HELP Medicaid Plan, also known as Medicaid Expansion, Premiums
Effective January 1, 2018, the HELP Medicaid plan, also known as Medicaid Expansion, including premiums will be administered by DPHHS.
Will I still have to pay a monthly premium?
You are still responsible for your monthly premium and may be disenrolled from the HELP/Medicaid Expansion 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.
HELP/Medicaid Expansion 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/Medicaid Expansion Plan coverage. You will remain in the HELP/Medicaid Expansion 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/Medicaid Expansion 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 Community Based Wellness Program administered by Chronic Disease Prevention and Health Promotion. See the Community Based Wellness Programs for a list of approved programs or call (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/Medicaid Expansion Plan. You will still be responsible for payment of your premiums.
If you are disenrolled because you have unpaid (delinquent) premiums, you may re-enroll in the HELP/Medicaid Expansion 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 Helpline at (888) 706-1535 or 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 (866) 471-9621.