income includes:
- Wages, salaries, and self-employment income
- Social Security benefits (for most purposes)
- Unemployment compensation
- Alimony received (if divorce finalized before 2019)
MAGI-based rules do not count:
- Child support received
- Gifts and inheritances
- Tax refunds
- Veterans' disability payments
For ABD Medicaid and long-term care programs, Montana uses the older SSI-based income counting rules rather than MAGI.
Spend-down option: If your income exceeds the limit, Montana offers a Medicaid spend-down pathway. You deduct medical expenses from your income to bring it below the threshold. This applies primarily to the ABD and long-term care categories.
Who Qualifies Without an Income Test
Some Montanans qualify for Medicaid automatically or without standard income verification:
- SSI recipients qualify automatically
- Foster care children up to age 26 qualify regardless of income
- Children aging out of foster care at 18 qualify through a separate pathway
- Individuals receiving adoption assistance may qualify automatically
How to Apply for Montana Medicaid
Montana processes most Medicaid applications through a single online portal.
Step 1: Check your eligibility estimate. Use our free benefits screener to see which Montana programs you likely qualify for before starting the full application.
Step 2: Gather your documents. Before applying, collect:
- Proof of identity (driver's license, passport, or state ID)
- Social Security numbers for all household members
- Proof of Montana residency (utility bill, lease agreement)
- Recent pay stubs or income documentation for the past month
- Bank statements if applying for ABD or long-term care
Step 3: Apply online. Go to apply.mt.gov and complete the Montana Medicaid application. The portal covers Medicaid, CHIP, SNAP, and other assistance programs in one application.
Step 4: Apply by phone or in person. Call the Montana DPHHS helpline at 1-888-706-1535 if you prefer phone assistance. You can also visit your local Office of Public Assistance.
Step 5: Complete any interviews or verification requests. Some cases require a brief phone interview. Respond to any requests for additional documents within the timeframe provided.
Step 6: Receive your determination. Montana aims to process most Medicaid applications within 45 days. Disability-based applications may take up to 90 days.
If approved: Coverage is typically effective the first day of the month you applied. In some cases, retroactive coverage for up to three months prior may apply.
Montana-Specific Rules and Notes
HELP Program 1115 Waiver: As of September 2025, Montana submitted a proposed 1115 Medicaid Demonstration Waiver to the federal Centers for Medicare and Medicaid Services. This waiver would strengthen the existing HELP Program and is pending federal approval.
Work requirements: As of 2026, Montana does not impose active work requirements for Medicaid enrollment.
No estate recovery for HELP enrollees: Unlike some Medicaid categories, the HELP expansion program does not trigger estate recovery for enrollees who die after age 55.
Postpartum coverage: Since 2023, Montana provides 12 months of postpartum Medicaid coverage after delivery, extended from the previous 60-day limit.
CHIP coverage: Healthy Montana Kids Plus covers children not eligible for full Medicaid between 143% and 261% FPL with low-cost premiums and comprehensive benefits.
Montana Medicaid vs. Marketplace Coverage
If your income falls between 100% and 138% FPL, you likely qualify for the HELP Program rather than Marketplace subsidies. If your income exceeds 138% FPL, you may qualify for subsidized Marketplace plans through healthcare.gov.
| Income Range (% FPL) | Coverage Option |
|---|
| 0 to 138% | Montana HELP Program (Medicaid) |
| 138% to 400% | ACA Marketplace subsidies |
| Above 400% | Full-price Marketplace or employer coverage |
Adults between 100% and 400% FPL may also qualify for premium tax credits on the Marketplace.
Check Your Eligibility
The income limits above are a starting point. Actual eligibility depends on your specific household composition, income sources, immigration status, and residency. The fastest way to get a personalized estimate is to use our free benefits screener or apply directly at apply.mt.gov.
For additional Montana-specific program details, visit our Montana benefits guide.
Frequently Asked Questions
What is the income limit for Medicaid in Montana in 2026?
For adults ages 19 to 64 under the HELP expansion program, the income limit is 138% FPL, which equals approximately $1,835 per month for a single person or $2,484 per month for a two-person household. Children qualify up to 143% FPL, and pregnant women qualify up to 162% FPL.
Does Montana have Medicaid expansion in 2026?
Yes. Governor Gianforte signed House Bill 245 in March 2025, permanently reauthorizing Medicaid expansion and removing the previous June 2025 sunset date. The HELP Program continues to cover adults ages 19 to 64 at or below 138% FPL.
How do I apply for Medicaid in Montana?
Apply online at apply.mt.gov, by phone at 1-888-706-1535, or in person at your local Office of Public Assistance. The online portal handles applications for Medicaid, CHIP, SNAP, and other programs together.
Is there an asset limit for Montana Medicaid?
The HELP expansion program for adults 19 to 64 has no asset test. ABD Medicaid and long-term care programs have a $2,000 asset limit for individuals. Married couples applying for long-term care may retain approximately $162,660 for the non-applying spouse.
Can I get Montana Medicaid if I am self-employed?
Yes. Self-employment income is counted under MAGI rules. Montana counts net self-employment income (after business expenses) toward the income limit. Use average monthly income over the prior year if your income fluctuates.
What is the HELP Program in Montana?
The HELP (Health and Economic Livelihood Partnership) Program is Montana's branded name for Medicaid expansion under the Affordable Care Act. It covers adults ages 19 to 64 with income up to 138% FPL and was permanently reauthorized by the legislature in 2025.
What happens if my income is over the Medicaid limit in Montana?
If you exceed the Medicaid income limit, you may qualify for subsidized Marketplace coverage through healthcare.gov. For ABD or long-term care Medicaid, Montana offers a spend-down option where you can deduct medical expenses to bring your countable income below the limit.
How long does Montana Medicaid approval take?
Most standard Medicaid applications are processed within 45 days. Applications based on disability may take up to 90 days. Presumptive eligibility is available for certain categories, providing temporary coverage while the full application is processed.
