Montana Medicaid Application Guide: Complete Coverage Information

Montana Medicaid provides healthcare coverage for eligible low-income Montana residents through the state's expanded Medicaid program. Montana Medicaid and HMK Plus are healthcare benefits for eligible low-income Montanans. The program includes traditional Medicaid and Montana's expansion population under the HELP Plan, which extends coverage to adults with incomes up to 138% of the Federal Poverty Level.

Eligible individuals include low-income families, pregnant women, children, seniors, and adults without dependent children who meet income requirements. The Montana Department of Health and Human Services (DPHHS) has extended coverage to postpartum women. This change will now allow postpartum women enrolled in Montana's Medicaid and Healthy Montana Kids Programs to be eligible for 12-month continuous coverage. Medicaid also covers individuals with disabilities and those requiring long-term care services.

Montana Medicaid covers essential health benefits including doctor visits, hospital stays, prescription medications, preventive care, mental health services, and substance abuse treatment. Passport is the primary care case management (PCCM) program for Montana Medicaid and HMK Plus members. The Passport programs support Medicaid and HMK Plus members, as well as providers, to establish a strong doctor/patient relationship and ensure the appropriate use of services. The program also includes specialized waiver services for individuals needing long-term care in community settings.

Applicants should be prepared to provide comprehensive documentation of income, household composition, and citizenship status. Contact the Offices of Public Assistance (OPA) for questions about applications and/or eligibility at 1-888-706-1535 The application process typically takes 15-45 business days, and coverage can begin up to three months prior to the application date if eligible. Be sure to report any changes in circumstances within 10 days to maintain continuous coverage.