Section 1115 Waiver for Additional Services and Populations (WASP)
(Formerly Basic Medicaid Waiver)

State Medicaid programs may request from the Centers for Medicare and Medicaid Services (CMS) a waiver(s) of certain federal Medicaid requirements that are found in the Social Security Act. A common public misconception is that any portion of the Medicaid program can be waived by CMS. In reality, only certain requirements can be waived.

The WASP was extended by CMS in 2023 and is now effective January 1, 2023 through December 31, 2027. Individuals are no longer eligible if they are no longer Montana residents or become otherwise eligible for Medicaid.

WASP Populations Covered


Individuals age 18 or older, with Severe Disabling Mental Illness (SDMI) who qualify for or are enrolled in the state-funded Mental Health Services Plan (MHSP), but are otherwise ineligible for Medicaid benefits and either:

  • Have income 0-138% of the Federal Poverty Level (FPL) and are eligible for or enrolled in Medicare; or
  • Have income 139-150% of the FPL regardless of Medicare status (they can be covered or not covered by Medicare and be eligible).

Individuals will remain enrolled if, at the time of redetermination, they meet the same eligibility qualifications.

Benefit:  Qualified individuals are offered Standard Medicaid benefits and 12-months of continuous eligibility without reporting monthly changes of income or resources.


Non-expansion Medicaid-covered individuals whose eligibility is based on Modified Adjusted Gross Income (MAGI), also referred to as Parent/Caretaker Relatives (PCR).

Benefit:  Qualified individuals are offered 12-months of continuous eligibility, subject to the exception explained below:

The 2021 Montana Legislature passed a budget that removed this funding for 12-month continuous eligibility for most adults on Montana Healthcare Programs and directed DPHHS to end the policy. This change included the adult PCR population of the WASP. The removal of funding was postponed at the onset of the Public Health Emergency (PHE) that began in March of 2020.

Following Federal guidance released in the December 2022 Omnibus Bill, continuous enrollment flexibilities were decoupled from the PHE declaration. In response, DPHHS resumed scheduled processing of annual redeterminations and changes in Montana Healthcare Programs members’ circumstances and adjusting members’ coverage as appropriate on April 1, 2023. DPHHS is now, one-by-one, redetermining all cases over a 10-month period that began in April, 2023.  Members do not need to take action (other than updating their contact information or if they have an income change to report) until they receive a notice from DPHHS.

Once a WASP PCR member is redetermined eligible for Medicaid benefits, the health care benefits will continue, but without the additional benefit of 12-month continuous eligibility. This single benefit is the only benefit offered to the PCR population under WASP. After an individual has completed the redetermination process during the afore mentioned 10-month period, the individual is no longer on the WASP.


Individuals determined categorically eligible for Medicaid in the Aged, Blind, or Disabled (ABD) category.

Individuals will remain enrolled if, at the time of redetermination, they meet the same eligibility qualifications.

Benefit:  Dental treatment services above the $1,125 State Plan dental treatment cap. 

In the past, this Waiver has also been called Health Insurance Flexibility and Accountability Waiver (HIFA) or MHSP Waiver. See the boxes at the right for past or future proposed changes to the WASP.

Montana Medicaid and Healthy Montana Kids Plus Member Guide – Benefit Coverage

The Montana Medicaid Member Guide is a great place to see the general services for Standard Medicaid benefits. The chart of benefits in the guide shows most covered services. In general and if medically necessary, benefits like doctor, clinic, inpatient/outpatient hospital, prescription drugs, family planning, home health services, hospice, nursing home, lab, mental health services, OB, OT, PT, ST, social worker, substance dependency non hospital outpatient, surgery, and non-emergency transportation (to list a few examples), are covered for Standard Medicaid benefits. See the Montana Medicaid and Healthy Montana Kids Plus Member Guide for more information.

Contact Information

Please direct any eligibility or benefit questions regarding individuals who qualify for the MHSP Waiver population in the WASP to:

Tracey Palmerton
DPHHS, Behavioral Health and Developmental Disorders Division
PO Box 202905
Helena, Montana 59620-2905
(406) 444-3187 or at 

Please direct any questions or comments about the WASP to:

Bridget Evans
DPHHS, Health Resources Division
PO Box 202951
Helena, Montana 59620-2951
(406) 444-9289 or at