Medicare in Montana
Key Takeaways
- Most people eligible for Medicare in MT are at least 65 years old and are U.S. residents.
- You have the option to enroll in Original Medicare (Parts A and B) 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). in Montana and then switch to a Medicare Advantage 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). plan.
- If you paid Medicare tax in your paycheck for at least 10 years, you won’t pay a monthly premium for Part A. Part B does carry a monthly premium.
If you’re one of the more than one million Montanans and nearing 65 or older, staying healthy will ensure you can enjoy the lowlands, mountains, and national parks. We will answer your questions about Medicare in MT so you can find coverage that meets your needs.
Is Medicare the Same in All 50 States?
Medicare is a federal program, so the core elements are the same in each state, but there are also key differences.
- If you enroll in Original Medicare, you have the option to add Part D drug coverage and Medigap supplemental coverage. Under federal regulation, private insurance companies offer different drug and supplemental coverage plans at different costs in each state.
- Depending on what ZIP code you live in, you have access to different Medicare Advantage plans in Montana.
- Some Medicare beneficiaries also qualify for Medicaid. While Medicare and Medicaid have a lot in common, Medicaid specifics are set at the state level, creating differences between Montana and other states.
Do I Qualify for Medicaid Montana?
While Medicare is available to any U.S. resident age 65 or older, Medicaid provides similar and sometimes more extensive coverage based on financial need or a qualifying disability, regardless of age.
Each state has its own rules for administering Medicaid, a federal/state program founded alongside Medicare in 1965. Montana provides a pre-screening tool to help determine eligibility.
Is Medicare Portable From State to State?
Original Medicare covers you in every state, as long as you confirm that the doctor or facility is Medicare-approved.
Looking for dental, vision and hearing coverage?
What Are the Parts of Medicare?
Are you looking for Medicare plans in Montana? At age 65, Medicare offers you the option to enroll in Part A (also known as hospital insurance), Part B (medical insurance) or both.
If you decide to stay enrolled in Original Medicare, you have the option to add Part D to cover a portion of your prescription expenses. You may also choose to add Medigap insurance, which is supplemental coverage that helps fill in the gaps in terms of out-of-pocket costs like copays and coinsurance.
On the other hand, once you’ve enrolled in Parts A and B, you have the option of switching to a Medicare Advantage plan (also known as Part C). Part C substitutes for Original Medicare, usually offering Part D prescription drug coverage and other benefits like dental and vision.
Are You Required to Enroll in Medicare at 65?
Enrolling in Medicare at age 65 isn’t required, but there are good reasons to enroll even if you have other healthcare coverage.
- Part A of Original Medicare provides coverage for hospital stays that can benefit you even if you have other insurance, usually without a monthly premium.
- Part B of Original Medicare provides coverage for medical expenses but does require a monthly premium. If you have similar insurance provided by an employer, you should at least see if Part B is the right fit for you. If you don’t have other insurance at 65 and decide to pass on Part B, you could face late-enrollment penalties that last a lifetime once you do add Part B.
What Part of Medicare is Free at Retirement?
If you paid employment-related taxes for at least 10 years, you don’t have to pay a monthly premium for Part A of Original Medicare. Even so, Part A is not “free” because of deductibles, copays, and coinsurance responsibilities associated with Medicare plans.
Let’s find your ideal Medicare Advantage plan.
Who Has the Best Medicare Advantage Plan?
The Centers for Medicare & Medicaid Services has a Medicare Star Rating system that assigns one to five stars (five being the highest-rated) to individual Medicare Advantage plans.
While the rating system can shed light on a Medicare Advantage plan’s performance, the enrollment process is not as simple as just picking the highest-rated plan.
What Is the Best Medicare Plan for Seniors?
With Original Medicare, you have the option to add Part D and Medigap plans from private insurance companies.
With Medicare Advantage in Montana, there are many plans available.
- Some Medicare Advantage plans mirror Original Medicare but are more affordable, including ones with $0 premiums that may offer benefits Original Medicare doesn’t.
- Some Medicare Advantage plans offer options for dental, vision, and hearing coverage not provided by Original Medicare.
- Some Medicare Advantage plans offer assistance with transportation costs or over-the-counter needs not offered by Original Medicare.
Thousands of older adults enroll in Medicare every day across the United States. The latest CMS data shows that 226,538 people are enrolled in Medicare Part A and B in Montana. The total number of beneficiaries enrolled in Medicare Advantage increased from 46,545 to 51,281 year over year. Medicare Advantage participation in Montana went from 21.25% to 22.64% year over year. If you’d like to dive deeper into how Medicare in Montana breaks down across the state, we provide a glance at who is using Medicare and how.
226,538 Beneficiaries with Part A & Part B
51,281 Medicare Advantage Beneficiaries
22.64% Medicare Advantage Participation Rate
51.92% Female
48.08% Male
91.91% Non-Hispanic White
0.22% African American
1.18% Hispanic
6.69% Other/Unknown
14.45% Eligible for Medicaid
0.82 Average HCC Score
$8,205.01 Actual Per Capita Costs
13.62% Hospital Readmission Rate
24.57% % of Beneficiaries with an Emergency Department Visit
46,545 Medicare Advantage Beneficiaries, Previous Year
Increased Medicare Advantage, Year over year
21.25% Medicare Advantage Participation Rate, Previous Year
Table reflects the latest Beneficiary Demographics Data: Medicare Geographic Variation – by National, State & County
Average HCC Score: The Hierarchical Condition Category score gauges a population’s overall health. The score is based on a value of 1.0. Populations with an HCC score of less than 1.0 are considered relatively healthy. The score can be used to estimate health costs.
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Montana Commissioner of Securities and Insurance
TDD: 1-406-444-3246
https://csimt.gov/contact/
What should I know about the CSIMT?
If you have questions about the health insurance you’ve bought, contact the Department of Insurance.
Montana Medicaid & Health and Human Services (MTHHS)
https://dphhs.mt.gov/MontanaHealthCarePrograms/
What should I know about MTHHS and Medicaid?
If you have questions about health coverage eligibility or are having a hard time affording coverage, contact Montana’s Department of Human Services.
Montana State Health Insurance Program (SHIP)
https://dphhs.mt.gov/sltc/aging/SHIP
What should I know about SHIP?
If you are on Medicare or have a disability or end stage renal disease, contact SHIP.
Montana Department of Veterans’ Affairs (MTDVA)
For TDD services, dial: 711
https://www.va.gov/montana-health-care/
What should I know about MTDVA?
If you are a veteran and have a question or concern about veterans’ health care benefits, contact MTDVA.
Nationwide Resources
Speak with a GoHealth insurance agent that is licensed in Montana about your Medicare questions.
Mon – Fri, 8 a.m. – 6 p.m. CT
Centers for Medicare and Medicaid Services
You can reach the Social Security Administration by phone for general questions. Not all questions can be answered over the phone.
Also, SSA.gov provides online resources for the following: Review information, apply for benefits, or manage your account online
1-800-722-1213
TTY 1-800-325-0778
Speak to SSA Representative, Monday – Friday, 8 AM – 7 PM ET
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
For those currently enrolled in Medicare
Low Income and Medicare Guide
For individuals with a qualifying income status
A Caregiver's Guide
For individuals with a qualifying income status
Sources
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.