Medicare Advantage Plans in Montana
Key Takeaways
- Medicare Advantage plans, offered by private insurance companies to anyone who is eligible for Original Medicare Original Medicare is a fee-for-service health insurance program available to Americans aged 65 and older and some individuals with disabilities. Original Medicare is provided by the federal government and is made up of two parts: Part A (hospital insurance) and Part B (medical insurance). , are available throughout Montana.
- You can switch to a Medicare Advantage plan Medicare Advantage (Medicare Part C) is health insurance for Americans aged 65 and older that blends Medicare benefits with private health insurance. This typically includes a bundle of Original Medicare (Parts A and B) and Medicare Prescription Drug Plan (Part D). in Montana if you are enrolled in both Parts A and B of Original Medicare.
- Medicare Advantage plans must offer the same coverage as Parts A and B but usually offer additional benefits not available with Original Medicare.
- In addition to bundling Part DMedicare Part D is prescription drug coverage for people enrolled in Medicare. Part D is optional and is offered by private insurance companies. drug coverage, many Medicare Advantage plans in Montana offer dental and hearing coverage, among other things.
Over a quarter of a million Montana residents are enrolled in Medicare, and nearly all have the option to choose a Medicare Advantage plan that provides the additional coverage and benefits they need. There are 29 Medicare Advantage plans offered in Montana in 2024, and 98.5% of residents have access to at least one Medicare Advantage plan with a $0 premium.
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Montana Medicare Advantage Plan Coverage
Everyone age 65 and older in Montana also has access to Original Medicare. If you enroll in Parts A and B of Original Medicare, you are eligible to switch to one of the Medicare Advantage plans in Montana.
Medicare Part A covers inpatient hospital stays, and Medicare Part B covers outpatient needs like doctors visits and durable medical equipment.
Here’s what Medicare Advantage — also known as Part C — covers:
- Offered by private insurance companies under the guidance of the federal Medicare program, these plans must offer at least the same coverage as Parts A and B.
- Most plans bundle prescription drug Part D coverage (people on Original Medicare also have access to stand-alone Part D plans from private insurance companies).
- Many plans offer coverage not available from Original Medicare — like dental, vision and hearing coverage.
MT Medicare Advantage Plan Costs
While Parts A and B of Original Medicare have standard monthly premiums A premium is a fee you pay to your insurance company for health plan coverage. This is usually a monthly cost. , each Medicare Advantage plan has its own premium. If you switch to Medicare Advantage, you are still responsible for any Part A and B premiums.
But keep this in mind:
- Almost every Montanan has access to a Medicare Advantage plan with a $0 premium in 2024.
- Some Medicare Advantage plans help pay your Part B premium.
- In 2024, the average Medicare Advantage premium in Montana is $24.28.
About 99 percent of people don’t have to pay a Part A premium because they’ve paid Medicare taxes through employment for at least 10 years. The standard Part B premium in 2025 is $185.
Monthly premiums are just one type of cost associated with Medicare.
Looking at Original Medicare in the simplest of terms, Part A covers the hospital-related expenses of an inpatient stay for up to 60 days, after you pay the benefit period deductible ($1,676 in 2025). Part B covers 80% of the services it covers, after you pay the annual deductible A deductible is an amount you pay out of pocket before your insurance company covers its portion of your medical bills. For example: If your deductible is $1,000, your insurance company will not cover any costs until you pay the first $1,000 yourself. ($257 in 2025). You pay the other 20%.
On the other hand, while Medicare Advantage plans cover the same services as Parts A and B, the cost structure varies from plan to plan. On some plans you will pay less with Medicare Advantage; on some you may pay more.
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Medicare Advantage Plan Eligibility and Enrollment in Montana
You already know that people are eligible for Medicare at age 65. Some people are eligible before age 65.
You are eligible regardless of age if you have received Social Security Disability Insurance for at least 24 months, or if you have End Stage Renal Disease or Lou Gehrig’s disease.
If you take advantage of your eligibility and enroll in Parts A and B of Original Medicare, then you are eligible to switch to a Medicare Advantage plan.
But when and how do you enroll?
- You can apply during your Initial Enrollment Period The Initial Enrollment Period (IEP) is the seven-month period around your 65th birthday when most people are eligible for the first time to enroll in Medicare. , a seven-month window surrounding your 65th birthday. If you enroll in both Parts A and B during this window, you trigger an Initial Coverage Election Period The Initial Coverage Election Period is the period you have when you first enroll in Parts A and B of Original Medicare that allows you to switch to a Medicare Advantage plan. in which you can switch to Medicare Advantage. If you act in a timely fashion, you can begin Medicare Advantage coverage on the first day of the month you turn 65 (or the first day of the month before if your birthday is on the first day of the month).
- If you don’t take advantage of your Initial Enrollment Period and want to sign up for both Parts A and B later, you’ll have to enroll during the General Enrollment Period (which runs from January 1 to March 31 each year) or during a Special Enrollment Period granted for your specific circumstances. Doing so triggers a concurrent Initial Coverage Election Period that allows you to switch to Medicare Advantage.
- If you’re already covered by Parts A and B of Original Medicare, you can switch to Medicare Advantage during the Medicare Open Enrollment Period, also called the Annual Enrollment Period (which runs from October 15 to December 7 each year).
Are There Montana Medicare Advantage Plans With Prescription Drug Coverage?
Everyone eligible for Medicare in Montana also has access to Part D drug coverage, be it as a part of a Medicare Advantage plan or as a stand-alone plan alongside Original Medicare.
If you’re enrolled in Medicare Advantage or Original Medicare and don’t have Part D coverage, the Annual Enrollment Period that runs from October 15 to December 7 each year affords you the opportunity to join.
If you miss that period, however, and want to add Part D coverage at the beginning of the calendar year, you can only do so if you’re already in a Medicare Advantage plan. From January 1 to March 31 each year (called the General Enrollment Period or the Medicare Advantage Open Enrollment Period), you can add drug coverage by either switching from a Medicare Advantage plan that doesn’t have drug coverage or by dropping Medicare Advantage and switching back to Original Medicare and adding a drug plan.
During this period, you can’t add a Part D plan to Original Medicare and you can’t switch from Original Medicare to Medicare Advantage.
Medicare Learning Guides
Healthcare is personal. So is choosing insurance. If you are new to Medicare, a beneficiary researching options, or a caregiver, we have tailored Medicare Guides for you.
Before 65 Guide
Understanding health insurance before age 65, especially when considering early retirement
Medicare Plans Guide
Costs, coverage and enrollment details for each Medicare plan
Medicare Beneficiary Guide
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Low Income and Medicare Guide
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A Caregiver's Guide
For individuals with a qualifying income status
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Sources
- FACT SHEET. CMS.gov.
- Medicare costs. Medicare.gov.
- Joining a health or drug plan. Medicare.gov.
This website is operated by GoHealth, LLC., a licensed health insurance company. The website and its contents are for informational and educational purposes; helping people understand Medicare in a simple way. The purpose of this website is the solicitation of insurance. Contact will be made by a licensed insurance agent/producer or insurance company. Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. Our mission is to help every American get better health insurance and save money.
Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.