Jump to: Overview, Eligibility, Tips for Students, How to apply, What to Expect After Applying,  Outside Help.

Medicaid

 

Medicaid is state administered health insurance provided to low-income individuals. Medicaid is free but requires an application to enroll and you must make less than $20,782. To determine income maximums for larger households, use 138% of the Federal Poverty Level for the number of people in the household. There are some copayments with medicaid if you are over 21 but they will not exceed 5% of your income.

Doctors can choose if they work with Medicaid patients, and many do but not all. If you have a specific physician you like to go to check that they accept Medicaid. Montana Medicaid works on the passport system, where you have a primary provider that acts as a guide to the rest of the healthcare system. Medicaid will only cover healthcare in the state you received it in. The exception to this is emergency (life or limb) care which is covered nationwide and accessible without going through your passport provider.

Eligibility

 

You can qualify for Medicaid as a household or as an individual if the individual is their own household. For the individual household income must be below $20,782, 138% of the Federal Poverty Level.  Income maximums can be calculated for larger households using the federal poverty level website. In addition to the income requirements the potentially insured must not have been offered employer coverage (or those who face unaffordable employer coverage). Additionally, Medicaid is geographically bound, and you must have an address in the state you are applying for benefits.

A helpful Medicaid eligibility screening resource is available, it will ask you some basic questions about your income, family size and residency. The Medicaid Policy Manual lists all requirements for applying but it is extensive and unless you have a specific question just apply or use the screening resource.

Student Specific Tips

  • If you are claimed by your parents on their taxes, you are considered part of their household if parents are on Medicaid, you can be on their coverage until the age of 26.
  • You may be eligible for up to 3 months of back coverage for medical expenses if you were uninsured, received eligible care, and were then found eligible for Medicaid.
  • As an MSU student you must have insurance. Medicaid fulfills this requirement.
  • Acute and primary care services are free to fulltime students (taking over 6 credits) through student health partners. Call 406-994-2311 to schedule.
  • Student Health Partners Pharmacy will directly bill Medicaid for prescriptions.

Examples of Potentially Medicaid Eligible Students

A 26yo student who recently lost their parents insurance, they work at a youth camp in the summers and make $20,000/year.

The Application Process

There are two ways to apply. Either through the Montana DPHHS application website or through the Affordable care act website. It is recommended that you use the affordable care site as it looks for eligibility options through the Affordable act up to 400 percent of the poverty line. If you are ineligible for Medicaid, other affordable options will be visible to you through this site.

What you will need:

  • Your projected income for the next year.
  • The name, address, contact info, and birth date for everyone in your household (so anyone you file taxes with)
  • Your social security numbers and/or immigration documents.
  • Employer and income information for everyone in your household. Examples include pay stubs or W2 forms.
  • Other income information including Social Security Administration (SSA) or Supplemental Security Income (SSI) payments for anyone claimed on your taxes.
  • Information about current health coverage for members of your household, including coverage through an employer, a spouse's employer, or Medicare.

What to Expect After Applying

If you are found eligible for Medicaid, you are considered insured from the point of your application date. However, receiving your actual Medicaid card may take up to 60 days ( ~2 months).

Once you receive the passport card you will need to be set up in the passport system and directions will be included with your card.

If you have questions about the status of your application, call 1-888-706-1535 option 1

Outside Resources

Cover Montana basic health insurance is a nonprofit with a 24/7 Montana specific health insurance online chat that can help you get enrolled and address specific questions.

Healthy Kids Montana is a health insurance plan that covers individuals under the age of 19 whose family's income is under and 260% of the federal poverty level. It is a BCBS Plan. The application is the same as for Medicaid.  

The Basic Needs program can assist with public assistance resource navigation. Basic Needs Staff can be reached at basicneeds@montana.edu