Montana Health Insurance Guide

Health Insurance Overview in Montana

Montana expanded Medicaid in 2015 and has reauthorized the expansion program multiple times. Montana uses the federal HealthCare.gov marketplace. Montana's rural character means marketplace insurer options are limited in many counties — some rural counties have only one carrier. The state has worked to maintain insurer participation in rural markets.

Average Health Insurance Costs in Montana

Marketplace Enrollment in Montana

Montana residents can enroll in individual and family health insurance plans through HealthCare.gov (Federal). Open enrollment runs November 1 – January 15 (federal marketplace).

Average Premiums by City in Montana

Medicaid in Montana

Montana Medicaid expanded in 2015, covering adults with incomes up to 138% of the federal poverty level. The program has been periodically reauthorized.

Children's Health Insurance (CHIP) in Montana

Healthy Montana Kids covers children under 19 in families with incomes up to 261% of the federal poverty level.

What Makes Montana Unique

Montana's HELP Act (Health and Economic Livelihood Partnership) — the initial Medicaid expansion vehicle — included unique work requirements and was time-limited, requiring periodic reauthorization. Montana's approach to structuring and reauthorizing its expansion has been distinctive among expansion states.

ACA Subsidies: What Montana Residents Should Know

The enhanced subsidies first enacted in the American Rescue Plan expired at the end of 2025. For 2026, premium tax credits follow the original ACA rules: there is no credit above 400% (the “subsidy cliff”), and enrollees are expected to pay up to 9.96% of income toward the benchmark Silver plan. House in January 2026 but has not become law, so 2027 plans are being priced and subsidized under the same rules unless Congress acts.

Montana’s Marketplace for 2027: Insurers, Rates, and Dates

Montana residents enroll through HealthCare.gov. Full-price premiums rose about 29.1% on average for 2026, before subsidies. 3 insurers sold plans for 2026; PacificSource is leaving for 2027, so its enrollees need to choose a new plan. Proposed 2027 changes average about 22.6% before subsidies.

About 73,000 people enrolled for 2026. About 80% received premium tax credits, and the average net premium after credits was about $230 a month.

Open enrollment for 2027: November 1, 2026 through January 15, 2027 on HealthCare.gov; enroll by December 15 for coverage starting January 1.

What’s Different About Health Coverage in Montana

Montana is home to Mountain Health CO-OP, one of only two ACA-created nonprofit CO-OPs still operating. PacificSource exits for 2027, leaving a smaller field. Montana’s reinsurance program, in place since 2020, briefly produced rate decreases, but 2026 full-price premiums rose about 29%.

Tips for Choosing Health Insurance in Montana

Rural Montana residents may have limited marketplace plan options — comparing all available plans is critical. Montana Medicaid covers low-income adults. Healthy Montana Kids provides coverage for children. ACA subsidies are available for incomes 100-400% of the federal poverty level. Telehealth options are particularly valuable for rural Montanans.

• Enroll during open enrollment (November 1 – January 15 (federal marketplace)) — missing the deadline means waiting until the next open enrollment unless you have a qualifying life event.

Frequently Asked Questions

Which insurers are leaving the Montana marketplace for 2027?

PacificSource is leaving for 2027. Enrollees with that insurer should choose a new plan during open enrollment; an automatic replacement may have a different network or drug list.

When is open enrollment in Montana for 2027?

November 1, 2026 through January 15, 2027 on HealthCare.gov; enroll by December 15 for coverage starting January 1.

How much do Montana marketplace enrollees pay after subsidies?

In 2026 about 80% of Montana enrollees received premium tax credits, and the average net premium was about $230 a month. There is no credit above 400% of the federal poverty level.

The information on this page is provided for general informational purposes only and reflects estimated industry averages and program eligibility rules as of 2026. Health insurance premiums, Medicaid eligibility thresholds, marketplace options, and program rules change annually. Always verify current eligibility and enrollment options at the official HealthCare.gov (Federal) or by contacting a certified navigator or broker. Premium figures shown are approximations before subsidies — actual net premiums depend on individual income, household size, and plan selection.