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Montana Health Insurance
Our phone number has changed. Please dial 1-800-447-7828, ext. 2128 to reach MCHA.
The Montana Affordable Care Plan (MAC Plan)
On March 23, 2010, President Obama signed the Patient Protection & Affordable Care Act (P.L. 111-148) into law. The Act contains a provision (Sec. 1101) for a new federal high risk health insurance pool program to be established within 90 days (the “Federal Pool”). In Montana, this plan is called the MAC Plan. The Montana Comprehensive Health Association (MCHA) will be offering this health benefit plan.
MCHA will begin accepting applications for this new option on July 1, 2010. The first date that coverage can be effective is August 1, 2010. Please keep in mind that applications received on the 1st through the 15th of the month may have an effective date of the first of the following month. Applications received the 16th through 31st may have an effective date of the 15th of the following month.
To qualify, an individual must be a citizen or national of the United States, or lawfully present, must be a Montana resident, must have a preexisting medical condition and must have been uninsured for at least 6 months before applying for the federal program.
Enrollment in the federal MAC Plan is limited and on a first-come basis.
The federal MAC Plan is funded by the premiums paid by insureds and funding authorized by the federal government. If the federal funding is exhausted, insureds may move to an MCHA traditional plan of the insured’s choice. The insured will need to pay the full MCHA premium for that coverage.
How to Apply: Applicants must complete the MCHA Traditional Plan/Federal High Risk Pool Application. Applicants will need to provide documentation of citizenship, Montana residency, and proof of a pre-existing condition or two denials or offers of coverage which excludes benefits for a pre-existing condition. Please see the application for the full requirements for making application.
The first month's premium and all documentation should be submitted with the completed application. If you would like assistance with the application process, you may contact any licensed Montana insurance agent.
Montana Affordable Care Application click link below:
Click the link below to view the outline of coverage:
The Montana Comprehensive Health Association (MCHA) is a program that offers policies of individual health insurance to eligible Montana residents who are considered uninsurable due to medical conditions. The MCHA also is 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 is 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 3,600 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
The Premium Assistance Plan is open on a limited basis. Enrollment is on a first-come, first served basis and is limited to the available funding. We encourage you to apply today if you think you may qualify for the plan.
(As of 8/12/2010 the Premium Assistance Plan is closed to new enrollment due to the enrollment cap being reached. Applicants can request to be placed on a waiting list. Waiting list applicants will be enrolled when enrollment falls below the cap.)
Attention Licensed Agents:
Under the HIPAA Privacy Rule, the MCHA is considered a covered entity. To attain compliance with the Privacy Rule, the MCHA must enter into Business Associate Agreements (BAs) with each agent that does business on our behalf. This BA will allow MCHA to provide information to you (as the agent) during the application process and to pay you the applicable agent fee for selling an MCHA policy of insurance. Please note that after the application is approved and the member becomes insured by MCHA, you will need to have your customer complete an authorization form (Authorization for Disclosure of an Individual’s Health Information) before any additional protected health information can be shared with you.
If you have not yet completed a BA, please download the agreement attached below, complete it, sign it and mail it to the address shown below. Please call if you have any questions.
Click here for MCHA Business Associate Agreement
The Authorization for Disclosure of an Individual’s Health Information can be downloaded from the Blue Cross and Blue Shield of Montana website (Member Forms section.)
Here is a link to that web page: https://www.bcbsmt.com/Pages/forms.aspx
Click here for MCHA's Notice of Privacy Practices
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