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Montana Health Insurance

The Patient Protection and Affordable Care Act went into effect in March 2010, and changes have been slowly rolling out to alter the way health insurance operates in the U.S.

As of the beginning of 2014, most of the act’s laws are in effect, including the individual insurance mandate that requires people to have individual insurance or get health insurance through an employer. In addition, insurers must offer policies within certain tiers, standardizing insurance between companies. Insurance companies must place reasonable limits on out-of-pocket spending for customers, and they are not able to deny coverage to customers based on pre-existing conditions.

Feedback has been mixed, and some states have had greater success in implementing the necessary changes than others.

According to an August 2013 report in the Missoulian, Obamacare health insurance premium costs in Montana remained similar to premium costs before the law was implemented, but many health plans would be cheaper once tax subsidies were factored in.

What is a health insurance marketplace?

Because all individuals are required to obtain health insurance, the government has taken steps to make shopping for and purchasing policies simpler. Now, individuals can shop for policies through a health insurance marketplace, an exchange where policies can be easily compared and reviewed. Every state was given the opportunity to establish its own insurance exchange or partner with the federal site to sell policies. In December 2012, state officials announced Montana would be one of 27 states to not establish its own exchange.

All Montana residents seeking ACA-compliant plans must purchase their health insurance through the federal site at HealthCare.gov.

To use the exchange, you’ll need to establish an account on the website and fill out a few questions about your family, income and lifestyle. From there, you’ll be matched with available plans in your area that suit your budget and needs.

Do I qualify for a Montana health insurance subsidy?

If you buy a Montana health insurance policy from the exchange, you may qualify for a tax subsidy to reduce the cost of your premiums. This subsidy is available to individuals and families with incomes between 100 and 400 percent of the federal poverty line.

This amounts to between $23,550 and $94,200 for a family of four and between $11,490 and $45,960 for an individual. The amount of the subsidy will depend on your income. At higher income levels, your subsidy amount will be lower, and you may not be eligible if your employer offers coverage.

Health insurance companies participating in Montana

The following insurers are available to Montana residents seeking coverage.

Blue Cross and Blue Shield of Montana
Montana Health Co-Op
PacificSource Health Plans

Health care for low-income families

Some states chose to expand Medicaid to provide insurance to low-income individuals. Montana, however, opted not to participate in this expansion, although this decision may be reversed with future legislation.

At present, Medicaid is available only to children in low-income families. Children whose families earn less than $1,369 per month are eligible for Medicaid. Infants can be eligible with monthly family incomes below $1,522.

Additionally, the Children’s Health Insurance Program in Montana, known as Healthy Kids, provides health care to children whose families earn less than $2,499 monthly.

Montana health and coverage statistics

Montana population (2013): 1,015,165
Population 65 and older (2012): 15.7 percent
Life expectancy (2010): 78.5 years
Number of Medicaid beneficiaries (2012): 125,100
Number of Medicare beneficiaries (2012): 173,200
Estimated number of uninsured residents (2012): 180,900

Overall state health ranking: 23

Sources: Kaiser Family Foundation, U.S. Census Bureau, America’s Health Rankings 2014 report.