Last updated: October 29, 2026
Medical information only
This guide gives general information about health coverage and health-cost help in Montana. It is not medical, legal, tax, disability, or government-agency advice. For medical symptoms, treatment choices, pregnancy concerns, disability decisions, or emergencies, contact a qualified provider, clinic, hospital, public agency, or crisis line.
Bottom line
If you are a single mother, single parent, pregnant mother, grandparent caregiver, or low-income family in Montana and need health coverage, start with Medicaid, Healthy Montana Kids, or the Marketplace. Montana Medicaid and Healthy Montana Kids can help with doctor visits, pregnancy care, hospital care, prescriptions, mental health care, dental care, and rides to covered medical care when rules are met.
The fastest way to start is the Montana health coverage page. If you also want SNAP, TANF, or other public assistance checked, use the state application portal or call the Public Assistance Helpline at 1-888-706-1535. If your income is too high for Medicaid, Cover Montana can help you compare Marketplace plans and find free enrollment help.
These programs are not only for mothers. Children, pregnant people, fathers, grandparent caregivers, people with disabilities, and other eligible adults can use the same official application paths. For a broader benefits map, keep ASMOM’s Montana help guide open while you work through health, food, housing, and child care needs.
If you need medical help now
- Call 911 or go to an emergency room if there is a serious injury, chest pain, trouble breathing, heavy bleeding, labor, danger to yourself or someone else, or another emergency.
- Call or text 988 crisis help if you or your child is in a mental health, suicide, substance-use, or emotional crisis.
- If you are pregnant, recently gave birth, or lost coverage, report the change through member services so the Office of Public Assistance can review pregnancy or postpartum coverage.
- If you are uninsured and need care soon, use the federal clinic finder. Community health centers can see people with or without insurance and may use sliding fees.
What has changed since June 2026?
Montana began its Medicaid Expansion activity rule on July 1, 2026. The July–September grace period ended, so the rule can affect decisions from October onward. Some parents, pregnant people, people with health needs, and other groups may qualify for an exclusion. Check the state’s rule FAQ before you assume you must meet the hours.
Montana also reports new noncitizen coverage limits from October 1, 2026. Some Medicaid Expansion members will face eligibility checks every six months starting in January 2027. These rules do not apply the same way to every child or adult in Medicaid. The details are in the changes section below.
Where to start
Start with the person who needs care most urgently. A child may qualify even if a parent does not. A pregnant person may fit different rules than another adult. A caregiver for a child with a disability may need Medicaid, disability supports, school help, and clinic referrals at the same time.
If you need coverage
Apply for Montana Medicaid. Adults ages 19 to 64 may qualify through Medicaid Expansion based on income and other rules. Activity rules may now apply, but some people are excluded. If you care for a child under age 14, ask OPA about the caregiver exclusion.
If your child needs care
Apply for Healthy Montana Kids or HMK Plus. Montana says HMK covers eligible children up to age 19.
If you are pregnant
Apply and report the pregnancy. Montana says eligible postpartum members can get 12 months of continuous coverage.
If Medicaid says no
Ask Cover Montana about Marketplace plans. A Medicaid denial or loss may open a Special Enrollment Period.
If pregnancy, birth, breastfeeding, or newborn needs are part of the problem, use the pregnancy help guide too. Ask OPA to check coverage for each person in the home.
Quick reference
| Need | Best first step | Reality check |
|---|---|---|
| Adult health coverage | Apply for Medicaid or Marketplace help. | Income, household size, age, disability, pregnancy, and immigration rules matter. |
| Child coverage | Apply for HMK or HMK Plus. | A child may qualify even when the parent does not. |
| Pregnancy care | Report pregnancy and apply right away. | OPA must have the update to review pregnancy or postpartum coverage. |
| Care while uninsured | Call a community health center. | Sliding fees can help, but appointments may fill fast in rural areas. |
| Ride to care | Ask before the appointment. | Ask about a trip ID and when advance approval is required. |
| Food and nutrition | Check WIC and SNAP. | WIC, SNAP, and Medicaid have different rules. |
Montana Medicaid and Healthy Montana Kids
Montana Medicaid and HMK Plus cover eligible low-income Montanans under Medicaid rules. Healthy Montana Kids (HMK) is Montana’s separate CHIP coverage for eligible children under age 19. Your child may qualify even if you do not. The HMK program page lists medical care, dental care, eyeglasses, and other covered services.
Montana’s member services page lists standard Medicaid and HMK Plus benefits such as doctor, hospital, and emergency services; maternity and newborn care; mental health and substance-use treatment; prescription drugs; dental care; transportation to appointments; vision care; and other covered services when medically necessary.
How to apply
- Apply online if you can, and save your confirmation number.
- Call 1-888-706-1535 if you need help applying, have no internet, need to report a change, or need a replacement card.
- Use the Public Assistance offices list if you need a local office, fax number, mailing address, or field office email.
- If you apply through HealthCare.gov, the Marketplace can send Medicaid or CHIP information to Montana when someone in the household may qualify.
Tip
Apply even if you are not sure. The state can check more than one category. Children, pregnancy, disability, age, and household changes can all affect the answer.
Income starting points
Use income numbers as starting points, not final eligibility decisions. The table shows rounded 2026 monthly screening figures for adults, children, and pregnancy. The figures are based on 138%, 261%, and 157% of the 2026 federal poverty guidelines, as described in Montana Legal Services’ Medicaid guide. The state coverage page still shows some lower adult figures under a 2026 heading. Ask OPA to check your case rather than relying on this screening table alone.
| Family size | Adult 19-64 | Child 0-18 | Pregnant woman |
|---|---|---|---|
| 1 | $1,835 | $3,471 | $2,088 |
| 2 | $2,489 | $4,707 | $2,831 |
| 3 | $3,142 | $5,942 | $3,574 |
| 4 | $3,795 | $7,178 | $4,318 |
| 5 | $4,448 | $8,413 | $5,061 |
| 6 | $5,101 | $9,648 | $5,804 |
If your income is close to the line, apply anyway. If your income is clearly above Medicaid, ask about Marketplace savings, employer coverage, tribal or IHS care, and sliding-fee clinics.
These are rounded estimates calculated from the 2026 federal poverty guidelines, not an official decision. A pregnancy may change the count used in a case. Other rules and income deductions may change the result. If your income is near any line, apply and request a written decision.
Pregnancy, postpartum, and family planning
If you are pregnant, apply for coverage and report the pregnancy as soon as you can. Montana says postpartum women enrolled in Medicaid and Healthy Montana Kids may be eligible for 12 months of continuous coverage. OPA must have updated pregnancy or postpartum information to review the extension.
If you need family planning care but do not qualify for full Medicaid, check Montana Plan First. It offers certain family planning services for eligible Montana women ages 19 through 44 who can become pregnant but are not pregnant and meet the income rules. Plan First is not full health insurance. Ask what it covers before you book a visit.
WIC can also help during pregnancy and after birth. Montana WIC services can include food benefits, nutrition education, breastfeeding support, and referrals. For food help in the home, see ASMOM’s Montana food help page.
If you do not qualify for Medicaid
Montana uses HealthCare.gov enrollment dates for Marketplace plans. The next regular open enrollment for 2027 coverage starts November 1, 2026. Enroll by December 15 for coverage starting January 1, or by January 15, 2027 for coverage starting February 1, if the required premium is paid. Outside open enrollment, a birth, move, or loss of other coverage may allow a Special Enrollment Period. You can apply for Medicaid and CHIP at any time of year.
Cover Montana can help you compare plans, check savings, and find a local enrollment assister. Its coverage help page says loss of Medicaid or Healthy Montana Kids can trigger a Special Enrollment Period, and many SEPs have short deadlines. Do not wait if you receive a denial or closure notice.
Watch out
Do not pick a plan only because the monthly premium looks low. Check doctors, hospitals, prescriptions, deductibles, copays, mental health care, pregnancy care, and whether your child may be better served by HMK or HMK Plus.
Clinics and low-cost care while you wait
If you have no insurance, lost coverage, or are waiting for a decision, call a community health center and ask for a sliding-fee appointment. These clinics can help with primary care, women’s health, behavioral health, referrals, prescriptions, and help applying for coverage.
If you are American Indian or Alaska Native, you may also be able to use IHS, Tribal, or Urban Indian health services. The IHS Billings area page lists regional facilities and contacts. Rules can vary by tribe, clinic, Purchased/Referred Care status, and residence, so ask the clinic benefits office before specialty care.
If health costs are part of a bigger crisis, use ASMOM’s Montana emergency help page for food, rent, utility, shelter, and local referrals.
If you already have a hospital bill, ask the billing office for its financial assistance policy. Ask for the form, income rules, deadline, and what happens to your bill while it is reviewed. This is not the same as a Medicaid application.
Extra help with health costs
| Help path | What it may help with | Where to check |
|---|---|---|
| Medicaid rides | Rides or mileage for covered care; trip IDs and advance authorization rules differ by trip type. | Check the transportation rules. |
| Adult dental | Medically necessary dental and denturist services, with limits for many adults. | Check the dental page. |
| Children’s dental | Dental care for children, with provider and program rules. | Ask HMK or a Medicaid dental provider. |
| Plan First | Limited family planning services for eligible people. | Use Plan First. |
| CSHS | Limited aid for some Montana children and youth with special health needs, up to $2,000 per year if eligible and funds remain. | Start at CSHS assistance. |
| WIC | Food, nutrition education, breastfeeding support, and referrals. | Use Montana WIC. |
For more about getting to covered care and finding a dentist, see our Montana transportation and dental care overview.
Before a medical ride: Montana now lists Modivcare as its transportation service. Ask for a trip ID and check whether you need advance approval. Prior approval is required for some trips over 100 miles one way, out-of-state care, meals or lodging, and an attendant. A short personal-car trip may have different reimbursement steps. Call 1-800-292-7114 and confirm what applies to your trip.
For local dental clinics, providers, and low-cost care, use the Montana dental care guide. The state rules can differ from the broader dental guidance below.
2026 Medicaid Expansion changes and what comes next
Montana DPHHS Medicaid updates say the new community engagement rules began on July 1, 2026. They apply to many adults ages 19 to 64 covered through Medicaid Expansion, not to every Medicaid member. The state reviewed compliance without denying people just for this new rule from July through September. That grace period ended in October.
Who may need to show 80 hours?
Expansion adults who are not excluded generally must show 80 hours in a month of approved activity. This can be work, school at least half time, job training, volunteer work, or a mix. Montana may check other records first, then ask for proof such as pay stubs, school letters, or volunteer logs. At a new application, the state looks at the prior month. At renewal, it checks at least three months since the last review.
Who may be excluded?
An exclusion means the activity rule may not apply to you. DPHHS lists parents and caregivers of a dependent child under 14 or a person with a disability, pregnant people and eligible postpartum people for up to 12 months, many American Indian or Alaska Native members, certain former foster youth under 26, some people with serious health needs, and others. There are also time-limited hardship exceptions. Ask OPA to check your status and tell you how to report it. Do not assume you are required to work 80 hours just because you are an adult.
October 2026 and January 2027 changes
- October 1, 2026: Montana reports new federal-funding rules that limit Medicaid eligibility for some qualified noncitizens, including some refugees and asylees. These are sensitive, case-specific rules. Ask OPA about coverage categories and a qualified legal aid or immigration professional before deciding there is no coverage path.
- January 1, 2027: For many Medicaid Expansion members, eligibility reviews change from once a year to every six months. Montana says this six-month change does not apply to American Indian/Alaska Native members.
- January 1, 2027: Retroactive Medicaid coverage changes. Expansion cases move from up to three months to up to one month; other groups move from up to three months to up to two months. Coverage for old bills is not automatic. Ask OPA whether you can request it and what dates can be checked.
Your next step: Open every DPHHS notice and keep your mailing address, phone, email, and coverage details up to date. If you think an exclusion applies or a decision is wrong, ask which form, proof, and appeal deadline apply to your own case. The medically frail guidance explains additional steps for people with serious health needs.
Documents and information checklist
You do not need every document before you ask for help. A small folder and a record of every call, date, notice, and upload can prevent delays.
| What to gather | Why it matters | Examples |
|---|---|---|
| Household details | Used to decide who is applying and household size. | Names, birth dates, address, phone, email. |
| Identity numbers | Needed only for people applying. | Social Security numbers or immigration documents. |
| Income proof | Used to decide Medicaid, HMK, and Marketplace help. | Pay stubs, employer letters, benefit letters, self-employment records. |
| Current coverage | Helps avoid gaps and wrong plan choices. | Employer insurance, COBRA, Medicare, another plan. |
| Pregnancy or birth update | Needed for pregnancy or postpartum review. | Due date, birth date, pregnancy statement, postpartum update. |
| Medical bills | May help if asking about past coverage or clinic aid. | Bills from recent months, collection letters, payment plans. |
For Medicaid Expansion activity checks: If the state asks, keep pay stubs, school records, signed volunteer logs, or proof of a care, pregnancy, disability, or health-related exclusion. Ask OPA what it can check on its own before sending private medical papers.
Common mistakes to avoid
- Not reporting pregnancy, birth, income, address, or household changes.
- Ignoring notices because the envelope looks routine.
- Missing a Marketplace deadline after a Medicaid denial or closure.
- Booking a long-distance medical trip before checking trip IDs and prior-approval rules.
- Assuming your dentist, therapist, or specialist takes your plan without checking.
- Using unofficial eligibility calculators as final decisions.
- Not asking about appeal rights when a denial looks wrong.
What to do if denied, delayed, or overwhelmed
If your application is delayed, call the Public Assistance Helpline and ask what is missing, what address is on the case, and when a notice was sent. If you applied through HealthCare.gov, ask whether the application was transferred to Montana and whether the state needs more proof.
If you are denied, ask for the written denial and appeal rights. Check whether the decision used the right household size, income, pregnancy status, child information, disability information, and address. Montana’s Medicaid changes page says adverse-action notices include appeal instructions, and formal appeals go through the Office of Administrative Hearings.
If you lose Medicaid or HMK, call Cover Montana quickly because a Special Enrollment Period may be time-limited. While you wait, use clinics, local health departments, 211, and hospital financial assistance offices for urgent needs. Keep your closure notice and proof of follow-up.
If disability is part of your case, ask OPA about disability-based coverage and whether SSI or SSDI rules are relevant. If health bills compete with rent, food, or child care, review Montana child care and Montana housing next.
If a notice says you missed the Medicaid Expansion activity rule, ask OPA whether an exclusion, short-term hardship, or missing record explains it. Request the written reason and follow the appeal instructions on that notice. The deadline can depend on the notice and program. Do not rely on a single general number of days.
If you have unpaid hospital bills, ask about hospital financial help while your case is reviewed. If you need general family support, see the related Montana housing or child care guidance above rather than waiting on a medical coverage decision to solve those needs.
Phone scripts
Calling OPA
“Hi, I applied for Medicaid or Healthy Montana Kids on [date]. My name is [name], and my case number is [number if I have it]. Can you tell me what is missing, what address you have, and when I should expect a notice?”
Reporting pregnancy or birth
“I need to report a pregnancy, birth, or postpartum change on my Medicaid or HMK case. What proof do you need, how should I send it, and will my case be reviewed for 12 months of postpartum coverage?”
Calling for a ride
“I have a Medicaid-covered visit on [date] at [clinic]. Do I need a trip ID, a ride booking, or prior approval? What records or signatures must I keep?”
Calling a clinic uninsured
“I do not have insurance right now, or my application is pending. Do you offer sliding-fee appointments? What should I bring for income proof, and can you help me apply for Medicaid or Marketplace coverage?”
Resumen en español
Si vive en Montana y necesita seguro médico, empiece con Medicaid, Healthy Montana Kids o el Mercado de seguros. Puede solicitar ayuda por internet, por teléfono o con una oficina local. Si está embarazada o acaba de tener un bebé, reporte el cambio a OPA para que revisen su cobertura.
Si no tiene seguro y necesita atención, llame a una clínica comunitaria y pregunte por tarifas según sus ingresos. Si recibe una carta de Medicaid, léala pronto y responda antes de la fecha límite. Si le niegan cobertura, pida la carta por escrito y pregunte por sus derechos de apelación.
Desde julio de 2026, algunos adultos con Medicaid Expansion deben cumplir una regla de actividades. Hay excepciones, como para ciertos padres que cuidan a menores de 14 años y para personas embarazadas. Pregunte a OPA qué reglas aplican a su caso. No ignore cartas sobre renovación, documentos o apelaciones.
FAQ
Can single mothers in Montana get Medicaid?
Yes, some can. Eligibility depends on income, household size, age, pregnancy, disability, immigration status, and other rules. The best way to know is to apply through Montana or HealthCare.gov.
Can my child qualify if I do not?
Yes. Children often have higher income limits through Healthy Montana Kids or HMK Plus. Apply for your child even if you think your own income is too high for adult Medicaid.
Does Montana Medicaid cover pregnancy after birth?
Montana says eligible postpartum women enrolled in Medicaid and Healthy Montana Kids can receive 12 months of continuous coverage. Report pregnancy, birth, or postpartum changes to OPA right away.
Does Medicaid pay for rides to appointments?
Montana Medicaid may help with eligible rides and mileage. The steps differ by trip. Check whether you need a trip ID, a ride booked with Modivcare, or advance authorization before travel.
What if I am denied Medicaid?
Ask for the written denial and appeal information. Check for mistakes in income, household size, pregnancy status, disability information, and address. Then ask Cover Montana about Marketplace coverage if Medicaid is not available.
Where can I get care while uninsured?
Call a community health center and ask about sliding-fee care. Hospitals can treat emergencies, but a community clinic is often a better starting point for routine care, prescriptions, and follow-up visits.
Do all single mothers have to work 80 hours for Medicaid?
No. The rule is for certain Medicaid Expansion adults ages 19 to 64. Some parents who care for children under 14, pregnant and eligible postpartum people, and other groups can be excluded. Ask OPA to check your situation.
How often will my Medicaid case be reviewed in 2027?
Starting January 2027, many Medicaid Expansion cases will be reviewed every six months. Other Medicaid groups can follow different rules, and Montana says the change does not apply to American Indian/Alaska Native members.
Can I get help with a hospital bill if I have no insurance?
Yes, you can ask a hospital for its financial assistance or charity care policy. Approval depends on that hospital’s rules and your case. Also ask OPA whether any past bills may qualify for Medicaid coverage.
About this guide
This guide uses official federal, state, local, and other high-trust nonprofit and community sources mentioned in the article.
A Single Mother is independent and is not a government agency, benefits office, lender, law firm, medical provider, or tax advisor.
Program rules, funding, local availability, and eligibility can change. Always confirm details with the official program before you apply or make decisions.
Verification: Last verified October 29, 2026; next review January 27, 2027.
Corrections: If you see something wrong or outdated, email suggestions@asinglemother.org.
Disclaimer: This article is for general information only. It is not legal, financial, medical, tax, immigration, disability, safety, or government-agency advice.
Last updated: October 29, 2026 Next review: January 27, 2027