Plan First Plan First Plan First is a Montana Medicaid Waiver that covers family planning services for eligible women. Some of the services covered include office visits, contraceptive supplies, laboratory services, and testing and treatment of STDs. June 2014 Medicaid 1115 Plan First Family Planning Waiver Renewal Submission December 2016 Medicaid 1115 Plan First Family Planning Waiver Renewal Submission December 2017 Medicaid 1115 Plan First Family Planning Waiver Revised Extension/Renewal Submission May 2018 Medicaid 1115 Plan First Family Planning Waiver Revised Extension/Renewal Submission: Repeat of Public Notice Period General Eligibility Criteria Montana Resident Female 19 through 44 Able to bear children and not presently pregnant Annual household income up to and including 211% Federal Poverty Level Plan First Public Input Forum Public Input Forum Announcement – December 12, 2018 Public Input Forum Agenda – December 12, 2018 Public Input Forum Handout – December 12, 2018 Plan First 2017 Annual Report and Budget Neutrality Plan First 2017 Annual Report Plan First 2017 Budget Neutrality Plan First Current Special Terms and Conditions from CMS 2018 Plan First Income Guidelines Family Size Yearly Family Income 1 $25,615 2 $34,731 3 $43,846 4 $52,961 5 $62,076 6 $71,191 7 $80,307 Acceptable Identity and Citizenship Documents Documents and Resources Plan First Application (Preferred method is the online application) Plan First Info Tips On Application Completion Covered Code List Plan First Provider and Covered Services Information How to Apply: The easiest way is to Apply Online. For more information: Plan First Brochure 1-855-854-1399 In-State Toll Free 1-406-444-6446 Out-of- State and Helena Area Email: planfirst@mt.gov