Medicare plans in Montana offer a range of coverage options. Whether you want basic coverage through original Medicare or a more comprehensive Medicare Advantage plan, Medicare Montana provides access to healthcare services in the state.
Medicare Montana is a health insurance program funded by the government. It provides healthcare coverage for people age of 65 and older and those who have certain chronic illnesses or a disability.
There are several parts in Medicare, and understanding these parts will help you choose the right Medicare plan in Montana.
Original Medicare is the basic insurance coverage program. It’s broken into two parts: Part A and Part B.
Part A, or hospital insurance, is premium-free for individuals who qualify for Social Security benefits. Part A covers:
- inpatient hospital care
- hospice care
- limited coverage for skilled nursing facility care
- some part-time home healthcare services
Part B, or medical insurance, covers:
- outpatient hospital care and surgeries
- health screenings for diabetes, heart disease, and cancer
- blood work
- most physician visits
- ambulance services
Medicare Advantage (Part C) and Medicare Part D
Medicare Advantage (Part C) plans are offered through private insurance companies rather than federal agencies. This means you’ll have a lot more options in terms of services covered and premium fees.
Medicare Advantage plans in Montana cover:
- all hospital and medical services covered by original Medicare parts A and B
- select prescription drug coverage
- dental, vision, and hearing care
- fitness memberships
- some transportation services
Medicare Part D prescription drug plans provide coverage to lower your out-of-pocket prescription drug costs. There are a variety of drug plans, each covering different medications. These plans can be added to your original Medicare coverage. Part D will also cover the cost of most vaccines.
Choosing the right coverage based on your healthcare needs may lead you to opt for original Medicare plus Part D coverage, or you may want to explore your Medicare Advantage plan options in Montana.
Advantage plans are provided by a number of health insurance carriers that vary based on your location. These plans are tailored to meet the healthcare needs of the area, so be sure you’re searching for plans available in your county. These are the health insurance providers in Montana:
- Blue Cross and Blue Shield of Montana
- Lasso Healthcare
- PacificSource Medicare
Each of these private health insurance carriers have several plans to choose from, with several premium levels, so check both the premium fees and the list of covered healthcare services when comparing plans.
Medicare plans in Montana benefit people when they turn 65 years old and those with certain chronic conditions or a disability. Many individuals are automatically enrolled in Medicare Part A through Social Security.
At age 65, you can also elect to enroll in Part B, Part D, or a Medicare Advantage plan. To be eligible for Medicare plans in Montana you must be:
- age 65 or older
- a permanent resident of Montana
- a U.S. citizen
Adults under 65 may also qualify for Medicare coverage. If you have a disability or a chronic illness such as amyotrophic lateral sclerosis (ALS) or end stage renal disease (ESRD), you may qualify for Medicare. Also, if you’ve been receiving Social Security Disability Insurance benefits for 24 months, you’ll qualify for Medicare in Montana as well.
Whether or not you were automatically enrolled in Medicare Part A, you’ll qualify for an initial enrollment period (IEP) when you turn age 65. You can begin the enrollment process 3 months before your birthday, and the IEP will extend another 3 months after your birthday. However, if you enroll after your birthday, coverage start dates will be delayed.
During your IEP, you can enroll in Part B, Part D, or a Medicare Advantage plan. If you don’t enroll in Part D during your IEP, you’ll have to pay a late enrollment penalty on your Part D premium in the future.
You can enroll in Medicare Advantage plans in Montana or a Part B plan during the Medicare open enrollment period from October 15 to December 7 each year. During this period, you can make changes to your healthcare coverage. You’ll be able to:
- enroll in a Medicare Advantage plan if you already have original Medicare
- enroll in a prescription drug plan
- disenroll from a Medicare Advantage plan and return to original Medicare
- switch between Medicare Advantage plans in Montana
- switch between drug plans
Medicare plans change every year, so you may want to reevaluate your coverage from time to time. In the Medicare Advantage open enrollment period from January 1 to March 31, you can make one change to your coverage including:
- switching from one Medicare Advantage plan to another
- disenrolling from a Medicare Advantage plan and returning to original Medicare
If you’ve recently lost employer coverage, moved out of the coverage area, or qualified for Medicare Montana due to a disability, you can apply for a special enrollment period to apply for Medicare or make changes to your coverage.
There’s a lot to consider when comparing Medicare plans in Montana, but with a bit of time and research, you can feel confident in your decision. Here are few tips to help you choose a plan that meets your needs:
- Write down all your healthcare needs. Are these needs covered by original Medicare? If not, look for Medicare Advantage plans in Montana that provide the coverage you need, and are still within your budget.
- Write down all your medications. Each drug plan and Advantage plan covers different medications, so make sure you find a plan that will offer appropriate prescription drug coverage.
- Know to which insurance network your doctor belongs. Each private insurance carrier works with in-network providers, so make sure your doctor is approved by the plan you’re considering.
You can find out more about Medicare Montana, or access additional resources, by contacting:
Medicare (800-633-4227). You can call Medicare for more information about plans offered, and for more tips on comparing Advantage Plans in your county.
Montana Department of Public Health and Human Services, Senior and Long-Term Care Division (406-444-4077). Find information about the SHIP assistance program, community services, and home care options.
Commissioner of Securities and Insurance (800-332-6148). Get Medicare support, find out more about enrollment periods, or receive in-person assistance.
As you research your plan options, carefully evaluate your current healthcare needs and budget to make sure the plans you’re considering will maintain or improve your quality of life.
- Be sure the plans you’re comparing are all offered in your county and zip code.
- Read the CMS star ratings of the plans you’re considering. Plans with a 4- or 5-star rating have been rated as great plans.
- Call the Advantage plan provider or access their website for more information.
- Begin the application process over the phone or online.
This article was updated on November 20, 2020, to reflect 2021 Medicare information.
The information on this website may assist you in making personal decisions about insurance, but it is not intended to provide advice regarding the purchase or use of any insurance or insurance products. Healthline Media does not transact the business of insurance in any manner and is not licensed as an insurance company or producer in any U.S. jurisdiction. Healthline Media does not recommend or endorse any third parties that may transact the business of insurance.