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Medicare in Montana

Learn more about coverage, costs and enrollment in Medicare

Reviewed by: Malinda Cannon, Licensed Insurance Agent. Written by: Bryan Strickland.

Key Takeaways

  • To be eligible for Medicare in MT, you must be at least 65 years old and a U.S. resident.

  • You have the option to enroll in Original Medicare (Parts A and B) in Montana, and once you have Part A and Part B, you have the option to switch to a Medicare Advantage plan.

  • If you pay Medicare tax in your paycheck for at least 10 years, you won’t pay a monthly premium for Part A. Part B does carry a monthly premium.

 

The Treasure State is known for big skies. Residents of Montana can enjoy the mountains and Granite Peak or the Great Plains Badlands. Whether hiking the grasslands in the spring or skiing the mountains in the winter, your health is essential.

If you’re one of the more than one million Montanans and nearing 65 or older, staying healthy will ensure you don’t miss any of Montana’s lowlands, mountains or national parks. To get you up to speed with Medicare, we will answer your questions about Medicare in MT.

Is Medicare the Same in All 50 States?

Medicare is a federal program, so the core elements are the same in each state. Still, there are notable differences to Medicare in Montana.

  • If you enroll in Original Medicare in Montana, you have the option to add Part D drug coverage and Medigap supplemental coverage. Under federal regulation, private insurance companies offer different drug and supplemental coverage plans at different costs in each state.
  • Some Medicare beneficiaries also will qualify for Medicaid. While Medicare and Medicaid have a lot in common, Medicaid specifics are set at the state level, creating differences between Montana and other states.

Do I Qualify for Medicaid Montana?

While Medicare is available to any U.S. resident age 65 or older, Medicaid provides similar and sometimes more extensive coverage — based on financial need or a qualifying disability — regardless of age.

Each state has its own plan for administering Medicaid, a federal/state program founded alongside Medicare in 1965. Montana provides a pre-screening tool to help determine eligibility. [1]

Is Medicare Portable from State to State?

Original Medicare in MT covers you in every state, as long as you confirm that the doctor or facility is Medicare-approved.

What Plans Do Medicare Offer?

Are you looking for Medicare plans in Montana? At age 65, Medicare offers you the option to enroll in Part A (also known as “hospital insurance”), Part B (“medical insurance”) or both.

Once enrolled in Parts A and B (also known as Original Medicare), you have the option of switching to a Medicare Advantage plan (also known as Part C). Part C replaces Original Medicare while offering the same coverage as Parts A and B and other benefits like dental and vision coverage.

If you decide to stay enrolled in Original Medicare, you have the option to add Part D to cover a portion of your prescription expenses. You may also choose to add Medigap insurance, which is supplemental coverage that helps fill in the gaps in terms of out-of-pocket costs like copays and coinsurance.

Medicare Advantage in Montana bundles Parts A, B, and D and supplemental coverage.

What Medicare Plans are Required at 65?

Enrolling in Medicare at age 65 isn’t required, but there are reasons you might want to enroll even if you have other healthcare coverage.

  • Part A of Original Medicare provides coverage for hospital stays that can benefit you even if you have other insurance, usually without a monthly premium.
  • Part B of Original Medicare provides coverage for medical expenses but does require a monthly premium. If you have similar insurance provided by an employer, you should at least see if Part B is the right fit for you. If you don’t have other insurance at 65 and decide to pass on Part B, you could face late-enrollment penalties that last a lifetime once you do add Part B.

What part of Medicare is free at retirement?

If you paid employment-related taxes for at least 10 years, you don’t have to pay a monthly premium for Part A of Original Medicare. Even so, Part A is not “free” because of deductibles, copays and coinsurance responsibilities associated with Medicare plans in Montana.

Who Has the Best Medicare Advantage Plan?

The Centers for Medicare & Medicaid Services has a Medicare Star Rating system that assigns one to five stars (five being the highest-rated) to individual Medicare Advantage plans.

While the rating system can shed light on a Medicare Advantage plan’s performance, the enrollment process is not as simple as just picking the highest-rated plan.

What is the Best Medicare Plan for Seniors?

With Original Medicare in Montana, there’s only one plan — Parts A and B, which does open the option to add Part D and Medigap coverage from private insurance companies.

With Medicare Advantage in Montana, there are many plans.

  • Some Medicare Advantage plans mirror Original Medicare but are more affordable. In 2020, the average monthly premium for a Medicare Advantage plan was $23.63. [2]
  • Some Medicare Advantage plans offer options for dental, vision and hearing coverage not provided by Original Medicare.
  • Some Medicare Advantage plans offer assistance with transportation costs or over-the-counter needs not offered by Original Medicare.

While picking Original Medicare is relatively simple, Medicare Advantage offers a variety that can be overwhelming without a helping hand. But it’s simple to get the assistance you need from a GoHealth licensed insurance agent, who can help determine what Medicare Advantage plan is the right fit for your specific situation.

Medicare in Montana by the Numbers

Thousands of older adults enroll in Medicare every day across the United States. The latest CMS data shows that 212,258 people are enrolled in Medicare in Montana. The total number of beneficiaries enrolled in Medicare Advantage in Montana is 43,466. The previous year, 46,608 enrolled in Medicare Advantage. Medicare Advantage participation in Montana went from 22.62% to 20.48% year over year. If you’d like to dive deeper into how Medicare in Montana breaks down across the state, we provide a glance at who is using Medicare, and how.

Outline of Montana
212,258
Beneficiaries with Part A & Part B
43,466
Medicare Advantage Beneficiaries
20.48%
Medicare Advantage Participation Rate
51.90%
% Female
48.10%
% Male
0.84
Average HCC Score
$8,423.1
Actual Per Capita Costs
15.82%
% Eligible for Medicaid
28.33%
% of Beneficiaries with an Emergency Department Visit
14.10%
Hospital Readmission Rate
91.95%
% Non-Hispanic White
0.22%
% African American
1.18%
% Hispanic
6.66%
% Other/Unknown

Table reflects the latest Beneficiary Demographics data: 2018, All Beneficiaries by State, Centers of Medicare & Medicaid Services (CMS)

Average HCC Score: The Hierarchical Condition Category score gauges a population’s overall health. The score is based on a value of 1.0. Populations with an HCC score of less than 1.0 are considered relatively healthy. The score can be used to estimate health costs.

Montana Medicare Resources & Contacts

Beneficiaries spend an average of $8,423.10 each year on Medicare in Montana. To be certain you are not leaving anything on the table, let us help. A GoHealth licensed insurance agent can assess your coverage or explain which Montana-based resources, like these, may be able to help:

Montana Commissioner of Securities and Insurance

1-406-444-2040
TDD: 1-406-444-3246

http://csimt.gov/contact/

What should I know about the CSIMT?

If you have questions about the health insurance you’ve bought, contact the Department of Insurance.

Montana Medicaid & Health and Human Services (MTHHS)

1-800-362-8312

http://dphhs.mt.gov/MontanaHealthCarePrograms

What should I know about MTHHS and Medicaid?

If you have questions about health coverage eligibility or are having a hard time affording coverage, contact Montana’s Department of Human Services.

Montana State Health Insurance Program (SHIP)

1-800-551-3191

http://dphhs.mt.gov/sltc/services/aging/SHIP/

What should I know about SHIP?

If you are on Medicare or have a disability or end stage renal disease, contact SHIP.

Montana Department of Veterans’ Affairs (MTDVA)

1-406-442-6410 (for help after-hours, dial and choose option 3)
For TDD services, dial: 711

hhttp://www.montana.va.gov

What should I know about MTDVA?

If you are a veteran and have a question or concern about veterans’ health care benefits, contact MTDVA.

Nationwide Resources

Speak with an insurance agent that is licensed in Montana about your Medicare questions.

1-855-792-0088 TTY: 711

Monday - Friday, 8 AM - 9 PM CT

Medicare & Medicaid

If you have general questions about Medicare in MT, or need help with current Medicare benefits.

1-800-MEDICARE (1-800-633-4227)

Social Security Administration

You can reach the SSA by phone for general questions. Not all questions can be answered over the phone.

Also, SSA.gov provides online resources for the following: Review information, apply for benefits, or manage your account online

Speak to SSA Representative, Monday - Friday, 8 AM - 7 PM ET

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