Montana Health Insurance 

NOTICE:

MCHA no longer offers coverage as of December 31, 2013.

Policyholders Notices are linked below:

Notice to MCHA Policyholders      Notice to MACP Policyholders  

The Patient Protection and Affordable Care Act (ACA), frequently referred to as "Obamacare," assures guaranteed issue coverage for all health insurance applicants. In other words, health insurance companies may no longer deny coverage because of an applicant's pre-existing condition. As such, MCHA's mission to provide a safety net for persons who couldn't obtain health coverage through traditional channels is now being addressed through Obamacare.

Q. Where should I go for new health insurance coverage?

A: You will be able to purchase health insurance through the new Healthcare Marketplace or outside of the Marketplace from any insurance carrier selling health insurance in Montana. Both options will offer a variety of plan types from participating insurance companies. The Healthcare Marketplace will offer you the opportunity to shop and compare insurance plans available in your area, and choose the premium and cost-sharing (deductible and co-insurance) combination that works best for you. You can also compare plans on your own outside of the Marketplace.

There will be four ways to access the Marketplace: by phone (800-318-2596), by mail, in person, or online at
http://www.healthcare.gov Licensed Montana insurance agents can assist you with purchasing coverage both inside and outside of the Marketplace.

The Marketplace began taking applications on October 1, 2013.

Q. How much will my health insurance cost in 2014?

A: Commissioner of Securities and Insurance Monica Lindeen announced the companies who are offering health insurance plans on the Exchange in late August. The companies include Blue Cross Blue Shield of Montana, PacificSource, and the Montana Health Cooperative. You can go to the  Montana Health Insurance Answers website to find the premium rate schedules for each product at this web address: 

http://montanahealthanswers.com/families/marketplace/

Click on each company to view the premium rates.

Please keep in mind these three things that we do know about costs:

1. There will be a range of cost options available in most areas.

2. Depending on your income, you may qualify for a "Premium Tax Credit," or cost sharing reduction, to help you pay for your premiums. Persons whose household income is at or below 400% of the Federal Poverty Level ("FPL") may qualify for cost sharing reductions. The lower your income, the higher your subsidy will be.

3. Persons whose household income is at or below 250% of FPL may qualify for additional assistance in the form of a "cost-sharing reduction." This means that out-of-pocket costs (deductibles and co-pays) can be lowered for qualifying individuals.


Premium Tax Credits and Cost-Sharing Reductions are only available when purchasing coverage through the Healthcare Marketplace. If you purchase coverage outside of the exchange from a private insurance carrier, you will not receive tax credits, even if your household income is below 400% of the Federal Poverty Level.

Q.: Can a person qualify for both the Premium Tax Credits and the Cost-Sharing Reduction subsidy?

A: Yes, if the appropriate income levels apply.

Q.: To be at or below 400% of Federal Poverty Level, what must my income be?

A: Currently, 400% of FPL is about $46,000 a year for an individual. For a family of four, 400% of FPL is about $94,200 a year. Your household income must be below these levels to qualify for the Premium Tax Credit.

 Household Size

 100%

 133%

 150%

200%

 300%

400%

 1

$11,490

$15,282

$17,235

$22,980

$34,470

$45,960

 2

15,510

 20,628

23,265

  31,020

46,530

62,040

 3

19,530

 25,975

29,295

  39,060

58,590

78,120

 4

23,550

 31,322

35,325

  47,100

70,650

94,200

 5

27,570

 36,668

41,355

  55,140

82,710

110,280

 6

31,590

 42,015

47,385

  63,180

94,770

126,360

 7

35,610

 47,361

53,415

  71,220

106,830

142,440

 8

39,630

 52,708

59,445

  79,260

118,890

158,520

 For each additional person, add

$4,020

 $5,347

$6,030

  $8,040

$12,060

$16,080

Source: FamiliesUSA.org

Q: Is there a deadline date for me to get new coverage?

A: In order for your new coverage to take effect right away on January 1, 2014, you must apply for other coverage and complete your enrollment process no later than December 15, 2013. If you do not complete the enrollment process by December 15, 2013, you will have until March 31, 2014, to apply for health insurance coverage, but you will have a gap in coverage. After March 31, 2014, you cannot apply for new health insurance coverage until October 15, 2014, with some limited exceptions.

Q. Should I use an agent to help me buy my new insurance?

A. Agents are trained to assist consumers with purchasing health insurance both inside the new Healthcare Marketplace and outside of the Marketplace. They can be of great value to MCHA and MACP (Federal) members when it comes to understanding the available options. Navigators and certified application counselors will also be available to assist you. You can find a navigator at this website: http://montanahealthanswers.com

Q. What health insurance companies are participating in the Healthcare Marketplace?

A: Montana Commissioner of Securities and Insurance Monica Lindeen announced that the companies will be Blue Cross Blue Shield of Montana, PacificSource, and the Montana Health Cooperative. Please check the website below for additional information.

http://montanahealthanswers.com


Montana Health Insurance  

The Montana Comprehensive Health Association (MCHA) is a program that offered policies of individual health insurance to eligible Montana residents who are considered uninsurable due to medical conditions. The MCHA also was the coverage available to persons who are leaving group coverage.

The MCHA is sometimes referred to as Montana’s “high-risk” pool. The MCHA provides coverage of “last resort” and was not intended to duplicate coverage from any other source, public or private. The MCHA plans are administered by Blue Cross Blue Shield of Montana and currently provide coverage for about 3,000 Montanans.

The MCHA is committed to providing access to quality health insurance coverage for uninsurable Montanans. In fulfilling this vision, the MCHA believes in:

  • Quality health insurance plans
  • Accessibility for qualifying Montanans
  • Effective programs to manage health care claims and expenses
  • Collaborative industry involvement

About Us


The Montana Legislature created the MCHA in 1985 to establish a program that provides access to health insurance to Montana residents who are otherwise considered uninsurable due to medical conditions. These Montanans are not part of the traditional health insurance market because of preexisting health conditions or significant exclusions of coverage. In general, these people have been rejected for health insurance coverage or offered a policy with a rider on their primary health condition.

In 1997 the Montana Legislature created a second MCHA plan for eligible individuals who have had prior health insurance coverage that meet the federal rules of eligibility as described in the eligibility section. This site contains information about benefits, exclusions, premium rates, eligibility, and application procedures for the MCHA program.

This site also provides information about program changes, publications, and upcoming events that affect the MCHA.

Effective August 1, 2003:  If you have lost your job due to foreign trade and are an eligible federal Trade Adjustment Act (TAA) qualifed individual, you may qualify for coverage under the Portability Plan.  The federal Trade Adjustment Act of 2002 provided a 65% tax credit for qualified persons to use to purchase health insurance.  The MCHA is one of the qualified plans that TAA qualified persons can purchase with the tax credit.  Please see the section about the Portability Plan for additional information.  

Please note:  all brochures, rate cards and applications are loaded as PDF files.  You must have Adobe Acrobat to download these documents.  If you don't have Adobe Acrobat, you can download it from this website: http://www.adobe.com/products/acrobat/.

More Information: Montana Health Insurance

Click this link for information about a class action lawsuit that involves MCHA.  MCHA Class Actions

Click here for the MCHA Notice of Privacy Practices


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Montana Comprehensive Health Association
PO Box 4309
560 North Park Avenue
Helena, MT  59604
Toll Free: 1-800-447-7828
Fax: 1-406-441-5520


In Helena, use 800 number
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