Medicare Advantage Plans in Montana

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.

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.

While Parts A and B of Original Medicare have standard monthly premiums A premium is a fee you pay to your insurance company for health plan coverage. This is usually a monthly cost. , 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 A deductible is an amount you pay out of pocket before your insurance company covers its portion of your medical bills. For example: If your deductible is $1,000, your insurance company will not cover any costs until you pay the first $1,000 yourself. ($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.

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 The Initial Enrollment Period (IEP) is the seven-month period around your 65th birthday when most people are eligible for the first time to enroll in Medicare. , 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 The Initial Coverage Election Period is the period you have when you first enroll in Parts A and B of Original Medicare that allows you to switch to a Medicare Advantage plan. 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).

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.