Montana Student Health Insurance Options | Healthcare Coverage and Plans

What You Need to Know

You can get medical insurance through your parents’ plan or one of your own.

Costs and benefits vary for the different kinds of insurance.

Specific enrollment periods apply for student health plans and plans that meet Affordable Care Act requirements, while others can be available year-round.

Are you thinking about healthcare as you leave home for your college or university? Like most college students, you probably feel you don’t need health insurance because you don’t visit doctors that often. Young adults have the highest uninsured rate. But if you want to be covered or if your school requires health insurance coverage, Montana offers you several choices.

What Are Health Insurance Options for Montana Students?

Here are some of the student health insurance policies available in Montana:  

• Through your college or university: Your school may offer its own affordable student plan or one from an insurance provider. 

• Your parents’ insurance plan: Legally, you can stay on their plan until you’re 26.

• Health Insurance Marketplace plans: You can buy plans that comply with the Affordable Care Act (ACA) through Montana’s federally run Marketplace.

• Medicaid (which includes its expansion, plus its children’s program and CHIP): State-based free or low-cost health insurance may be available, based on your age and income.

• Catastrophic health plans: If you’re under 30, you can get a lower-premium plan with a high deductible that covers serious accidents or sickness. 

• Short-term health plans: You can get short-term plans, but they may be for less than the legal maximum (364 days initially, plus renewals for a total of 36 months). 

• Job-based health plans: If you’re employed, your job may provide medical coverage.

Why Do Montana Students Need Health Insurance? 

You may be required to buy your school’s student health plan if you can’t show proof of comparable coverage. Or, like one-sixth of young adults, you may have a chronic medical condition you need to manage.

Without insurance, one serious accident or illness could mean large medical bills, which could follow you through and even after college. For example, government estimates say that it costs up to $7,500 to fix a broken leg or $30,000 for a three-day hospital stay. 

What Should You Consider When Searching for Student Health Coverage in Montana?

Here are some questions to consider as you look at insurance options:

Will You Attend School In-State or Out-of-State? 

If your parents’ Marketplace or job-based plan covers dependents, it can cover you regardless of where you go to school. Check that their plan has network providers near your school so you can get in-network rates for services.

Can Someone Claim You as a Dependent? 

Your parents can claim you as a dependent, but if they do, you won’t qualify for premium subsidies if you buy your own Marketplace plan. 

Will You Stay on Your Parents’ Plan or Enroll in Your Own Plan?   

By law, you can stay on your parents’ Marketplace or employment plan until age 26 if the plan covers dependents. On your own plan, your lower income could qualify you for lower premiums through subsidies.

What Plans Are Cheaper?

Your family’s or your income will determine your eligibility for Medicaid’s no- or low-cost health coverage or subsidies on Marketplace plans. Catastrophic plans have low premiums but don’t qualify for subsidies.

What Plans Offer Better Coverage?

Health policies that follow ACA requirements typically offer the best coverage. They must cover preexisting conditions and “10 essential health benefits,” including hospital care, emergency services, prescription drugs and mental health services.  

What If You Skip Health Insurance? 

Montana doesn’t mandate health insurance, so you won’t pay a fine if you don’t have any. If your school doesn’t require health insurance, you could save the cost of monthly premiums, but you risk paying large out-of-pocket bills if you need medical care. 

What Are Health Insurance Rules in Montana?

In 2019, the Centers for Medicare & Medicaid Services (CMS) approved Montana’s reinsurance waiver starting in 2020, which reimburses insurers for high-cost claims so that premiums stay lower for individuals buying coverage. Premiums may be lowered by up to 9%, but subsidies will be lowered as well. CMS also approved a waiver that requires a small contribution from Medicaid expansion (HELP) recipients in the form of premiums. In 2019, Montana requested a work requirement for Medicaid expansion recipients but it hasn’t been approved. 

How Do You Get Covered Under Your Parents’ Plan in Montana?

You can be added to your parents’ Marketplace insurance plan during the annual Open Enrollment Period (or during a Special Enrollment Period if you’re eligible). Legally, a plan has to cover you to age 26 if it has dependent child coverage. You qualify even if you no longer live with your parents or if you graduate, get married or have a child.

How Do You Get Covered Under Your School Plan in Montana?

If schools require insurance, many will offer affordable student health insurance plans to full-time undergraduates who carry a minimum number of credit hours. Health insurance costs and coverage vary by school. Some schools add those costs to your student account so that you can pay for them with your financial aid. Your school’s admissions office can provide the details.

Search Your University using UnitedHealthcare’s student resource finder to see requirements and options. 

How Do You Get Covered Through the Affordable Care Act in Montana?

Your parents can add you to their ACA plan during the Open Enrollment Period, between November 1 and January 15 each year. You can still be added if you miss that period by qualifying for a Special Enrollment Period for reasons like losing other health coverage.  

In Montana, you can buy an ACA-compliant individual plan and apply for financial help to lower premiums through the federally run exchange at HealthCare.gov. This is where you can preview health insurance plans and prices from different health insurance companies. You can also buy ACA plans on- and off-exchange from insurers, certified agents, brokers, certified producers and navigators. 

Since Marketplace plans run month-to-month, you don’t have to buy a full policy year’s coverage.

Your out-of-pocket costs can be lower if you qualify for subsidies such as an advanced premium tax credit (APTC) or cost-sharing reductions (CSR) available with specific Marketplace plans.About 85% of Montana residents who apply qualify for APTCs.¹⁵ You can’t get subsidies if you buy ACA plans outside of the Marketplace. 

How Do You Get Covered Through Medicaid or CHIP in Montana?

Medicaid provides healthcare coverage to eligible low-income or disabled Montanans through these Montana Department of Public Health & Human Services (DPHHS) programs: Medicaid, the HELP Plan and Healthy Montana Kids.  

Coverage under Montana’s Medicaid program depends on your age, household size, and income.In 2018, Montana expanded Medicaid (called the Montana Health and Economic Livelihood Partnership or HELP) under the ACA to include almost all childless adults ages 19-64 with incomes up to 138% of the federal poverty level. Benefits are the same as under standard Medicaid.

Two programs offer free or low-cost health insurance to children under age 19. Healthy Montana Kids Plus (HMK Plus) used to be known as Children’s Medicaid. Healthy Montana Kids (HMK) is the Montana Children’s Health Insurance Program (CHIP) for those who are uninsured, ineligible for Medicaid and meet income requirements.

You can apply for health coverage assistance under the various Montana DPHHS programs at its website or call the Public Assistance Help Line at (888) 706-1535 with your questions about applications or eligibility.

What Are Other Options for Coverage in Montana?

If you’re under 30, catastrophic coverage may be of interest. Although these lower-premium plans don’t cover all ACA-required benefits, they are available through the Marketplace. With the high deductible, you may have to pay for most services out-of-pocket before your coverage begins. Your plan does cover preventive care and three primary care office visits per year before the deductible is met.

Consumer Operated and Oriented Plans (CO-OPs) grew out of the Affordable Care Act as private, nonprofit, state-licensed health insurance carriers whose profits are reinvested in the business to help lower premiums. The goal was a less expensive, member-run alternative to the big health insurance companies. While not many states’ CO-OPs have survived the decade, Montana’s Mountain Health CO-OP has expanded coverage to Idaho and Wyoming. Plans can be purchased on Montana’s Marketplace and may be eligible for government tax credits.¹⁹

Short-term health plans are meant to be temporary until you’re able to get coverage under a traditional plan. It’s available for up to 3 months with a 1-month extension. Unlike plans purchased through the Health Insurance Marketplace, short-term health insurance is not required to include the 10 essential health benefits outlined in the ACA and generally doesn’t cover pre-existing conditions.

What Are Resources for Montana Students?  

Your school’s admissions office will be able to help you. You can get information on nonschool plans through Montana’s Offices of Public Assistance (OPA) at (888) 706-1535 or Montana’s Department of Public Health & Human Services.   

Next Steps

If you want health insurance, look at the various healthcare options available in Montana, so the plan you choose is the best one for you before you head off to school.

Article Sources

1. “Montana Medicaid Redetermination.” Montana Department of Public Health and Human Services. 7 June 2024, https://dphhs.mt.gov/InteractiveDashboards/MontanaMedicaidRedetermination.
2. Mountain Health CO-OP. “Benefits.” Mountain Health CO-OP. 7 June 2024, https://mountainhealth.coop/benefits/.
3. Healthcare.gov. “Catastrophic Health Plans.” Healthcare.gov. 7 June 2024, https://www.healthcare.gov/choose-a-plan/catastrophic-health-plans/.
4. Mountain Health CO-OP. “Mountain Health CO-OP.” Mountain Health CO-OP. 7 June 2024, https://mountainhealth.coop.
5. Healthcare.gov. “Montana SHOP Rates.” Healthcare.gov. 7 June 2024, https://www.healthcare.gov/small-businesses/shop-rates/montana/.
6. Montana State Employee Benefits Plan. “Montana Benefits.” Montana State Employee Benefits Plan. 7 June 2024, https://benefits.mt.gov.