Best Health Insurance Plans Montana
Montana is nicknamed as the Big Sky Country and has numerous mountain ranges. With plenty of natural beauty, residents of this state can plan outdoor visits to stay active.
There are several health insurance options also available in the state, which residents should look upon while thinking of their overall health. Though, the state rank middle in health rankings by state, still there is room for improvement in their resident’s health. Montana participate in the federal marketplace and residents can enroll in ACA compliant health plans sold through health insurance exchange Healthcare.gov. While applying through health insurance exchange residents can even apply for income-based financial assistance that help them lower their monthly premiums as well as out-of-pocket expenses. Residents should keep in mind that only marketplace plans provide income-based premium tax credits and cost-sharing subsidies. Residents of Montana can find both marketplace, on-exchange plans, off-exchange plans as well as private plans at health insurance exchange. Currently there are three insurers offering health plans in the Montana health insurance exchange.
Highlights and Updates
- For 2020 coverage in Montana Open enrollment run from November 1 to December 15, 2019 and individuals with qualifying event can only enroll outside of that window.
- To stabilize the market and reduce premiums in 2020, the state has enacted reinsurance legislation. As a result the state has received federal approval for a 1332 waiver, which provides pass-through funding.
- Currently the short-term plans in Montana is available for a maximum terms of six months but the Montana did not pass the legislation in 2019 to limit short-term plans to three months, so these plans can now be sold in Montana with the initial plan terms of up to 364 days.
- Average rate decrease of more than 10% has been proposed by the Montana’s insurers for 2020, which is expected to decline even further.
- To reduce the insurance premiums and stabilize the market Montana enacted reinsurance legislation in 2020.
- The state has received federal approval for a 1332 waiver, which provides federal pass-through funding.
- In 2020 three insurers are offering health plans in Montana.
Individual and Family Health Insurance in Montana
Individual and Family Health insurance plans in Montana are designed to keep residents and their families stay healthy and protected. Residents can receive affordable coverage through Individual and Family health insurance plans offered by state health insurance marketplace. The cost of individual and family health insurance plan in Montana is usually derived by plan’s metal tier and the age of the insured. Plans of the higher metal tier are expensive having higher monthly premiums but lower out-of-pocket costs like deductibles, co pays and coinsurance while availing coverage. The monthly premium across all the metal tiers increases with the age.
The following types of health insurance plans are available in Montana for individuals and families:
Preferred Provider Organizations (PPOs) – Individuals who wish to have flexibility while choosing doctors, hospitals and other health care providers will find PPO plans as the right plan for themselves and their families. The PPO plans allow individuals to visit doctor of their choice without requiring a referral from their primary care physician or visiting a doctor of their plan’s provider network. Members of the PPO plans do not need a primary care physician to manage their health or to provide a referral to see a specialist. Members are free to receive health care from in-network or out-of-network health care providers. PPO plans have PPO network of several healthcare providers like doctors, hospitals, clinics, pharmacies, labs, medical equipment vendors etc. In some of the PPO plans members may require to meet a deductible before their coverage begins.
Health Maintenance Organizations (HMOs) – HMO plans are designed for individuals and families who are looking for health plan, which is easy to use and understand and is also pocket-friendly. HMO plans often cost less compared to other types of plans. Members of HMO plans have a Primary Care Provider that manages their healthcare needs, right form routine care to serious illness and also provide referral for visiting a specialist. Primary Care Provider carry out early diagnosis and treatment to prevent common health issues from getting worse. As a result of this health issues of the HMP plans members are managed before getting it worse. Members of the HMO plans should receive healthcare services from the HMO’s network of doctors. There is a fixed copayment for every doctor’s visit and other healthcare service in these plans.
High-Deductible Health Plans with Health Savings Accounts (HDHP w/HSAs) – Health Savings Account is an individually-owned tax-advantages account in which individuals and their employers can make tax free contributions up to an annual limit, which can be later on used to pay for the qualified medical expenses. Any investment or interest incurred in this account are tax-free and the account stays with the individual even if he changes jobs or health plans. The unused funds of the accounts rollover year-to-year irrespective of the amount in the account. High Deductible Health Plan is a higher deductible plan having higher deductible compared to traditional plan. These plans have lower monthly premium but the insured need to pay higher deductible before the insurer starts to pay its share. These plans are generally combined with a health saving account that allow insured to pay for their certain medical expenses and the money saved in the account is free from federal taxes.
Flexible Spending Accounts (FSAs) – Residents of Montana are allowed to contribute $2500 every year in Flexible Spending Accounts, which is tax free. This amount can be used for out-of-pocket healthcare expenses that are usually not covered under health insurance plans like over-the-counter preparations, equipment and devices. Though, residents need to obtain a prescription for OTC items and submit an itemized receipt to avail tax deduction.
Short-term health insurance in Montana
Short term health insurance plans was primarily designed for individuals to cover gaps in coverage. Individuals who are without health coverage for a short period of time can obtain these plans. If any individual misses the open enrollment period for the Affordable Care Act or an individual is in between jobs and waiting for their employer coverage to start, then short term plan can be bought that will provide coverage for hospitalization and emergency care.
As per the Trump Administration, short-term plans are now allowed to have initial terms of up to 364 days that can be further renewed up to 36 moths. Though, prior to October 2018, federal regulations limited short-term plans to three months period and even renewals were prohibited. In 2018 Montana published guidance that state is deferring to federal rules for short-term plans. Beside, in 2019 even legislation was introduced to limit short-term plans to three months but it did not pass. Three insurers offer short-term plans in Montana.
Montana Dental Insurance
In Montana there are three types of dental plans available:
Preferred Provider Organization – PPO dental plans have a specific network of participating dentists to whom the members can visit for receiving dental care. The dentists participating in the network agree to provide dental care services at negotiated rates. This keeps the dental care costs down for the members of the PPO plans. Though members can visit out of network dentists but this will certainly increase their out-of-pocket costs.
Indemnity – Indemnity dental plans give its members the flexibility to visit any dentist of their choice, as there are not network of dentists in this plan. In the indemnity plan when the members visit the dentist of their choice, the dentist submit the bill to their insurance company who go to one of their network dentist to find the cost of the dental care which the member has received. The insurance company will pay benefits up to what their network dentist would have charged and the members need to pay the remaining amount from their own pocket.
Dental Discount – It is not basically a true dental plan but is like availing a club membership where members are given discounts for specific services. In the dental discount, members need to visit dentist that is within the plan network to receive discount on the received dental care. The members do not require to fill out any insurance form and even there is no billing.
Vision Insurance in Montana
Residents of Montana who are looking to save on eye care costs should opt for vision insurance plans that provide coverage for eye exams, frames, lens and lens treatments, contact lenses and some other eye care services that vary plan to plan. Vision insurance plans in Montana also have group of eye-doctors, hospitals and other professionals in a network. Members of the plan receive eye care from the in-network provider, the eye-care cost is lower compared to receiving eye-care from outside network providers.