Medicare Advantage Plans in Montana
Written by: Bryan Strickland
Reviewed by: Brett Braithwaite, Licensed Insurance Agent
Medicare Advantage plans, offered by private insurance companies to anyone who is eligible for Original Medicare , are available throughout Montana.
You can switch to a Medicare Advantage plan in Montana if you are enrolled in both Parts A and B of Original Medicare.
Medicare Advantage plans must offer the same coverage as Parts A and B but usually offer additional benefits not available with Original Medicare.
In addition to bundling Part D drug coverage, many Medicare Advantage plans in Montana offer dental and hearing coverage, among other things.
Despite Montana ranking among the smaller states in terms of population, Medicare Advantage plans have Montana residents covered.
There are 27 Medicare Advantage plans offered in Montana in 2023, and 100% of residents have access to at least one Medicare Advantage plan with a $0 premium.
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Montana Medicare Advantage Plan Coverage
Everyone age 65 and older in Montana also has access to Original Medicare. If you enroll in Parts A and B of Original Medicare, you are eligible to switch to one of the Medicare Advantage plans in Montana.
Medicare Part A covers inpatient hospital stays, and Medicare Part B covers outpatient needs like doctors visits and durable medical equipment.
Here’s what Medicare Advantage — also known as Part C — covers:
- Medicare Advantage plans, offered by private insurance companies under the guidance of the federal Medicare program, must offer at least the same coverage as Parts A and B.
- Most Medicare Advantage plans bundle prescription drug Part D coverage (people on Original Medicare also have access to stand-alone Part D plans from private insurance companies).
- Many Medicare Advantage plans offer coverage not available from Original Medicare — things like dental, vision and hearing coverage.
MT Medicare Advantage Plan Costs
While Parts A and B of Original Medicare have standard monthly premiums , each Medicare Advantage plan has its own premium. If you switch to Medicare Advantage in Montana, you are still responsible for any Part A and B premiums.
But keep this in mind:
- Every resident in Montana has access to a Medicare Advantage plan with a $0 premium in 2023.
- Some Medicare Advantage plans help pay your Part B premium.
- In 2023, the average Medicare Advantage premium in Montana is $23.06.
About 99 percent of people don’t have to pay a Part A premium because they’ve paid Medicare taxes through employment for at least 10 years. The standard Part B premium in 2023 is $164.90.
Monthly premiums are just one type of cost associated with Medicare.
Looking at Original Medicare in the simplest of terms, Part A covers the hospital-related expenses of an inpatient stay for up to 60 days, after you pay the benefit period deductible ($226.00 in 2023). Part B covers 80% of the services it covers, after you pay the annual deductible ($226.00 in 2023). You pay the other 20%.
On the other hand, while Medicare Advantage plans cover the same services as Parts A and B, the cost structure varies from plan to plan. On some plans you will pay less with Medicare Advantage; on some you may pay more.
A GoHealth licensed insurance agent can help you figure out which plan is the right fit for your specific situation.
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Medicare Advantage Plan Eligibility and Enrollment in Montana
You already know that people are eligible for Medicare at age 65. Some people are eligible before age 65.
You are eligible regardless of age if you have received Social Security Disability Insurance for at least 24 months, or if you have End Stage Renal Disease or Lou Gehrig’s disease.
If you take advantage of your eligibility and enroll in Parts A and B of Original Medicare, then you are eligible to switch to a Medicare Advantage plan.
But when and how do you enroll?
- You can apply during your Initial Enrollment Period , a seven-month window surrounding your 65th birthday. If you enroll in both Parts A and B during this window, you trigger an Initial Coverage Election Period in which you can switch to Medicare Advantage. If you act in a timely fashion, you can begin Medicare Advantage coverage on the first day of the month you turn 65 (or the first day of the month before if your birthday is on the first day of the month).
- If you don’t take advantage of your Initial Enrollment Period and want to sign up for both Parts A and B later, you’ll have to enroll during the General Enrollment Period (which runs from January 1 to March 31 each year) or during a Special Enrollment Period granted for your specific circumstances. Doing so triggers a concurrent Initial Coverage Election Period that allows you to switch to Medicare Advantage.
- If you’re already covered by Parts A and B of Original Medicare, you can switch to Medicare Advantage during the Medicare Open Enrollment Period, also called the Annual Enrollment Period (which runs from October 15 to December 7 each year).
Are There Montana Medicare Advantage Plans with Prescription Drug Coverage?
Everyone eligible for Medicare in Montana also has access to Part D drug coverage, be it as a part of a Medicare Advantage plan or as a stand-alone plan alongside Original Medicare.
If you’re enrolled in Medicare Advantage or Original Medicare and don’t have Part D coverage, the Annual Enrollment Period that runs from October 15 to December 7 each year affords you the opportunity to join.
If you miss that period, however, and want to add Part D coverage at the beginning of the calendar year, you can only do so if you’re already in a Medicare Advantage plan. From January 1 to March 31 each year (called the General Enrollment Period or the Medicare Advantage Open Enrollment Period), you can add drug coverage by either switching from a Medicare Advantage plan that doesn’t have drug coverage or by dropping Medicare Advantage and switching back to Original Medicare and adding a drug plan.
During this period, you can’t add a Part D plan to Original Medicare and you can’t switch from Original Medicare to Medicare Advantage.
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Medicare Learning Guides
If you are new to Medicare, a beneficiary researching options, or a caregiver, we have tailored Medicare Guides for you!
Before 65 Guide
Understanding health insurance before age 65, especially when considering early retirement
Medicare Plans Guide
Costs, coverage and enrollment details for each Medicare plan
Medicare Beneficiary Guide
For those currently enrolled in Medicare
Low Income and Medicare Guide
For individuals with a qualifying income status
A Caregiver’s Guide
For individuals with a qualifying income status