Montana Medicaid provides free or low cost health coverage to hundreds of thousands of residents across the state. As of late 2025, more than 210,000 Montanans were enrolled in Medicaid or CHIP, including roughly 75,000 adults covered through the state's Medicaid expansion program. If you live in Montana and are wondering whether you qualify for Medicaid in 2026, this guide covers everything you need to know, from income limits and eligibility categories to the application process and recent legislative changes.
For a broader look at all assistance programs available in the state, visit our Montana Benefits Overview page or use our free benefits screener to check your eligibility for multiple programs at once.
Montana Medicaid Expansion: Permanently Extended
Montana first expanded Medicaid in January 2016, extending coverage to adults aged 19 to 64 with incomes up to 138% of the Federal Poverty Level (FPL). The expansion was originally set to expire on June 30, 2025.
In March 2025, Governor Gianforte signed House Bill 245, which permanently extended Medicaid expansion in the state. The bill passed with bipartisan support and removed the previous sunset clause, ensuring that low income adults will continue to have access to Medicaid coverage going forward.
This is significant news for the roughly 75,000 Montanans who rely on expansion coverage. Without the extension, those enrollees would have lost their health insurance.
Montana Medicaid Income Limits for 2026
Medicaid eligibility in Montana is based on your household size and monthly income relative to the Federal Poverty Level. The table below shows the approximate monthly income limits used to determine eligibility. These figures are based on the most recent guidelines published by the Montana Department of Public Health and Human Services (DPHHS). Note that 2026 FPL adjustments are typically published in January or February, so the limits below may be updated slightly during the year.
Monthly Income Limits by Category
| Household Size | Adults (19 to 64) | Children (0 to 18) | Pregnant Women |
|---|---|---|---|
| 1 | $1,735 | $3,404 | $2,048 |
| 2 | $2,344 | $4,600 | $2,767 |
| 3 | $2,954 | $5,796 | $3,487 |
| 4 | $3,563 | $6,993 | $4,206 |
| 5 | $4,173 | $8,189 | $4,926 |
| 6 | $4,783 | $9,385 | $5,646 |
Important: These figures reflect 2025 guidelines published by DPHHS. The 2026 amounts may increase slightly once updated FPL figures are applied. Even if your income is somewhat above these limits, you may still qualify for reduced cost coverage through the Health Insurance Marketplace.
Understanding the Income Categories
- Adults (19 to 64): Eligible at incomes up to approximately 138% of FPL through the Medicaid expansion program.
- Children (0 to 18): Eligible for Medicaid at incomes up to approximately 148% of FPL. Children in households with higher incomes may qualify for Healthy Montana Kids (CHIP), which covers children up to age 19.
- Pregnant Women: Eligible at incomes up to approximately 157% of FPL. Coverage includes prenatal care, delivery, and postpartum services.
- Seniors and People with Disabilities: Individuals aged 65 and older or those with qualifying disabilities may be eligible for Medicaid under different rules that include asset limits. Nursing home Medicaid applicants in 2026 generally must have assets under $2,000 for a single individual.
Who Qualifies for Montana Medicaid?
To be eligible for Montana Medicaid, you must meet the following general requirements:
- Residency: You must be a resident of Montana.
- Citizenship or Immigration Status: You must be a U.S. citizen, U.S. national, or have qualifying immigration status. Some immigrants may be eligible for emergency Medicaid regardless of status.
- Income: Your household income must fall below the applicable limit for your eligibility category (see table above).
- Other Factors: Depending on your category, additional factors like age, pregnancy, disability status, or household composition may apply.
Montana does not currently impose an asset or resource test for most Medicaid eligibility categories under the expansion. However, asset limits do apply to certain groups, including seniors applying for nursing home Medicaid and individuals applying for Supplemental Security Income (SSI) related Medicaid.
New Requirements Coming in 2026
The federal One Big Beautiful Bill Act, signed into law in 2025, introduces several changes to Medicaid nationwide. For Montana residents, the most notable upcoming change is a work requirement for Medicaid expansion enrollees. Under the new federal law, states must implement community engagement or work requirements for expansion enrollees by the end of 2026.
Montana's state legislature had already included work requirement provisions in HB 245 when it extended Medicaid expansion. The state is currently working with the Centers for Medicare and Medicaid Services (CMS) to finalize the details of these requirements.
While specific details are still being developed, work requirements typically ask able bodied adults to demonstrate a certain number of hours per month of work, job training, community service, or education. Exemptions are generally available for individuals with disabilities, caregivers, pregnant women, and others facing specific hardships.
If you are currently enrolled in Montana Medicaid or plan to apply, it is a good idea to stay informed about these changes by checking the DPHHS website for updates.
How to Apply for Montana Medicaid
Applying for Montana Medicaid is free and can be done year round. There is no limited enrollment period for Medicaid. Here is a step by step guide:
Step 1: Gather Your Documents
Before you start your application, collect the following:
- Names, addresses, and birth dates for everyone in your household
- Social Security numbers for anyone applying for coverage
- Immigration documents (if applicable)
- Proof of income such as pay stubs, W-2 forms, or tax returns
- Information about any current health insurance coverage
- Details about any Social Security, SSI, or other benefit payments
Step 2: Choose Your Application Method
You can apply through any of the following channels:
- Online at HealthCare.gov: Visit healthcare.gov to create an account and complete your application. If you are found eligible for Medicaid, your application will be forwarded to Montana DPHHS.
- Online at apply.mt.gov: Visit apply.mt.gov to apply directly through Montana's state portal. This option also lets you apply for SNAP (food assistance) and TANF (cash assistance) at the same time.
- By Phone: Call 1-800-318-2596 (the federal Marketplace helpline) or the Montana Public Assistance Helpline at 1-888-706-1535.
- In Person: Visit any of Montana's Offices of Public Assistance located throughout the state.
- Find Local Help: Visit covermt.org to find navigators and enrollment assisters in your area who can help you through the process at no cost.
Step 3: Complete and Submit Your Application
Fill out all required sections of the application honestly and completely. Incomplete applications are one of the most common reasons for delays or denials. During the 2023 Medicaid redetermination process, nearly two thirds of Montana enrollees who lost coverage were actually still eligible but lost it due to paperwork issues.
Step 4: Respond to Any Requests
After submitting your application, DPHHS may contact you for additional information or documentation. Respond promptly to avoid delays in processing.
Step 5: Receive Your Determination
You will receive a notice in the mail (or electronically if you opted in) letting you know whether you have been approved. If approved, your coverage can begin as early as the date of your application or even up to three months before you applied in some cases (retroactive coverage).
What Does Montana Medicaid Cover?
Montana Medicaid provides comprehensive health coverage, including:
- Doctor visits and preventive care
- Hospital stays (inpatient and outpatient)
- Prescription medications
- Mental health and substance use disorder services
- Laboratory and diagnostic services
- Maternity and newborn care
- Pediatric services including dental and vision for children
- Emergency services
- Rehabilitative services
- Home health services
- Transportation to medical appointments
Most services have no premiums or copays for enrollees, though some cost sharing may apply for certain groups.
Healthy Montana Kids (CHIP)
Children who do not qualify for Medicaid because their family income is too high may still be eligible for Healthy Montana Kids (HMK), Montana's CHIP program. HMK provides free or low cost health coverage for children up to age 19.
To learn more or apply, visit the HMK page at DPHHS or apply through apply.mt.gov.
Check Your Eligibility Now
Not sure if you qualify for Montana Medicaid or other assistance programs? Use our free benefits screener to check your potential eligibility for Medicaid, SNAP, LIHEAP, WIC, and other programs in just a few minutes. It is completely free and confidential.
Frequently Asked Questions
What is the income limit for Montana Medicaid in 2026?
For a single adult aged 19 to 64, the approximate monthly income limit is $1,735 (based on 138% of the Federal Poverty Level). For a family of four, the limit is approximately $3,563 for adults. Children and pregnant women have higher income limits. These figures are based on 2025 DPHHS guidelines and may be adjusted slightly for 2026.
Is Montana a Medicaid expansion state?
Yes. Montana expanded Medicaid in 2016 and permanently extended the expansion in March 2025 through House Bill 245. This means adults aged 19 to 64 with incomes up to 138% of FPL can qualify for Medicaid coverage.
How do I apply for Montana Medicaid?
You can apply online at healthcare.gov or apply.mt.gov, by phone at 1-800-318-2596 or 1-888-706-1535, or in person at a local Office of Public Assistance. There is no enrollment deadline for Medicaid; you can apply at any time during the year.
Will Montana Medicaid have work requirements in 2026?
Montana is in the process of implementing community engagement (work) requirements for Medicaid expansion enrollees. Federal law now requires states to have these in place by the end of 2026. Details are still being finalized, but exemptions are expected for people with disabilities, pregnant women, caregivers, and others.
Can I apply for Medicaid and food stamps at the same time?
Yes. If you apply through apply.mt.gov, you can submit a single application for Medicaid, SNAP (food assistance), and TANF (cash assistance) simultaneously.
What if I make too much for Medicaid?
If your income is above the Medicaid limits, you may qualify for subsidized health coverage through the Health Insurance Marketplace at healthcare.gov. Use the income and savings estimator to see what help is available to you.
How many people are on Medicaid in Montana?
As of late 2025, more than 210,000 Montanans were enrolled in Medicaid or CHIP, with approximately 75,000 of those covered through the Medicaid expansion program.
