Montana Health Insurance

Montana (MT)

Individual Health Insurance Regulations

Medical insurance is necessary to protect your family's health against unfortunate circumstances of sickness or injury. Before opting for health coverage, you need to go through your family's medical needs and your budget. Being a Montana resident, you can choose from various product alternatives. The Montana State Auditor's Office supervises the regulations under which the Montana health insurers can sell private health plans to individuals and families.
Insurance companies offering individual/family medical insurance in the state of Montana are permitted to medically underwrite any application for health insurance. Thus, the insurance company may decline an application based on the health status of the applicant. Insurance companies may approve and application from a person with a pre-existing medical condition and place an elimination rider on the policy the limits or restricts benefits for the treatment of this medical condition. Montana also requires each insurance company to offer a uniform health plan that has a 50% coinsurance, a $1,000 annual deductible and out-of-pocket maximum of $5,000. Each insurance carrier is also allowed to offer other non-standardized health plans with their own benefit levels. There are no premium caps imposed on insurance carriers offering individual health insurance. Higher rates may be charged based on health status and other demographic factors. There is a maximum 36 month look-back period and 12-month pre-existing condition exclusionary period, but creditable coverage must be recognized and applied to this exclusionary period.
Search for plans and the costs associated with them using the search box above. We provide individual, family, group and student health plan quotes for you to compare on all states and zip codes. Remember that having coverage leads to a healthier lifestyle as you are able to get regular doctor checkups and therefore a low-cost premium.

Montana (MT)

Small Group Health Insurance Regulations

In Montana, a small business is and company with 2-50 employees. Insurance companies offering small business health plans must insure and small group that meets eligibility requirements and they may not decline any qualified group for medical reasons. Premiums charged to newly enrolled small groups may vary by 25% based on certain factors, including the overall health status of the group. Employees may require a waiting period for new hires, and employees must enroll in the group plan within 30 days to enroll after becoming eligible. HMO carriers are permitted to place a 2-month waiting period on any new employee that wishes to enroll in an HMO plan. Newborns and newly adopted children can be added to the group plan outside of the enrollment period but must do so within 31 days of birth or final adoption. Insurance companies are allowed to exclude treatment of pre-existing medical conditions for a maximum period of 12 months after reviewing the health history for 6 months, but they must recognize prior creditable coverage and deduct that from the exclusion period time. Any small business purchasing group medical insurance must meet minimum participation requirements.

Montana COBRA and Continuation Coverage

Any business with 20 or more employees are bound by Federal COBRA regulations and must offer 18 months of continued coverage under the group health plan to any departing employee that meets COBRA eligibility requirements. Some qualified dependents are able to remain on COBRA for up to 36 months. Montana does not have a mini-COBRA law that applies to companies with fewer than 20 employees. For persons leaving a group plan that is not subject to federal COBRA regulations, conversions options are available if they have been on the group plan for at least 3 months. However, Montana does not have a mini-cobra for companies with less than 20 employees. A conversion plan allows the insured individual to convert their group coverage into an individual health plan with a premium no greater than 150% of the standard rate. For those that exhaust their COBRA benefits, or are uninsurable for medical reasons, the Montana Comprehensive Health Association is the state's high-risk pool and offers guaranteed issue coverage at a higher monthly premium.