Montana Medicaid Statistics

Enrollment

  • From 2006 to 2007, 20 percent of women with low income were enrolled in Montana Medicaid.
  • In 2011, 128,000 individuals were enrolled in Montana Medicaid.

Costs Covered

  • Total Medicaid spending for Montana in 2012 was almost $8 billion.
  • In 2012, almost $180,000 Montana Medicaid spending went toward home health and personal care.
  • 36% of Medicaid spending for Montana in 2011 went toward individuals with disabilities.
  • 13% of Medicaid spending for Montana in 2011 went toward seniors over the age of 65.

CHIP

  • In October 2014, 100,111 children were enrolled in Montana Medicaid and CHIP.

Medicaid Expansion

  • An estimated 55,000 Montana residents are without insurance or access to Medicaid.
  1. What is Medicaid?

Medicaid is the largest healthcare programs in the United States, with coverage and medical services to more than 68 million low-income individuals and families. Funded by both federal and state governments, the program provides everything from preventive services to emergency care. Eligibility depends on numerous factors, ranging from one’s low income to their household size.

The Children’s Health Insurance Program (CHIP) offers various services and healthcare benefits to eligible children under the age of 19. In some instances, pregnant women and parents or caretakers of these children may also qualify for the program. As part of CHIP, some of the covered services include the following: routine checkups, doctor visits, immunization shots, dental care, vision examinations, mental health services and so much more. Basic dental coverage for children includes teeth restoration, dental health maintenance, pain relief and infections relief.

In 2014, the Affordable Care Act allowed Medicaid to expand its coverage to 28 states across the country. However, with those states that have chosen not to provide additional Medicaid access and benefits coverage, thousands of residents have fallen in the “coverage gap” as a result. In other words, many are currently left uninsured and without medical assistance.

  • How do I apply for Medicaid in Montana?

You can apply for MT Medicaid through the Montana official state government website. While on the page, you can start filling out a new application by following the proper guidelines which explain how to apply for Medicaid. Keep in mind that prior to applying you will need to have these documents at hand: proof of your current income, proof of your regular expenses, proof of your financial situation, proof of your identity, proof of your Social Security Number, proof of pregnancy (if applicable), and proof of your residency in Montana. If you do not have these bits of information available, your Montana Medicaid application process may be delayed.

Should you feel more comfortable submitting your MT Medicaid application by mail, you can do so by writing to the address below:

Montana Department of Public Health
and Human Services-Division of Child and Adult Health Resources
1400 Broadway, Cogswell Building
PO Box 8005
Helena, MT 59604-8005

You can also speak to a Montana Medicaid representative over the phone by calling 1-800-362-8312. They will be able to guide you step-by-step throughout the process, along with providing you some helpful resources. If you meet the eligibility requirements, a Medicaid application can be sent to you in the mail. You can hand the application in person, use it as a draft for your submission online or mail it to the aforementioned address.

  • What does Montana Medicaid cover?

Montana Medicaid covers essential medical services, emergency care needs and everything in between. Depending on what type of plan you have – basic Medicaid or full Medicaid – these services may vary. Fortunately, you can always consult a Montana Medicaid handbook for further information.

Generally speaking, Montana Medicaid provides services and benefits that include the following: kidney dialysis, prescription drugs, doctor visits, clinic services, birth control pills, birth control services, hospice, inpatient hospital services, outpatient hospital services, laboratory testing, X-ray testing, hearing exams (if required for employment), physical therapy, immunizations, social work services, obstetric services, nursing home services, occupational therapy, urgent care, surgery, and substance treatment for alcohol and drug dependency in a non-hospital outpatient setting.

You can also take advantage of preventive services by discussing with your doctor about getting routine checkups that look at your cholesterol, blood pressure, heartbeat and other vitals.

Children who qualify may enroll in the Children’s Health Insurance Program (CHIP), which provides a number of medical services and healthcare benefits as well. If you are the parent or caretaker of a child in your residential home, you can also apply on their behalf.  Find out more by contacting your local Montana Medicaid agent.

  • Who is eligible for Medicaid in Montana?

Low income and the size of your household unit are two of the main factors that are carefully reviewed when applying for Medicaid in MT. Other eligibility requirements for the program include any of the following:

  • You are a pregnant woman.
  • You are an individual with a disability.
  • You are a caregiver, guardian or parent with dependent children.
  • You are a woman with breast cancer.
  • You are a woman with cervical cancer.
  • You are a child under the age of 19.

Additionally, you must also be a United States citizen or a legal qualified immigrant who resides in the state of Montana. Should you qualify, you will need to present necessary documents that show proof of your identity, proof of income, proof of finances, proof of pregnancy (if applicable) and proof of Social Security Number.

If you would like to find out whether or not your child is eligible for the Children’s Health Insurance Program (CHIP), you can call the Healthy Montana Kids Public Assistance line at 1-888-706-1535. Some of the services offered by CHIP include dental care, medical care, doctor visits, routine checkups, prescription medicine and vision examinations.

In 2012, almost 80 percent of eligible children in Montana were part of CHIP/Medicaid.

Review the 2015 Montana Medicaid income requirements below:

  • 1 person = $11,770
  • 2 family members = $15,930
  • 3 family members = $20,090
  • 4 family members = $24,250
  • 5 family members = $28,410
  • 6 family members = $32,570
  • 7 family members = $36,730
  • 8 family members = $40,890
  • Add $4,160 for each additional person for families with more than eight family members.
  • What is the Medicaid expansion? Did my state accept the Medicaid expansion?

In 2014, with the Affordable Care Act, Medicaid coverage was expanded to 28 states. Due to this expansion, millions of Americans who were previously uninsured now have access to the program and its healthcare benefits. Montana was not one of the states that chose to expand coverage though, and as a result, 55,000 residents currently do not have health insurance or access to Medicaid.

Some of the states that have provided Medicaid expansion include Colorado, Oregon, Rhode Island, Arkansas, Arizona, Hawaii, California, Vermont, Ohio, New Jersey, New York, Kentucky, Maryland, Pennsylvania, Nevada, Iowa and others.

Since Montana has not extended Medicaid, thousands of residents fall under what is considered the “coverage gap.” For example, a total of four million Americans are part of this coverage gap: 43 percent work full time, 23 percent work part time and 34 percent are unemployed. In terms of gender, 49 percent are female and 51 percent are male.

The federal government is currently covering all the costs related to Medicaid expansion. Starting in 2020, however, the government will only be responsible for 90 percent of the costs. You can learn more by visiting your state website or speaking to a Medicaid customer service professional directly.

  • How do I contact Montana Medicaid?

If you need assistance with the Medicaid application process, or if you would like to review your medical coverage, you can contact MT Medicaid in a number of ways. If you would like information about a particular Medicaid office location, you can visit the Montana state government website to find one near you. You can search for office locations in various counties, including Flathead, Lake, Hill, Custer, Broadwater, Big Horn, Madison, Sanders, Yellowstone, Richland, Prairie, Garfield, Granite, Toole, Stillwater, Wibaux, Roosevelt, Missoula and others.

For general queries, contact the Medicaid phone number at 1-800-362-8312. If you are calling on your child’s behalf, you can reach the Children’s Health Insurance Plan at 1-877-543-7669. For information regarding Medicaid transportation approval, call 1-800-292-7114. The Montana Medicaid Handbook will provide you with several other contact information and phone numbers that may be useful for you.

In order to submit a paper Medicaid application by mail, you can write to the Montana Department of Public Health and Human-Services Division of Child and Adult Health Resources. Simply send your information or request to the address below:

1400 Broadway, Cogswell Building
PO Box 8005
Helena, MT 59604-8005

After a sufficient amount of time has passed, you can find out the status of your application or request by calling the Montana Medicaid phone number listed above.

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