Medicare insurance is a federally funded program available to all states, including Montana. It is designed to provide affordable and adequate health insurance coverage for qualified beneficiaries over 65. Workers and younger people with disabilities may also qualify.
While Medicare is a federal program, the state of Montana also offers various types of support and assistance for Medicare beneficiaries in the state.
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Montana Medicare Insurance Trends
The Centers for Medicare & Medicaid Services (CMS) reported the following information on 2024 Medicare trends in Montana:
- Currently, 260,311 residents of Montana have Medicare.
- On average, Medicare Advantage’s monthly premiums decreased slightly in Montana from $23.98 in 2024 to $17.01 in 2025.
- There are 29 Medicare Advantage plans available in Montana in 2025.
- 99.5% of people with Medicare will have access to a Medicare Advantage plan with a $0 monthly premium
- There are 16 stand-alone Medicare prescription drug plans available in Montana in 2024.
- The lowest monthly premium for a Medicare prescription drug plan in 2025 is $0.
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Thanks to the Inflation Reduction Act, people with Medicare may qualify for even more savings through the Extra Help program.
Medicare Offered in Montana
Medicare is a federal health insurance program that offers coverage to those aged 65 or older, have usually lived in the US for ten years and meet specific medical requirements. It also covers people with disabilities under 18-years old and individuals receiving benefits from Social Security Disability Insurance (SSDI) but not retirement pensions.
The Montana Department of Public Health & Human Services has offices all around the state where residents can apply for this benefit if they qualify.
Original Medicare
In many ways, Medicare offers adequate coverage for a reasonable cost. Qualified beneficiaries can obtain Original Medicare directly from Medicare, which comprises Medicare Part A and Part B.
Medicare Part A usually is premium-free, and it covers hospital services, including inpatient care. Medicare Part B requires a premium depending on the beneficiary’s income. Both Medicare Part A and Part B involve out-of-pocket expenses such as deductibles, copays, and coinsurance.
Medicare Advantage
Instead of obtaining Original Medicare, qualified beneficiaries may instead opt to purchase Medicare Advantage Plans. These include coverage that Original Medicare provides and the coverage that a supplemental plan may offer. This type of Medicare plan is also known as Medicare Part C. The extra benefits can be coverage of additional health services or coverage for prescription medication.
Montana Medicare Advantage options typically include plans from the following private insurance companies:
- Blue Cross Blue Shield of Montana
- Lasso Healthcare
- PacificSource Medicare
- UnitedHealthcare
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Medicare Supplement Plans
Some beneficiaries feel that Original Medicare does not offer enough coverage. They choose to purchase optional supplemental plans to add more benefits to Part A and Part B. These may be plans covering extra health services that are not covered by Medicare Part A and Part B.
A more common type of supplemental plan covers the cost of Medicare prescription drugs. This is called Medicare Part D and can be added to Part A and Part B. Other plans may instead cover the costs of deductibles, coinsurance, and copays involved with Original Medicare.
All these plans can be purchased from private carriers, which Medicare has approved. These will entail the payment of a separate premium as well.
Medigap insurers in Montana have the choice to use attained-age rating (rates increase as an enrollee gets older), issue-aged ratings (rates are based on the age a person was when they enrolled), or community rates, which do not vary by someone’s age.
Montana Medicare Enrollment
Montana residents are eligible for Medicare if they are a U.S. citizen and above 65 years old or are under 65 but are permanently disabled, have end-stage renal disease, or Amyotrophic Lateral Sclerosis. Use Medicare’s online eligibility tool if you are unsure if you qualify.
Requirements
- You are 65 or older, and you or your spouse worked and paid Medicare taxes for at least 40 quarters.
- You are under age 65 and collect benefits from Social Security or the Railroad Retirement Board for at least 24 consecutive months.
- You have ESRD or ALS.
Enrollment Period Dates
Initial Enrollment Period
This is a seven-month window that allows you to sign up for a plan
- Begins 3 months before the month you turn 65
- Ends 3 months after the month you turn 65
Medicare Open Enrollment Period
This is when you can sign up for a plan, switch a plan or leave a plan
- Begins Starts October 15th
- Ends December 7th
Special Enrollment Period
Special enrollment periods allow you to enroll outside the regular enrollment periods under specific circumstances.
General Enrollment Period
This is when you can sign up for Medicare Part A and/or Part B if you didn’t sign up when first eligible or if you’re not qualified for a Special Enrollment Period.
- Starts January 1st
- Ends March 31st
Medicare Advantage Open Enrollment Period
This is when you can switch or leave a Medicare Advantage Plan
- Starts January 1st
- Ends March 31st
Montana Enrollment Tips & Advice
When it comes to Medicare, the options are often overwhelming. However, with a bit of time and research, you can feel confident in your decision to get coverage.
The Montana Human & Community Services Division offers numerous programs and services. These include the Medicare Savings Programs (MSP) that offer eligible Medicare beneficiaries assistance in paying for Medicare costs. These programs come with several requirements, including income limits, as these programs are meant only for low-income applicants.
Additional resources:
- Montana Department of Public Health and Human Services, Senior and Long-Term Care Division
- SHIP assistance program
- Commissioner of Securities and Insurance
How Do I Enroll in a Medicare Plan?
Have you been looking for a Medicare plan in Montana but not sure where to start? There are so many choices, and they all come with their own pros and cons. Contact the Coverage Haven licensed insurance professionals today to find the best coverage that suits your needs and budget.
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