How to get Medicaid or low-cost care in Montana

Montana Medicaid in plain words

Medicaid is a program that pays for health care for people with low incomes. In Montana, the Department of Public Health and Human Services runs it, and most people call that agency DPHHS. The department sets the rules, and its Offices of Public Assistance help people sign up in their own towns.

According to KFF, a health policy research group, Montana began covering low-income adults under the national health law on January 1, 2016. The state says its expansion covers adults with an income up to about 138 percent of the federal poverty level. That level is a dollar amount the government sets each year to measure poverty, and it grows with the size of your household.

Children, pregnant people, older adults and people with disabilities can qualify under other rules. Our guide on who qualifies for Medicaid explains each group.

Ways to apply for Montana Medicaid

The state lists several ways to apply for health coverage.

• Apply online at apply.mt.gov, the state's benefits portal.
• Apply through HealthCare.gov, which sends your Medicaid form to the state.
• Call HealthCare.gov at 1-800-318-2596, the number the state's apply page lists for health coverage.
• Find a local community health center or Office of Public Assistance at covermt.org.
• If you also need food or cash help, call the Montana Public Assistance Helpline at 888-706-1535.

Before you start, gather the names, birth dates and addresses of everyone in your home. You will also need Social Security numbers or immigration papers for each person who is applying, plus your income and any current coverage. Our guide to how to apply for Medicaid has a full checklist.

The Montana work rule is already in effect

Montana did not wait for 2027. The state says it started its community engagement requirement for expansion adults on July 1, 2026. That is the name Montana uses for a work rule.

New applicants must meet the rule from that date. Members who already have coverage are checked at their next renewal. The state began with cases that were due for renewal on August 31, 2026.

The rule asks for at least 80 hours a month of activity. That can be work, community service, approved job training, an internship or apprenticeship, or school at least half time. Any mix of these counts. The state first tries to confirm your hours from records it already has. If that does not work, you fill out two community engagement forms and send in proof. The state keeps a chart that lists the proof for each type of activity.

Some adults do not have to meet the rule. The state lists American Indians and Alaska Natives. It also lists people who care for a child 13 or younger or for someone with a disability. Pregnant people and those up to 12 months after a birth are excused. So are people in drug or alcohol treatment, young adults under 26 who left the child welfare system, and veterans with a total disability rating. People with a medical condition that limits their work can also be excused.

The best first step is to log in at apply.mt.gov and check that your phone number and mailing address are right. The state has been sending letters, and missing one of those letters can cost you your coverage. Our guide to the Medicaid work requirement covers the national rules.

If your income is above the Medicaid limit

Montana's own insurance office says the state's marketplace is HealthCare.gov. A marketplace plan is private insurance that you buy yourself. A tax credit can lower the monthly cost if your income qualifies. For 2027 coverage, HealthCare.gov open enrollment starts November 1, 2026, and the deadline for coverage that begins January 1 is December 15.

Cover Montana offers free local enrollment help at 844-682-6837. If you lost a job, our guide on losing your health insurance explains the special sign-up window.

Community health centers and low-cost clinics

Community health centers get federal money, and they serve everyone and charge by income and family size. The Health Resources and Services Administration offers a free Find a Health Center tool, and you only type in your zip code. Montana has many small towns, so ask each center whether it has a satellite office closer to you.

Before you call, ask about the sliding fee, which is a price scale based on what you earn. Ask what proof of income to bring and how long the wait is for a first visit. Our guides on community health centers and sliding-scale clinics can help you compare.

Checking a Montana doctor and paying a flat fee

Montana lists its licensed physicians in a free tool called the Licensee Lookup System, which you reach through the state's eBiz portal. You do not need a password to use it. If the search is confusing, the state's Professional Licensing Customer Service line at 406-444-6880 can help.

Some Montana doctors charge a flat monthly fee for primary care, and they do not bill insurance for those visits. That kind of care is called direct primary care. Our directory lets you search for cash-pay doctors. Ask the office to give you the monthly fee in writing.

Emergencies and hospital bills

In an emergency, call 911 or go to the nearest emergency room. Federal law says a hospital with an emergency room must examine you and treat an emergency whether or not you have insurance. If a bill arrives later, our guide to hospital financial assistance shows how to ask for a discount.