Best Medicare Plans in Montana

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Have you reached age 65 and live in Montana? You’re likely familiar with Medicare, though it has many intricacies. We’ll break down the dos and don’ts of acquiring Medicare in the great state of Montana and the Medicare options that can satisfy your unique health needs. 

The Best Medicare in Montana:

Best Medicare Insurance Providers in Montana

Though the median age is just under 40 for the state of Montana, an average of 21% of Montana residents had Medicare as of December 2018, compared to just 18% nationally. Here are a few companies Benzinga recommends.  

1. Humana

You already saw that Humana has some of the highest star ratings and some of the lowest monthly costs. Humana can give you an HMO versus a PPO plan and even more options for supplemental health care coverage

It offers a HumanaFirst Nurse Advice Line, where a registered nurse is available 24/7 to consult about your particular health condition. The company also offers Humana pharmacy mail delivery as well as online prescriptions from your doctors. Its SilverSneakers Fitness Program also allows all Humana Medicare Advantage participants to work out in locations throughout Montana. This is your best choice if you’re looking for solid, highly-rated insurance with a boatload of extra features. 

3. Blue Cross Blue Shield of Montana

There’s a reason that Blue Cross Blue Shield serves more than 250,000 clients nationwide. Montanans specifically get a variety of provided networks. Most importantly, it’s customer-owned. Customer support is focused more on getting the plan that is right for you, not right for the investor report. 

Blue Cross Blue Shield takes a 2-run streak on this countdown, thanks to its various Advantage Plan options that offer low premiums and high benefits. The company has several PPOs with premiums as low as $40 per month and some even include prescription coverage. You’re also not pigeonholed into seeing certain doctors or referrals for specialists. 

What is Medicare?

You’ve heard politicians hammer on it, you’ve been paying money toward it for years — but do you really know what Medicare is?

Medicare is a federally governed health insurance program that provides health care coverage to U.S. citizens or permanent legal residents who are 65 or older. There are select exceptions for those younger who are eligible. If you have been receiving Social Security Disability Insurance for at least 2 years or if you suffer from end-stage renal disease or ALS (Lou Gehrig’s disease), you can also get Medicare. 

There are varying versions of Medicare and it’s important to do your homework so you can decide which is right for you and your health requirements. We’ve mapped them out below:

Part A

Medicare Part A takes care of inpatient care in a hospital or a skilled nursing facility. It can pay for some home health care as well as hospice care. Some people think that Medicare is free, but that isn’t quite the case. Even “bare bones” Part A has a deductible of $1,364 (as of 2019) and coinsurance, meaning you’ll foot part of the bill, depending on the length of your stay and which services you utilize. 

Part B

Medicare Part B is medical insurance that covers everything outside the scope of hospitalization, including doctor visits, X-rays, outpatient care and blood tests. You’ll pay a monthly premium as well as a deductible on these types of activities. You’ll pay 20% of doctor’s bills at the end but the plan usually does cover the full cost of lab tests ordered by your physician. 

Part C

Also called a Medicare Advantage plan, this alternative route takes you into private waters and bundles the services you are offered in Parts A and B with the possibility of prescription drug coverage as well (see Part D below). You are not mandated to enroll in Part C. On the contrary, you are encouraged to choose whether this insurance is the right choice for your particular health needs. The benefits of this plan include possible dental, hearing and vision coverage, which are services that are not touched in Parts A or B. 

Part D

Medicare Part D is also optional and focuses on covering prescription drugs. Enrolling in Part D will require that you pay a deductible and either part or the full cost of some prescription meds. As of 2019, there are nearly 30 standalone Part D options for sale in Montana. Premiums span $15 – $94 per month.

Legalities of Medicare in Montana

The U.S. Department of Health and Human Services (HHS) is in charge of Medicare regulation. One in 5 Montana residents uses Medicare — the state has a wealth of resources in its health coverage program. 

The Montana State Health Insurance Assistance Program (SHIP) offers a free counseling service that can help you understand your health benefits. It’s geared toward Medicare beneficiaries and their loved ones or caregivers. It’s focused on educating the public about:

  • Medicare eligibility, enrollment and benefits
  • Medicare Part D (Medicare prescription drug coverage) plan comparisons
  • Related types of health insurance benefits
  • Medigap supplemental insurance
  • Medicare health plans
  • Medicare fraud, waste and abuse
  • Long-term care options and information

Types of Medicare Advantage Plans

You might be drawn to managed care plans like HMOs and PPOs versus fee-for-service plans. 

Health maintenance organizations (HMOs) and preferred provider organizations (PPOs) are worth learning about before you make your final health care decisions. They vary between cost, the size of your network, coverage for out-of-network services and access to specialists. 

  • HMO: An HMO plan is great if you want to keep your out-of-pocket costs low. Depending on your HMO plan, you’ll have either a low or even no deductible as long as you choose doctors within your HMO network. Your primary care physician will act as a gatekeeper for helping you to see specialists without paying 100% of the cost, but you’ll need to get a referral.
  • PPO: A PPO is a flexible (but slightly more costly) option. Patients can make appointments with specialists directly and don’t require referrals. Using in-network doctors will save you on medical costs. Prescription drugs are often bundled into a PPO plan, which is another added benefit. 

How to Sign Up for Medicare in Montana

Don’t assume you’ll be automatically signed up for Medicare. However, if you sign up for Social Security before you hit 65, you’ll be automatically enrolled in Part A on your 65th birthday. Otherwise, your enrollment period will begin 3 months prior to and 3 months after you celebrate your 65th turn around the sun. Don’t wait or you’ll be penalized!  

Check to see if you’ve been enrolled in Parts A and B. You must first be enrolled in Medicare Plan A and B before you can sign up for a supplemental plan. Montana SHIP offers detailed explanations about exactly what you’re eligible for past that. 

Average Cost of Medicare Advantage Plans in Montana

Curious about what you’ll pay for each company? Check out the chart from an eligible participant from Missoula.

Plan NameCompany Plan TypeHealth and Drug Costs
HumanaChoice HumanaPPO (doesn’t include Plan B premium of $135.50)$0/monthly
$0 health plan deductible
$10 primary doctor 
$45 specialist
$10,000 out of network, $6,700 in network 
Humana Gold Plus HumanaHMO (doesn’t include Plan B premium of $135.50) Includes: Dental, Hearing, Vision, Fitness, more
$0 health plan deductible
$0 primary doctor
$40 specialist
$4,900 out of pocket max
$325 drug deductible
HumanaPPO (doesn’t include Plan B premium of $135.50) Includes: Dental, Hearing, Vision, Fitness, more$49/monthly
$0 health plan deductible
$15 primary doctor
$45 specialist$10,000 out of network, $6,700 in network 
$350 drug deductible
Blue Cross Medicare Advantage ClassicBlue Cross Blue ShieldPPO (doesn’t include Plan B premium of $135.50) Includes: Dental, Hearing, Vision, Fitness, more$85/monthly
$0 health plan deductible
$15 primary doctor
$45 specialist
$10,000 out of network, $6,700 in network, $10,000 in and out-of network max 
$415 drug deductible
Blue Cross Medicare Advantage Optimum
Blue Cross Blue ShieldPPO (doesn’t include Plan B premium of $135.50) Includes: Dental, Hearing, Vision, Fitness, more$146/monthly
$0 health plan deductible
$10 primary doctor
$35 specialist
$10,000 out of network, $3,900 in-network, $10,000 in and out-of-network max 
$415 drug deductible

Get Premium Health Care without Premium Costs

Medicare covers more than 1 in 5 Montana residents, which says something about the health care caliber of the state and its people. Whether you opt for low premiums, low deductibles, good customer service or all-around affordability, Montana can offer you an array of options in each category. Learn more so you can live out your best years with comprehensive health coverage.