For Immediate Release
Montana Medicaid Community Engagement Requirements Begin July 1
Contact:
- DPHHS: Jon Ebelt, Communications Director, (406) 444-0936, (406) 461-3757, jebelt@mt.gov
HELENA, MT — Department of Public Health and Human Services (DPHHS) Director Charlie Brereton today reminded Montanans that new Medicaid Expansion community engagement requirements will take effect July 1, 2026.
Beginning tomorrow, most Medicaid Expansion members aged 19-64 who are not excluded must complete and document at least 80 hours of qualifying community engagement activities each month, which will be reviewed at their next redetermination to maintain coverage.
“The Department is fully prepared for this transition, with trained staff, clear exemption processes, and systems ready to support members,” said Dir. Brereton. “We are focused on helping eligible Montanans keep their coverage while successfully meeting these new requirements.”
This launch of these new requirements follows the Montana Legislature’s reauthorization of the state’s Medicaid Expansion program and the implementation of federal mandates under H.R. 1, enacted on July 4, 2025.
In September 2025, Gov. Gianforte and DPHHS announced the State of Montana had submitted a 1115 Medicaid Demonstration waiver application to the Centers for Medicare and Medicaid Services (CMS) to strengthen its Medicaid program. Following CMS direction, DPHHS converted its waiver application into a State Plan Amendment.
DPHHS maintains a Changes to Medicaid website that provides clear, up-to-date information about the community engagement requirements, qualifying activities, and exclusions.
“Montana has made a strong, sustained commitment to implementing community engagement requirements, and we are proud to be among the first states to move forward in close partnership with CMS,” Dir. Brereton said.
DPHHS officials note that these requirements for able-bodied adults are intended to promote self-sufficiency, increase workforce participation, and ensure responsible use of public resources, while preserving coverage for those who qualify. The Changes to Medicaid website will remain a primary resource for members, providers, and community partners seeking current information and tools.
Key Requirements Effective July 1
Under federal law, non-excluded adults ages 19-64 covered through Montana’s Medicaid Expansion program must complete 80 hours of qualifying community engagement activities each month to remain eligible for health coverage.
Qualifying activities include:
- Working at a job
- Community service or volunteering
- Workforce training or job readiness programs through the State of Montana’s Department of Labor and Industry (DLI)
- Going to school
Excluded Populations
Some individuals are not required to meet the community engagement requirement and are considered “excluded”.
Exclusions include:
- American Indian/Alaska Native
- Caregivers for children under age 14 or persons with disabilities
- Children aged 18 or younger
- Former foster youth under age 26
- Inmates of a public institution or incarcerated in the last three months
- People with a medical condition or health needs that impact their ability to work or do other community engagement activities
- People who meet TANF work requirements, or receive SNAP and are subject to SNAP work requirements
- People in a drug or alcohol treatment program
- Women who are pregnant or postpartum (up to 12 months)
- People eligible for Medicare
- Veterans with a total disability rating
A full list of exclusions and documentation requirements is available at medicaidchanges.mt.gov.
Next Steps for Members and Stakeholders
Since March, DPHHS has been conducting direct mail outreach to all affected Medicaid members to explain the new requirements and available supports.
Members should log in to apply.mt.gov as soon as possible to verify their contact information and make any changes. Officials say keeping information up to date is essential to maintaining coverage.
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