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Medicare in Montana

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By the numbers

Medicare is a federal program that provides health coverage for Montana residents who qualify by age, disability, or having certain health conditions (such as end-stage renal disease or amyotrophic lateral sclerosis). In Montana, as in the rest of the country, you can get your benefits through Original Medicare, the federally administered program that includes Part A (hospital coverage) and Part B (medical coverage).

Below is some statistical information from the Centers for Medicare & Medicaid Services on Medicare enrollment in Montana in 2015*:

  • Montana beneficiaries enrolled in Medicare: 199,588
  • Montana beneficiaries enrolled in Medicare plans that include prescription drug coverage: 126,085
  • Beneficiaries enrolled in stand-alone Medicare Part D Prescription Drug Plans: 91,322
  • Beneficiaries enrolled in Medicare Advantage Prescription Drug plans: 34,763

Original Medicare isn’t the only option for Montana beneficiaries. You can, as an alternative way to get your Original Medicare benefits, get your Medicare Part A and Part B coverage through a Medicare Advantage plan (such as a Medicare HMO). These plans must provide at least the same level of coverage as Original Medicare, but may also include other benefits, such as hearing, routine dental, or prescription drugs. Medicare Advantage plans that include prescription drug coverage are known as Medicare Advantage Prescription Drug plans.

If you decide to get your coverage through Original Medicare but would like prescription drug benefits (Medicare Part D), you can get this through a stand-alone Medicare Prescription Drug Plan. Original Medicare doesn’t automatically include prescription drug coverage; you must manually enroll in a separate plan to get Medicare Part D benefits.

Both Medicare Advantage and Medicare Prescription Drug Plans are available through private insurance companies that contract with Medicare. Plan availability, costs, and benefits may vary by location, so always make sure to research Medicare plan options for your specific zip code and county in Montana.

Medicare resources in Montana

Montana Medicare Savings Programs: Beneficiaries in Montana may be eligible for help with Medicare costs if they have limited income or assets. Depending on the level of assistance you qualify for, Medicare Savings Programs may help pay for premiums, copayments, coinsurance, and deductibles. To find out if you’re eligible for a Medicare Savings Program in Montana, contact the Montana Medicaid department.

Montana State Health Insurance Counseling and Assistance Program (SHIP): The Montana State Health Insurance Assistance Program (SHIP) is a free counseling service for Medicare beneficiaries and their families or caregivers. The program is funded by the Centers for Medicare & Medicaid Services (CMS) and may be a good resource if you need more information on how Medicare works and your coverage options.

*Statistical data from the Centers for Medicare & Medicaid Services, “On its 50th anniversary, more than 55 million Americans covered by Medicare” as of July 28, 2015.

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