Best Health Insurance Plans In Montana

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Looking for health insurance in Big Sky Country? According to a study by US News, Montana has the 26th best health care in the nation. That study focuses on health care access, quality, and public health.

Health Care Choices in Montana

MT residents have several options when it comes to health care in their state:

  1. Employer-provided
    1. From your employer
    2. Through your spouse's employer
    3. Through COBRA
  2. Individual or family plans
    1. Through HealthCare.gov
    2. Directly from a health insurance company
  3. Government-assisted
    1. Medicare
    2. Medicaid

Where do most Montana residents get their health insurance coverage?

Montana Health Insurance Sources
Sources Percent
Employer-Provided 43%
Individual or family 7%
Medicaid 22%
Medicare 18%
Other Public Care 3%
Uninsured 7%
Source: Kaiser Family Foundation, Health Insurance Coverage of the Total Population

Seven percent of MT residents are uninsured, less than the national average. That’s a boost for policyholders. A high percentage of uninsured people raises rates for insured people.

Montana Health Insurance Costs and Rate Factors

MT residents spend an average of $8,221 per year on health care, slightly more than the national average. What influences your prices in Big Sky Country? Prices vary person to person, but are based primarily on these factors:

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Body Mass Index

According to the CDC, a high body mass can cause serious health risks. That’s why insurance companies analyze your BMI to determine your risk-level. A higher BMI means more expensive health insurance.

In 2016, MT had a 25.3 percent obesity rate, the fifth lowest in the nation. Of the Montanans who used QuoteWizard to compare health insurance plans, 26 percent have a BMI in the obese range.

Tobacco Use

Smokers pay more for health care due to the high risks from tobacco use. About 18.5 percent of MT residents are smokers, the 33rd lowest rate in the country.

Age

According to HealthCare.gov, health care costs up to three times more for older people than for younger people. State residents who used QuoteWizard to shop for health insurance are, on average, 42 years old.

Plan Type

Marketplace plans come in metal tiers: bronze, silver, gold, and platinum. It’s no surprise that the more coverage you want, the more you’ll have to pay in monthly premiums.

How much should you expect these premiums to be in your state? These are the average rates for each plan type for a middle-aged MT resident in 2018:

Montana Martketplace Plan Rates
Bronze Silver Gold
$347 $495 $582
Source: Kaiser Family Foundation, Change in Average Marketplace Premiums by Metal Tier

A gold plan costs about 68 percent more than a bronze plan. That’s no surprise, especially since gold plans cover 80 percent of medical costs, whereas bronze plans cover 60 percent of costs.

Some people may qualify for a catastrophic plan, the lowest level of coverage available in the marketplace. Catastrophic plans come with low monthly premiums but a high yearly deductible of $7,150. Even with those higher monthly premiums, it can save you money to buy a bronze or silver plan if you need to use your health insurance.

Location

Your location pays a big role in your rates. That’s because every state has different laws, regulations, and providers for health insurance.

Also, health insurance providers use community-rating to determine your prices. That means rates are based in part on the combined claims everyone files. So, if your neighbors file an unusually high number of claims, it could hurt your rates.

That means that living in a health-conscious state could help keep your prices low. According to America’s Health Rankings, Montana is the 22nd healthiest state in the country.

Montana Health Insurance Companies

There are a few health care providers that offer coverage to MT residents. These health insurance companies offer both individual and family plans in your state:

Montana Health Insurance Laws

The Affordable Care Act limits what factors insurance companies can use to determine your prices.

There’s a limit to how much you’ll pay out-of-pocket with a marketplace plan. In 2018, the out-of-pocket maximum is $7,350 for an individual plan and $14,700 for a family plan.

MT law requires health care providers to offer at least some coverage for the following services:

  • Well-child care
  • Outpatient diabetes management
  • Minimum hospitalization after childbirth
  • Coverage for mental illness, alcoholism, and drug addiction
  • Autism spectrum disorders
  • Coverage for severe mental illness

There are additional services that companies need to provide. Find the full list on cms.gov.

Medicare and Medicaid in Montana

Medicare and Medicaid are both federal-funded health care programs in the US. The programs cater to two different groups in MT. Medicare aids seniors, whereas Medicaid covers kids and low-income families.

Medicare

MT residents 65 and older qualify for Medicare. There are several coverage options within this program, including parts A, B, C, D, and supplemental coverage plans. You may also qualify for a Medicare Savings Program:

QMB:

  • Single person with a monthly income lower than $1,012.
  • Couple with a monthly income lower than $1,372.

SLMB:

  • Single person with a monthly income between $1,012.01 and $1,215.
  • Couple with a monthly income between $1,372.01 and $1,647.

QI:

  • Single person with a monthly income between $1,215.01 and $1,367.
  • Couple with a monthly income between $1,647.01 and $1,853.

Medicaid

Medicaid aids low-income families and children. These are the state’s Medicaid financial requirements:

Montana Medicaid Financial Requirements
Household Size Maximum Yearly Income
1 $12,140
2 $16,460
3 $20,780
4 $25,100
5 $29,420
6 $33,740
7 $38,060
8 $42,380

Office of the Montana State Auditor

Website:
Homepage
Commissioner: of Securities & Insurance
Matt M. Rosendale
Insurance Hotline:
(800) 332 – 6148
Office Hours:
Monday - Friday
8:00 am to 5:00 pm
File a Consumer Insurance Complaint
Complaint Page

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