Montana Health Insurance

According to the Center for Disease Control, an average of 16.1% of Montana residents went uninsured for Montana health insurance every year between 2001 and 2003.

Montana Health Insurance Regulations

An individual obtaining Montana health insurance through an employer cannot be denied access to medical insurance, nor can that insurance coverage be limited. Persons looking to obtain individual Montana health insurance, however, can be denied or limited in their access to medical insurance coverage. These limitations and denials can be a result of health or age or any other factor that the insurance company sees as a potential risk-factor.

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Pre-Existing Conditions

Montana health insurance companies can impose elimination riders and/or pre-existing condition provisions. Any individual insurance policy in Montana can be amended to exclude certain pre-existing conditions for the duration of the insurance plan. It can also exclude coverage for an entire body part or system. Montana health insurance companies define a pre-existing condition as any medical condition that has been diagnosed or received treatment within the three years prior to the new Montana health insurance policy. The new medical insurance plan can exclude coverage for this condition for up to 12 months but prior continuous medical insurance can be credited for this time provided previous coverage has not had a lapse of over 30 days.

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Health Insurance Renewal

Every individual is guaranteed the right to renew existing Montana health insurance provided they have not provided false information and have paid all premiums on time. There are, however, no regulations on Montana health insurance rates and therefore, even if the policy is renewed, policy rates can increase based on changes in health and age. The same is true for new policy owners: Montana health insurance companies can charge more depending on health and age.

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Benefits

Montana does require all health insurance companies to offer uniform health benefits to all consumers. These plans are less costly but have sparse coverage. It does not cover other benefits that Montana law requires all other individual health insurance policies to cover.

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Pregnancy

Although pregnancy can sometimes be considered a pre-existing condition under Montana law, all newborns are automatically covered under the parent’s individual health insurance plan for the first 31 days following birth. After this time the policies must be adjusted to accommodate the new dependent. Disabled children can remain under a parent’s health insurance policy beyond the age at which most individuals are no longer considered dependents.

For individuals between plans or between employers, some Montana health insurance companies sell temporary medical insurance.

Alternative Montana Health Insurance Options

For individuals unable to afford individual Montana health insurance or might otherwise be considered “uninsurable” the state has programs that can help:

• Montana Medicaid is available to eligible individuals who meet the qualifying criteria.
• Montana Comprehensive Health Association (MCHA) is Montana’s high-risk pool for health insurance. Individuals who might be considered “uninsurable” can buy insurance through a state group health insurance plan. Pre-existing condition periods may apply. There are a number of health care options to choose from.
• Montana Children’s Health Program (MTCHIP) is designed to provided health insurance to children up to 19 years of age whose families do not qualify for Medicaid and who cannot otherwise afford Montana health insurance.

Montana Department of Insurance

Montana Department of Insurance/ Montana State Auditor’s Office:

840 Helena Ave.
Helena, MT 59601
Helena 444-2040
In Montana (800) 332-6148
TDD (406) 444-3246
Main Fax (406) 444-3497

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For other Montana Insurance Resources, See:

• Montana Auto Insurance
• Montana Home Insurance
• Montana Health Insurance

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