Montana's Healthcare Plan
HELP Plan members will now receive health coverage through Montana Medicaid. You do not need to reapply, your coverage will be transferred automatically.
You will receive a new Montana Medicaid card to use beginning January 1, 2018.
Your card will look like the Montana Medicaid card below.
What about my benefits?
Your benefits will stay the same.
Please see Standard Medicaid for your benefit information.
What about my providers?
You can get health services from any doctor, clinic, or other health care provider who accepts Montana Medicaid. Nearly all of the providers will remain the same and some additional providers will be available to you.
You can find a list of over 11,500 Montana Medicaid providers using the provider finder, or by calling the Medicaid Member Hotline at 1-800-362-8312.
If your provider would like to be added to this list, have them contact Provider Relations at 1-800-624-3958.
Will I still have to pay a monthly premium?
You are still responsible for your monthly premium and may be disenrolled from the HELP Program if you do not pay your premium. It is due on the first of each month and should be submitted to the address below or online.
Montana HELP Program
State of Montana
PO Box 35154
Seattle, WA 98124-5154
If you have premium related questions call 1-866-471-9621.
Premium Rights and Obligations
Even if you cannot pay your premium, you may still be able to keep HELP Plan coverage. You will remain in the HELP Plan if:
A. Your income is under 100% of the FPL, which is approximately $1,005 a month for an individual, or $2,050 a month for a family of four; or
B. If your income is above 100% of the federal poverty level, you may lose your coverage if you fail to pay your premiums. You are still responsible for the payment of your premiums. The unpaid premium balance will be transferred to the State of Montana for collection from your state income tax refund.
Even if you cannot pay your premiums, you may still be able to keep HELP Plan coverage under certain circumstances including:
- You have been discharged from the United States military service within the previous 12 months;
- You are enrolled for credit in any Montana University System unit, a tribal college, or any other accredited college within Montana offering at least an associate degree;
- You see a primary care provider who is part of primary care case management program;
- You are in a substance use treatment program; or
- You are in a DPHHS approved wellness program administered by DPHHS. See the Community Based Wellness Programs for a list of approved programs or call 1-844-684-5848 questions.
If Montana DPHHS determines that you meet two or more of these conditions, you will continue to have access to the health care services covered by the HELP Plan. You will still be responsible for payment of your premiums.
If two of the items above describe you, go to https://apply.mt.gov, call 888-706-1535, or visit any local Office of Public Assistance.
If you are disenrolled because you have unpaid (delinquent) premiums, you may re-enroll in the HELP Plan after:
A. You have paid your unpaid premium balance in full; or
B. You have received notice from the State of Montana that your unpaid premium balance has been assessed against your future state income tax. This assessment occurs once per calendar quarter.
Members that would like to re-enroll should contact the Montana Public Assistance Help Line at 844-792-2460 or https://apply.mt.gov/.
What if I am having my premium automatically deducted?
If your premium is being automatically deducted from your checking or savings account, be sure to go online to update this information in the new payment system. If you haven't signed up for automatic deduction and would like to, you can do so online. If you have questions please call 1-866-471-9621.
Do I still have copayments?
You are still responsible for copayments. There are different copayments for different health services. Your total copayments and premiums are limited to 5% of your total household income on a quarterly basis.
See Montana Medicaid for additional copayment details.
What about Wellness Programs?
Community Based Wellness Programs:
- Montana Living Life Well Program
- Diabetes Self-Management Education
- Asthma Self-Management Education
- Arthritis Foundation Exercise Program
- Walk with Ease Program
- Diabetes Prevention Program
- Montana Tobacco Quit Line
What if I have more questions?
Additional information about Montana Medicaid can be found on the Medicaid page or by calling the Member HELP Line at 1-800-362-8312.