Finding Medicare Plans in Montana
Montana offers a variety of different Medicare options. But sorting through all of them to find the right coverage can be overwhelming. We don’t think it should be! We’ll guide you through the many Medicare plans in Montana to find the right coverage for you.
What Is Medicare and What Does It Cover?
Medicare is a government sponsored health insurance program that covers certain health care expenses. Medicare serves people 65 or older, as well as some people under the age of 65 with a qualifying condition. Medicare isn’t intended to pay for 100% of medical expenses. Medicare beneficiaries still pay a portion of their medical bills through coinsurance, copayments, and deductibles.
There are four parts of Medicare:
Original Medicare (Parts A and B)
Original Medicare is the federal component of Medicare and has two parts:
Part A (Hospital Insurance) covers inpatient services, like hospital care, nursing home care, and skilled nursing facility care.
Part B (Medical Insurance) covers outpatient services and supplies, like mental health care, ambulance services, and durable medical equipment (e.g., canes, blood sugar monitors, and walkers). Part B also covers some services that prevent or detect illnesses at an early stage, like flu shots, cardiovascular screenings, and diabetes screenings.
Original Medicare doesn’t cover everything. For example, it doesn’t cover long term care (custodial care), most prescription drugs, hearing exams/aids, vision, or dental care. For this reason, there is a variety of additional Medicare plans available in Montana, offered by Medicare-approved private insurance companies.
Medicare Advantage Plans (Part C)
Private insurance companies, approved by Medicare, offer Medicare Advantage plans that work as an alternative to your Original Medicare coverage. These plans can also include additional benefits, like dental, vision, and prescription drug coverage. Medicare Advantage plans with prescription drug benefits are called Medicare Advantage Prescription Drug (MAPD) plans.
You must first be enrolled in both parts of Original Medicare to be eligible for a Medicare Advantage plan. Premiums for these plans can start at $0 and increase based on the level of coverage selected. Medicare Advantage plans can have lower deductibles and copays than Original Medicare. If you enroll in a Medicare Advantage plan, you will need to continue paying your Part B premium in addition to the your Part C premium.
Medicare Prescription Drug Plans (Part D)
Prescription drugs are not covered by Original Medicare or Medigap plans. Medicare-approved private insurance companies offer stand-alone Medicare Prescription Drug plans to add prescription drug coverage to your Original Medicare. These plans place drugs into tiers, each tier having a certain copay/coinsurance. Each plan provides a drug formulary, so you can see what the copay/coinsurance would be for each drug. This way, you can select the plan with the best value for your prescription needs.
Medicare Supplement Plans (Medigap Plans)
As we mentioned earlier, Medicare beneficiaries are still responsible for paying a portion of their medical bills. This is where Medicare Supplement plans come in. Medigap plans are available through private insurance companies and work alongside your Original Medicare. These plans can help reduce your out-of-pocket expenses by helping pay certain expenses, like coinsurance, copayments, and deductibles.
Am I Eligible for Medicare Plans in Montana?
To qualify for Medicare, you must be eligible for Social Security benefits. Most people first become Medicare eligible once they reach 65 years of age. If you’re under 65, you may also qualify if you have Amyotrophic Lateral Sclerosis (ALS) or End-Stage Renal Disease (ESRD). You may also qualify if you have been a recipient of Social Security Disability Insurance (SSDI) for 24 months.
To qualify, you must be a US citizen or permanent resident, having lived in the US for at least 5 years. You or your spouse must also have had a job that paid towards your Medicare through Social Security deductions for at least 10 years.
If you will be turning 65 in the next six months, or you’re unsure about your eligibility for Medicare plans in Montana, we can help. You can view plans in your area online or talk to a licensed insurance agent by giving us a call.
When Can I Enroll in A Medicare Plan?
Medicare Advantage and Medicare Prescription Drug Plans
Your Initial Enrollment Period (IEP) is your first opportunity to enroll in Medicare. Your IEP starts three months before your 65th birthday month and lasts for seven months.
You can then make changes to your Medicare Advantage or Medicare Prescription Drug coverage during the Annual Election Period. The Annual Election Period occurs every year from October 15th to December 7th.
Key Fact: If you miss your IEP, the General Enrollment Period offers another chance to enroll in Original Medicare. This period occurs every year, from January 1st to March 31st. If you w ant to enroll in a Medicare Advantage plan, you can then do so from April 1st to June 30th each year.
Medicare Supplement Plans
Once you are 65 or older and enrolled in Medicare Part B, you will have an opportunity to enroll in a Medigap plan. Your Medigap Open Enrollment Period begins the same month as your Part B coverage and runs for the following six months.
Important Note: If you enroll during this period, you’re guaranteed the Medigap plan of your choice, regardless of any pre-existing conditions. But if you miss this window, carriers may charge you a higher premium or deny you coverage altogether.
Special Enrollment Periods
If you’ve recently experience a qualifying life event, you may be eligible for a Special Enrollment Period. Special Enrollment Periods allows you to make changes to your coverage outside of the normal times. Qualifying life events include moving out of your plan’s coverage area, moving into or out of a care facility, and more. Our licensed insurance agents can help you determine if you qualify for a Special Enrollment Period.
How Do I Select a Medicare Plan?
We’ll help you sort through your options to find the coverage that’s right for you. You can compare plans online by using the form below, or you can give us a call to speak with a licensed insurance agent.
Additional Medicare Resources in Montana
The Montana State Health and Insurance Assistance Program (SHIP) provides free, unbiased assistance and counseling to Medicare beneficiaries.
The Medicare Savings Program is available to Medicare beneficiaries whose income falls below a certain level, to help pay for medical expenses, like premiums and deductibles.
Sources: Medicare.gov; www.tn.gov; dphhs.mt.gov