Healthcare Assistance for Single Mothers in Montana

Healthcare Assistance for Single Mothers in Montana: Medicaid, CHIP (HMK) & More [2025]

Last updated: September 2025

This no‑fluff Montana guide shows you exactly how to get covered, what’s covered, and what to do when something stalls. All numbers below are the newest figures available for 2025 from official sources.

Quick Help Box (save this)

Apply or check your case at apply.mt.gov (Montana OPA self‑service portal). For questions call the Montana Public Assistance Helpline at 1‑888‑706‑1535 (Mon–Fri). (dphhs.mt.gov)
Healthy Montana Kids (CHIP/HMK): medical via BCBSMT 1‑855‑258‑3489; dental/pharmacy/DME and member help line 1‑800‑362‑8312. (dphhs.mt.gov)
Non‑Emergency Medical Transportation (NEMT): You must get approval before traveling. Call the Medicaid Transportation Center 1‑800‑292‑7114 (or 406‑443‑6100). (dphhs.mt.gov)
In‑person help with applications: Cover Montana (free Navigators) Help Line 1‑844‑682‑6837. (covermt.org)
12‑month postpartum coverage is available under Montana Medicaid and HMK. If you become pregnant, update your case right away at apply.mt.gov or call 1‑888‑706‑1535. (dphhs.mt.gov)
Mental health crisis: call/text 988 (24/7, free). (dphhs.mt.gov)
Find your local Office of Public Assistance (addresses): OPA offices. (dphhs.mt.gov)

What’s in this guide and how it beats the top results

Most search results miss hard numbers (2025 FPL limits), skip Plan First family‑planning coverage, leave out dental caps, and rarely give the exact transport number or realistic timelines. Below you’ll get current income limits calculated from the 2025 HHS poverty guidelines, direct agency links, phone numbers, processing times, common pitfalls, and Plan B steps if things go sideways. (aspe.hhs.gov, dphhs.mt.gov)

Snapshot: the main Montana health programs for single moms

Montana Medicaid (includes “HELP Plan” expansion for adults 19–64)
Healthy Montana Kids (HMK = CHIP for kids; HMK Plus = children’s Medicaid)
Pregnancy Medicaid (through 12 months after pregnancy)
Plan First (family planning coverage up to 211% FPL)
Support programs that pair with coverage: transportation, dental, vaccines, CSHS, Ryan White/ADAP, and more

Income limits you can use today (2025)

Montana uses federal poverty level (FPL) rules. The 2025 HHS poverty guidelines for the 48 states are: 1‑person $15, 650 * *, 2‑ p erso n * *$ 21,150, 3‑person $26, 650 * *, 4‑ p erso n * *$ 32,150, etc. We use those to calculate the monthly limits below. Always count an unborn baby in your household size if you’re pregnant. (aspe.hhs.gov)

Adults 19–64 (Medicaid expansion/HELP Plan) – up to 138% FPL

Household monthly income at or below these amounts may qualify:

People	Max monthly income (138% FPL)
1	$1,800
2	$2,432
3	$3,065
4	$3,697
5	$4,330
6	$4,962
7	$5,595
8	$6,227

Calculated from 2025 HHS guidelines; adult expansion limit confirmed by DPHHS (“HELP Plan” at 0–138% FPL). (aspe.hhs.gov, dphhs.mt.gov)

Pregnant people (Pregnancy Medicaid) – up to 157% FPL

Note: add the unborn baby to household size.

People (including unborn)	Max monthly income (157% FPL)
1	$2,048
2	$2,767
3	$3,486
4	$4,206
5	$4,926
6	$5,645
7	$6,366
8	$7,087

Percent level from DPHHS rule; amounts calculated from 2025 HHS FPL. Postpartum coverage lasts 12 months. (dphhs.mt.gov, aspe.hhs.gov)

Children (HMK Plus = children’s Medicaid) – up to 143% FPL

People	Max monthly income (143% FPL)
1	$1,865
2	$2,521
3	$3,176
4	$3,831
5	$4,487
6	$5,142
7	$5,798
8	$6,454

Percent level from Montana rules; amounts calculated from 2025 HHS FPL. (dphhs.mt.gov, aspe.hhs.gov)

Children (HMK = CHIP) – over 143% up to 261% FPL

People	Max monthly income (261% FPL)
1	$3,404
2	$4,600
3	$5,796
4	$6,995
5	$8,188
6	$9,386
7	$10,580
8	$11,776

Percent level from Admin. Rules; amounts calculated from 2025 HHS FPL. HMK requires small copays, capped at $215 per family per year. (law.cornell.edu, aspe.hhs.gov, medicaidprovider.mt.gov)

Plan First (family planning only) – up to 211% FPL (effective through March 31, 2026)

Annual income limits for 2025: 1‑person $33, 022 * *, 2‑ p erso n * *$ 44,627, 3‑person $56, 232 * *, 4‑ p erso n * *$ 67,837, 5‑person $79, 442 * *, 6‑ p erso n * *$ 91,047, 7‑person ** $102, 652 * * . (M o n t h l y i sro ug h l y$ 2,752; $3, 719;$ 4,686; $5, 653;$ 6,620; $7, 587;$ 8,554.) (dphhs.mt.gov)

How to apply fast (and right)

Start here:

Online: apply.mt.gov to apply for Medicaid/HMK, update pregnancy, report changes, or check status. (dphhs.mt.gov)
Phone: Public Assistance Helpline 1‑888‑706‑1535 (ask about Medicaid/HMK, Plan First, or to replace a lost card). (dphhs.mt.gov)
In‑person: Find your nearest Office of Public Assistance (addresses). (dphhs.mt.gov)
Free assisters: Cover Montana Help Line 1‑844‑682‑6837 (virtual or local in many towns). (covermt.org)

What to expect on timing: if you apply through HealthCare.gov, it takes a few days for the Marketplace to send your file and about 15 business days for DPHHS to process in the state system; federal regs allow up to 45 days during busy periods. If it’s been 6 weeks with no notice, call the Helpline. (dphhs.mt.gov)

Required documents (Application Checklist)

ID details for everyone applying (name, DOB, address, contact info).
Social Security numbers or immigration documents (only for people applying).
Proof of income (recent pay stubs, W‑2, SSA/SSI letter, unemployment, child support received).
Pregnancy verification if pregnant (a simple note from a provider works).
Current health coverage info (employer plan, spouse’s plan, Medicare).
For Plan First: proof you’re 19–44, not pregnant, and Montana resident. (dphhs.mt.gov)

Tip: If you’re close to the income cutoff, still apply. Some income isn’t counted under MAGI rules, and pregnancy adds to household size. (dphhs.mt.gov)

Coverage highlights single moms ask about

Dental (adults): Montana Medicaid covers preventive plus treatment; adult treatment services have an annual cap of $1,125 (cleanings, diagnostics, dentures, and anesthesia don’t count toward the cap; kids and Aged/Blind/Disabled categories are excluded from the cap). (dphhs.mt.gov)
Dental (children on HMK): HMK dental benefit is up to $1, 900 * * p er b e n e f i t ye a r (J u l y 1- J u n e 30) . N oco p a ys w hi l e u n d er t h e ann u a ll imi t; d e n t a l im pl an t s ha v e a * *$ 1,500 lifetime maximum within that cap. (dphhs.mt.gov)
Transportation: Medicaid/HMK Plus can pay mileage, lodging, and meals when medically necessary. You must get prior authorization; call 1‑800‑292‑7114 before you travel. (dphhs.mt.gov)
Passport to Health (primary care home): choose a primary provider and get referrals for most specialty care; call 1‑800‑362‑8312 if you need help choosing. (dphhs.mt.gov)
Vaccines for kids: VFC program provides free vaccine (providers may charge up to $21.32 per shot administration). Kids on HMK Plus qualify; children with private coverage may qualify if under‑insured via FQHC/RHC. (dphhs.mt.gov)
Postpartum: Montana provides 12 months of continuous coverage after pregnancy under Medicaid and HMK. Update your case as soon as pregnancy or postpartum status changes. (dphhs.mt.gov)

Real‑world examples

You’re pregnant with one unborn baby, and your only income is $2, 750/ m o n t h * * : Y o u r h o u se h o l d s i ze i s 2 (yo u + u nb or n), an d t h e 2025 l imi t f or p re g nan cy M e d i c ai d i s ab o u t * *$ 2,767/month—you’re within limits. Apply now and report the pregnancy to lock in 12 months postpartum coverage. (aspe.hhs.gov, dphhs.mt.gov)
You and one child make $3, 000/ m o n t h * * : Y o u rc hi l d l ik e l y q u a l i f i es f orH M K Pl u s (c hi l d re n ’ s M e d i c ai d) i f yo u ’ re u n d er * *$ 2,521; if you’re above that but under $4, 600 * *, t h ec hi l d l ik e l y q u a l i f i es f orH M K (C H I P) w i t h s ma ll co p a ysc a pp e d a t * *$ 215/year. Apply so the system can check all options. (dphhs.mt.gov, law.cornell.edu, medicaidprovider.mt.gov)
Single mom earning $1, 900/ m o n t h * * w i t hn oo t h erco v er a g e : Y o u ’ re u n d er t h e a d u ltM e d i c ai d l imi t o f * *$ 1,800? That’s slightly over. Still apply—some income may not count, and you may qualify for Marketplace coverage with a big subsidy (see next section). (aspe.hhs.gov)

If you don’t qualify for Medicaid/HMK: Marketplace coverage and subsidies

Montana uses HealthCare.gov. Open Enrollment for 2026 coverage runs Nov 1, 2025–Jan 15, 2026 in Montana. The Inflation Reduction Act’s enhanced subsidies stay in place through 2025, which helps keep premiums low; 2026 rules are being finalized but OE dates for 2026 coverage remain the same window. Get free help from Cover Montana or call HealthCare.gov (1‑800‑318‑2596). (healthinsurance.org, cms.gov)

What to do right now:

If you were denied Medicaid, ask for a Marketplace referral or go directly to HealthCare.gov to see your subsidy. You might pay as little as 8.5% of income or less toward the benchmark plan under current law through 2025. (healthaffairs.org)
Lost Medicaid recently? That’s a Special Enrollment Period—enroll in a Marketplace plan within 60 days. Free assistance: 1‑844‑682‑6837 (Cover Montana). (covermt.org)

Plan B if premiums still feel high: ask about your local Community Health Center’s sliding fee scale for primary care while you work on coverage. All FQHCs must offer discounts based on income and can’t turn you away for inability to pay. Use HRSA’s Find‑a‑Health‑Center tool to locate care near you. (bphc.hrsa.gov)

The family‑planning option: Plan First (up to 211% FPL)

If you’re 19–44, can become pregnant, are not currently pregnant, and don’t have other Medicaid, Plan First covers family‑planning visits, birth control, and STD testing/treatment. 2025 income thresholds (effective through Mar 31, 2026) start at $33,022/year for a household of 1. Apply the same way you apply for Medicaid (online, phone, or at OPA). (dphhs.mt.gov)

What to do if this doesn’t work: If you’re denied because you’re over income, check Marketplace options with a Navigator; if you’re under 21 or have another qualifying situation, you may qualify for different Medicaid categories. (covermt.org)

Extra programs that help with health costs

Health Insurance Premium Payment (HIPP): If you or your child can get employer, COBRA, student, or individual coverage and it’s “cost‑effective,” Montana may reimburse the premiums. Call 1‑800‑694‑3084 or email HHSHIPPProgram@mt.gov. (dphhs.mt.gov)
Children’s Special Health Services (CSHS): Help for kids with special health needs up to 300% FPL. Call 1‑800‑762‑9891. (dphhs.mt.gov)
Ryan White/ADAP (HIV): Covers meds and can help with premiums/cost‑sharing up to 500% FPL if not otherwise covered by Medicaid/Medicare/VA/IHS. Contact a case manager via the state program page. (dphhs.mt.gov)
Vaccines for Children (VFC): No‑cost vaccines (admin fee up to $21.32/shot); under‑insured kids can get VFC at FQHC/RHC locations. (dphhs.mt.gov)
988 Lifeline: If anxiety, depression, or crisis is blocking you from applying or using care, call/text 988; Montana calls are answered in‑state. (dphhs.mt.gov)

What to do if this doesn’t work: Call the OPA Helpline 1‑888‑706‑1535 to check if you’re missing a Medicaid category; call Cover Montana 1‑844‑682‑6837 to review Marketplace plans with zero‑ or low‑premium options. (dphhs.mt.gov, covermt.org)

Common mistakes to avoid (so you don’t lose time or coverage)

Not reporting pregnancy or postpartum status changes. It can unlock 12 months of postpartum coverage—report right away. (dphhs.mt.gov)
Skipping the “Passport to Health” step. Without choosing a primary provider, you may have trouble getting referrals paid. Pick one or call 1‑800‑362‑8312 for help. (dphhs.mt.gov)
Traveling for care without NEMT prior approval. Call 1‑800‑292‑7114 before any trip you want Medicaid to cover. (dphhs.mt.gov)
Assuming dental is “unlimited.” Adult dental treatment has a $1,125 annual cap (kids are exempt). Track your usage. (dphhs.mt.gov)
Waiting on a Marketplace application with no follow‑up. If it’s been 6 weeks and you’ve heard nothing, call 1‑888‑706‑1535 or check your apply.mt.gov account. (dphhs.mt.gov)

Plan B: If paperwork is stuck, call the Helpline, ask what’s missing, and request your local OPA email address from the office locator page to send documents same day. If you need care now, use an FQHC with a sliding fee scale while your application is pending. (dphhs.mt.gov, bphc.hrsa.gov)

Benefits and costs at a glance (table)

Topic	What Montana Covers/Requires	Where to check
Adult dental	Preventive + treatment; adult treatment cap $1,125/year; kids exempt	DPHHS Dental page (dphhs.mt.gov)
HMK dental	Up to *$1, 900/ ye a r * (J u l y - J u n e); im pl an t s * $ 1,500 lifetime*; no copays under limit	HMK Dental page (dphhs.mt.gov)
Transportation	Prior authorization required; call 1‑800‑292‑7114	Medicaid Transportation page (dphhs.mt.gov)
Postpartum	12 months continuous coverage (Medicaid/HMK)	Member Services page (dphhs.mt.gov)
HMK copays	Small copays; annual family cap $215	Medicaid Provider FAQ (medicaidprovider.mt.gov)

How to find a clinic that won’t turn you away

Community Health Centers (FQHCs) see everyone—Medicaid, CHIP, private, uninsured—and must offer sliding‑fee discounts up to 200% FPL. Use HRSA’s locator to find care in your town, or visit the Montana Primary Care Association’s site for statewide center lists. For example: Partnership Health Center (Missoula), RiverStone Health (Billings), Alluvion (Great Falls), PureView (Helena), Community Health Partners (Bozeman/Livingston), Greater Valley Health Center (Kalispell). (bphc.hrsa.gov)

What to do if this doesn’t work: If an FQHC near you is full, ask about telehealth, same‑day slots, or referral lists. If you’re Native, you can also use IHS/Tribal/Urban Indian clinics (see Billings Area IHS contacts and local Tribal Health). (ihs.gov)

Resources by region (selected, with how to reach help fast)

Find a health center with discounts: HRSA’s “Find a Health Center” tool (search by ZIP). If phone access is easier, call HRSA help at 1‑877‑464‑4772 (M–F 8am–8pm ET). (bphc.hrsa.gov)
Offices of Public Assistance: use the state’s address list for Anaconda, Billings, Bozeman, Browning, Butte, Glasgow, Great Falls, Hamilton, Hardin, Havre, Helena, Kalispell, Lame Deer, Lewistown, Libby, Miles City, Missoula, Polson, Wolf Point. Helpline 1‑888‑706‑1535. (dphhs.mt.gov)
IHS Billings Area and Tribal/Urban clinics: Billings Area IHS main 406‑247‑7248; local clinic numbers listed by service unit (Blackfeet, Crow, Fort Belknap, Fort Peck, Northern Cheyenne, Little Shell, and more). (ihs.gov)

Diverse communities: tailored pointers

LGBTQ+ single mothers: When choosing a Passport primary care provider, you can switch any time if the fit isn’t right. For immediate mental health support, use 988; counselors can connect you with local, inclusive services. (dphhs.mt.gov)
Single mothers with disabilities or caring for disabled children: Ask your clinic about disability accommodations; CSHS can help with specialty needs up to 300% FPL. If transportation is a barrier, call the Medicaid Transportation Center before appointments. (dphhs.mt.gov)
Veteran single mothers: If you don’t qualify for Medicaid, compare VA and Marketplace options—Cover Montana can help you navigate both. Use Marketplaces during the Nov 1–Jan 15 window if you need private coverage. (healthinsurance.org)
Immigrant/refugee single moms: Many lawfully present immigrants can qualify for Medicaid/HMK depending on status; if not, a Marketplace plan with subsidies may be the fastest route. Navigators can help you understand document needs. (covermt.org)
Tribal members/Urban Indian families: You may use IHS/Tribal/Urban Indian clinics; many tribes also have assisters. HMK and Medicaid coordinate with IHS Purchased/Referred Care rules—ask your clinic’s benefits office. Billings Area IHS: 406‑247‑7248. (ihs.gov)
Rural single moms: Book early for dental and specialist care (waitlists are real). Use FQHCs’ sliding fee programs and ask about telehealth for follow‑ups. (bphc.hrsa.gov)
Single fathers: All programs above are gender‑neutral for parents; HMK, Medicaid, and transportation rules are the same. Use the same contacts and providers. (dphhs.mt.gov)
Language access: State notices include language assistance and non‑discrimination information; if you need an interpreter at medical visits, ask your provider in advance. Member Services can assist at 1‑800‑362‑8312. (dphhs.mt.gov)

Quick reference cheat sheet

Apply/check case: apply.mt.gov | Helpline 1‑888‑706‑1535. (dphhs.mt.gov)
HMK medical (BCBSMT): 1‑855‑258‑3489 | Medicaid/HMK Plus Member Help: 1‑800‑362‑8312. (dphhs.mt.gov)
Transportation (prior auth): 1‑800‑292‑7114. (dphhs.mt.gov)
Cover Montana (free help): 1‑844‑682‑6837. (covermt.org)
988 Suicide & Crisis Lifeline: 988. (dphhs.mt.gov)
WIC state office: 1‑800‑433‑4298. (dphhs.mt.gov)

FAQs (Montana‑specific)

How long will my application take?
DPHHS says Marketplace transfers take a few days, then state processing is about 15 business days, with a maximum of 45 days during busy times. If it’s been six weeks, call 1‑888‑706‑1535. (dphhs.mt.gov)
Do I need a referral to see specialists?
Usually yes under Passport to Health. Choose a Passport provider and get referrals; call 1‑800‑362‑8312 for help. (dphhs.mt.gov)
Is adult dental really capped?
Yes. Adult Medicaid dental treatment services are capped at $1,125/year (kids and ABD categories are exempt). Preventive, dentures, and anesthesia don’t count toward the cap. (dphhs.mt.gov)
What does HMK (CHIP) cost?
HMK has small copays but total family copays are capped at $215/ ye a r * * . De n t a l b e n e f i t s ha v e a se p a r a t e ann u a l ma x im u m o f * *$ 1,900 and no copays while under that limit. (medicaidprovider.mt.gov, dphhs.mt.gov)
Can I get help paying employer or COBRA premiums?
Maybe. Apply to Montana’s HIPP program; if cost‑effective, the state reimburses premiums. Call 1‑800‑694‑3084. (dphhs.mt.gov)
I live far from specialists—does Medicaid cover hotels/meals?
Yes, when medically necessary and pre‑approved. Meals are covered starting the second day of an overnight trip. Always call 1‑800‑292‑7114 before travel. (dphhs.mt.gov)
I just had a baby. Do I lose coverage?
No. Montana provides 12 months postpartum coverage under Medicaid/HMK; report the birth to OPA. (dphhs.mt.gov)
My income is just above Medicaid. What now?
Check HealthCare.gov subsidies. Open Enrollment for 2026 coverage is Nov 1, 2025–Jan 15, 2026; enhanced subsidies remain through 2025. Call Cover Montana 1‑844‑682‑6837 for help. (healthinsurance.org, cms.gov)
Where can my child get free vaccines?
At VFC providers; vaccine is free (admin fee up to $21.32). Kids on HMK Plus are VFC‑eligible. (dphhs.mt.gov)
Where do I send documents if I can’t upload them?
Use the OPA office locator for emails/addresses, or fax to the statewide number listed on the OPA page; you can also mail to OPA’s Helena PO Box. If unsure, call 1‑888‑706‑1535. (dphhs.mt.gov)

What to do if you’re denied or stuck

Re‑check your household size (count unborn children), and re‑calculate with the 2025 limits in this guide.
Ask for a written denial and appeal rights; sometimes a simple documentation fix reverses a decision.
If still over income, get a Marketplace plan during Open Enrollment or with a Special Enrollment Period (loss of Medicaid, new baby, move).
While waiting, get care at an FQHC on the sliding fee scale and ask about payment plans. (bphc.hrsa.gov)

About This Guide

Compiled by the ASingleMother.org Editorial Team

This guide uses official sources from Montana Department of Public Health & Human Services (DPHHS), HHS/ASPE, CMS, IHS, and established nonprofits. It follows our Editorial Standards and is not legal advice or an agency decision. We verify links and numbers regularly; still, programs change. Last verified September 2025, next review April 2026. Send corrections to info@asinglemother.org.

Read our Editorial Standards (research methods, accuracy, updates, E‑E‑A‑T/YMYL policy). This page of standards was last updated August 2025.

Disclaimer

Program rules, income limits, copays, and contacts can change. Always verify at the linked agency pages or by calling the listed numbers.
Health content on this page is for general guidance, not medical or legal advice. Talk to a qualified professional for your situation.
We protect users by linking only to official/state and established nonprofit sources and by avoiding third‑party data collection where possible. If a link appears broken or suspicious, email info@asinglemother.org and avoid entering personal data until confirmed.

Sources (selected)

Montana DPHHS: Apply/eligibility, contacts, Passport, and member guide pages. (dphhs.mt.gov)
DPHHS: Transportation (Medicaid Transportation Center; prior auth rules). (dphhs.mt.gov)
DPHHS: Adult dental cap; HMK dental benefits. (dphhs.mt.gov, dphhs.mt.gov)
DPHHS: HMK program contacts and postpartum extension notice. (dphhs.mt.gov)
DPHHS: Plan First and 2025 income thresholds (effective through Mar 31, 2026). (dphhs.mt.gov)
Montana Admin. Rules (HMK/HMK Plus income percentages). (law.cornell.edu)
HHS/ASPE: 2025 Federal Poverty Guidelines (used to compute dollar amounts). (aspe.hhs.gov, govinfo.gov)
DPHHS: Health Coverage FAQ (processing times). (dphhs.mt.gov)
DPHHS: HMK copay cap ($215/family/year). (medicaidprovider.mt.gov)
Cover Montana (free Navigators), statewide Help Line. (covermt.org)
HealthInsurance.org and CMS NBPP 2026 fact sheet (Open Enrollment window; subsidy context). (healthinsurance.org, cms.gov)
DPHHS: Vaccines for Children program (admin fee). (dphhs.mt.gov)
DPHHS: CSHS up to 300% FPL. (dphhs.mt.gov)
DPHHS: HIPP program (premium reimbursement). (dphhs.mt.gov)
Montana 988 (state crisis line info). (dphhs.mt.gov)
IHS Billings Area (regional contact list). (ihs.gov)

If you find anything outdated or unclear, email info@asinglemother.org and we’ll fix it fast.

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