Healthy Montana Kids Plan

Centers for Medicare & Medicaid Services (CMS) in Healthcare
December 19, 2018

Overview

The Healthy Montana Kids (HMK) Plan is a free or low-cost health insurance plan that provides coverage to eligible Montana children up to age 19. Covered services include medical, dental, eyeglasses, and other related services.

Financial eligibility is based on a household's gross income. A Work Expense Disregard (up to $1,440/year of each income earner's income) and/or a Dependent Care Disregard ($2,400 /year for care of a child or incapacitated adult) may be deducted from the household's gross income. There are no asset or resource tests. Children cannot be eligible for Medicaid or health insurance under the state employee benefit plan. They cannot have other health insurance and/or have been covered by insurance during the previous month (some exceptions apply). Some families share in the cost of their children's health care by making co-payments when services are received. A family's maximum co-payment amount is $215 per benefit year.

After receiving an application for insurance coverage, the State's HMK office will notify a family if children are eligible and when benefits will begin. There is no current waiting list for newly eligible children. HMK will pay for services on and after the date of enrollment but will not pay for services incurred before enrollment begins.

Administration

Healthy Montana Kids Plan is administered by Centers for Medicare & Medicaid Services (CMS).

Program Requirements:

In order to qualify for this benefit program, you must be a resident of Montana, under 19 years of age, not covered by health insurance (including Medicaid), a U.S. citizen or a qualified alien.

 

 

 

In order to qualify, you must have an annual household income (before taxes) that is below the following amounts:

Household Size* Maximum Income Level (Per Year)
1 $30,350
2 $41,150
3 $51,950
4 $62,750
5 $73,550
6 $84,350
7 $95,150
8 $105,950

*For households with more than eight people, add $10,800 per additional person. Always check with the appropriate managing agency to ensure the most accurate guidelines.

Application Details

You can apply for this application online or download an application on the Healthy Montana Kids website. 

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