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 over the age of 65, and those under 65 who have a chronic illness or 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 care, is premium free for individuals who qualify for social security benefits, and it covers:
- inpatient hospital care
- hospice care
- limited coverage for skilled nursing facility (SNF) care
- some part-time home health care services
Part B, or medical care, covers:
- outpatient hospital care
- some surgeries
- health screenings for diabetes, heart disease, and cancer
- blood work
- most physician visits
- ambulance services
Medicare Montana prescription drug coverage plans, or Part D, are supplementary plans that provide medication 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.
Medicare Advantage plans in Montana, known as Part C, provide the most comprehensive Medicare Montana coverage. These Advantage plans are offered through private insurance companies rather than federal agencies, and 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
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.
Medicare Advantage and Medicare Part D prescription drug plans are subject to change every year. Updated plan information for 2021 should become available on October 1, in advance of Medicare’s Annual Election Period beginning October 15. Healthline.com will provide updated 2021 plan information once it is announced by the Centers for Medicare & Medicaid Services (CMS).
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:
- Health Care Service Corporation
- Sierra Health and Life
- PacificSource Health Plans
- Anthem (Blue Cross Blue Shield)
- Port Holdings
Each of these private health insurance carriers have several plans to choose from, with several premium levels, so when be sure to check both the premium fees and the list of covered healthcare services when comparing plans.
Medicare plans in Montana benefit people over the age of 65 and people with a chronic condition or disability. Many individuals are automatically enrolled in Medicare Part A through Social Security. At 65, you can also elect to enroll in Part B, Part D, or an Advantage plan. To be eligible for Medicare plans in Montana you must:
- be 65 or older
- be a permanent resident of Montana
- be a U.S. citizen
Adults under 65 may also qualify for Medicare coverage. Do you have a disability or a chronic illness such as amyotrophic lateral sclerosis (ALS or Lou Gehrig’s disease), dementia, or multiple sclerosis (MS)? If you’ve been receiving Social Security benefits on the basis of a disability for 24 months, you’ll qualify for Medicare Montana coverage, 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 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 an Advantage plan. Be aware that if you don’t enroll in Part D in the 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 drug plan during the Medicare Open Enrollment Period from October 15 – December 7 each year. During this period, you can make changes to your healthcare coverage and you’ll be able to:
- enroll in a Medicare Advantage plan if you already have original Medicare
- enroll in a prescription drug plan
- dis-enroll from an Advantage plan and return to original Medicare
- switch between Medicare Advantage plans in Montana
- switch between drug plans
Medicare Montana 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 – March 31, you can make one change to your coverage including:
- switching from one Advantage plan to another Advantage plan
- dis-enroll from an Advantage plan and return 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. You can call Medicare for more information about plans offered, and for more tips on comparing Advantage Plans in your county (800-633-4227).
Montana Department of Public Health and Human Services, Senior and Long-Term Care Division. Find information about the SHIP assistance program, community services, and home care options (406-444-4077)
Commissioner of Securities and Insurance. Get Medicare support, find out more about enrollment periods, or receive in-person assistance (800-332-6148).
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.
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 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 does not recommend or endorse any third parties that may transact the business of insurance.