Children who receive proper medical care typically perform better in school, studies show
Health insurance can be too costly for some, yet paying the costs out of pocket may not be a solution either. In Montana, families and certain qualified adults may be eligible for one of the health insurance plans offered by the state. These plans provide free or low-cost care for medical treatment, and in some instances, the plan may also include dental and prescription drug coverage.
Healthy Montana Kids
Healthy Montana Kids provides medical care for children up to 19 years of age. Eligible participants must be residents of Montana and either qualified aliens or U.S. citizens. Income limits apply and depend on the number of people in the household. Co-payments apply in some instances, but the maximum co-pays are $215 per family. The HMK plan is comprehensive, including dental, vision and hearing care, prescription drugs, physician and hospital care, ambulance services and mental health care. No exclusions apply for pre-existing conditions. Applications are available online or by telephone, as well as through local health departments, WIC offices, Head Start facilities, Offices of Public Assistance, Indian Health Services and health care facilities.
Income Guideline for HMK
Montana adjusts the income guidelines annually, and those with higher incomes may still be eligible, since dependent-care costs and the number of family members working are also factors in determining eligibility. As of April 1, 2011, the maximum adjusted gross income for a family of two is $36,775, $46,325 for a family of three and $55,875 for a family of four. For a five-person household, the income limit is $65,435 and it's $74,975 for a six-person household. The adjusted gross income for a family of seven is $84,525 and it's $94,075 for a family of eight.
Montana Medicaid and Healthy Montana Kids Plus
The Montana Department of Public Health and Human Services administers the state's Medicaid program, with the federal government providing about two-thirds of the cost and Montana providing the balance. Healthy Montana Kids Plus is the new name for the children's Medicaid program. Medicaid and HMK Plus provide health care for low-income families and certain adults. Families with children who are 18 years of age or younger; women who are pregnant or have cervical or breast cancer or pre-cancer; and adults who are either disabled or at least 65 years of age are eligible to apply. Applicants must be Montana residents and U.S. citizens or legal aliens. Income and resource limits apply. Coverage depends on whether the applicant receives full or basic Medicaid. Basic Medicaid does not normally cover dental, vision and hearing care, in-home personal care or medical equipment. Applications are available through a local Office of Public Assistance.
Income and Resources for Montana Medicaid and HMK Plus
The federal poverty level for family size is the basis for calculating income limitations. The limits range from 33 percent of the FPL to twice the FPL depending on the coverage and the qualifying reason. Other programs do not have income limits, such as coverage for a newborn whose mother was receiving Medicaid under the pregnancy coverage. Allowable resources also vary, but are $3,000 per household for most programs. Resources do not include home equity or the value of an income-producing vehicle. A caseworker with the Montana DPHHS is the best source of specific information, since an individual or family may qualify under more than one set of criteria.
Tags: Healthy Montana, Healthy Montana Kids, Montana Kids, health care, adjusted gross, adjusted gross income, Applications available
