Health Care Coverage and You – What are your options?

As you may know November 2nd marked the beginning of Open Enrollment for healthcare coverage through the Marketplace. It’s crucial that you investigate your options and find coverage that is right for you and your family. Failure to have health insurance this year means you will probably have to pay a fee of at least $695 per adult and $347.50 per child under 18.

Healthcare Marketplace

You may be wondering how you’ll afford this healthcare coverage, but don’t stress there are many great options! To start your research look at Montana's Marketplace website and their get covered calculator, which allows you to get simple estimates on what your monthly costs would be. The Marketplace is the only place that offers Advanced Premium Tax Credits, which cover part or most of your monthly costs so long as you filed taxes for this past year – it’s really a great system to get VERY affordable healthcare coverage. Last year these tax credits helped 80% of Montanans enrolled through the Marketplace pay for health insurance. Enrollment through the Marketplace is open November 2nd 2015 through January 31st 2016, so get on it! If you have any questions or need assistance in navigating the Marketplace you can contact a local enrollment specialist. You can also go directly to the Marketplace at


Healthcare for Kids

Some low income families may qualify for Medicaid, Healthy Montana Kids Plus (HMK+ which is basically Medicaid for children), and Healthy Montana Kids (HMK). Generally if your family’s income falls under 138% of the Federal Poverty Line you will probably qualify for Medicaid and HMK+, though there are many exceptions and different qualifying circumstances for those with disabilities, veterans, etc., so it’s worth looking into your circumstances and seeing if you can qualify. HMK provides free or low-cost health insurance for children and generally one qualifies for it if you family’s income falls within 144% and 261% of the Federal Poverty Line.

Enrollment for these programs is always open.

  • If you need help figuring out where you may be in regards to the Federal Poverty Line you can look here.
  • Find out more about Medicaid for kids and getting covered here
  • Look here to find out more about HMK.
  • You can apply for all of these programs at


Montana Medicaid Expansion

Montana has expanded Medicaid, and coverage will be available from January 1, 2016 onwards. This means that many more Montana residents will be able to access health coverage. Individuals who make up to 138% of the federal poverty level, are Montana residents, and are not eligible for Medicare should apply.

Enrollment for Medicaid is always open

  • If you need help figuring out where you may be in regards to the Federal Poverty Line you can look here.
  • For more information about Medicaid expansion:
  • Apply

– Over the phone at the Federal Marketplace at 1–800–318–2596

24 hours a day / 7 days a week

– Online at or


Another option to look into is Medicare, which provides supplemental coverage to your primary health insurance for people 65 or older or with disabilities. Enrollment is open now until December 7th, 2015. You can check out plans and cost estimates by looking at their website here.




There are many options for affordable health insurance. Finding It may seem daunting at first, but there’s lots of information out there and you can always speak to a local enrollment specialist to help you sort through it all. Just make sure to do it before the open enrollment closes and to file you taxes so you can qualify for these benefits!

Here’s to healthy year for you and your family in 2016!