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.
Get Medicare Quotes From Top Providers
Tip: Select from 2-3 companies
The Best Medicare in Montana:
- Best Overall in Montana: Humana
- Most Affordable in Montana: Humana
- Best for Customer Support: Blue Cross Blue Shield of Montana
- Best for Lowest Premiums: Blue Cross Blue Shield of Montana
- Best for Widest Coverage Throughout the State: Lasso Healthcare
- The Best Medicare in Montana:
- What is Medicare?
- Legalities of Medicare in Montana
- Types of Medicare Advantage Plans
- How to Sign Up for Medicare in Montana
- Average Cost of Medicare Advantage Plans in Montana
- Best Medicare Insurance Providers in Montana
- Get Premium Health Care without Premium Costs
- Frequently Asked Questions
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:
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.
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.
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.
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. Check out Benzinga’s list of 5 best companies for Medicare Part D plans.
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 Name||Company||Plan Type||Health and Drug Costs|
|HumanaChoice H5525-031 (4-star rating)||Humana||PPO (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 H6622-007 (4-star rating)||Humana||HMO (doesn’t include Plan B premium of $135.50) Includes: Dental, Hearing, Vision, Fitness, more||$25/monthly$0 health plan deductible$0 primary doctor$40 specialist$4,900 out of pocket max$325 drug deductible|
|HumanaChoice H5525-027 (4-star rating)||Humana||PPO (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 Classic (3.5-star rating)||Blue Cross Blue Shield||PPO (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 (3.5-star rating)||Blue Cross Blue Shield||PPO (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|
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. Best Overall in Montana: 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.
2. Most Affordable in Montana: Humana
Humana has a streak in this line up for one simple reason: Good service and good prices on Montana Medicare. One example of an all-star collaboration was when Humana teamed up with Walmart to create the Humana Walmart Rx Plan, which is a prescription drug plan (PDP, also known as Plan D).
This plan can be synced with an Advantage Plan to get you some of the lowest rates out there on services and prescriptions. It offers far and away the lowest prescription costs at more than 5,000 Walmart or Sam’s Clubs, many of which have $0 deductibles and copays as low as $1 for some generic drugs.
Check out Humana if you’re looking for Medicare coverage options and companies that have partnered with some of the most economical branches available.
3. Best for Customer Support: 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.
4. Best for Lowest Premiums: Blue Cross Blue Shield of Montana
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.
5. Best for Widest Coverage Throughout the State: Lasso Healthcare
Lasso Healthcare is available in 30 of Montana’s 56 counties and offers the widest coverage in Montana.
Lasso Healthcare operates in several states but includes coverage in more than 50% of counties in Montana.
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.
Frequently Asked Questions
Q: What are the different parts of Medicare?
Medicare has 4 parts named Parts A, B, C, and D. Part A provides hospitalization coverage while Part B provides outpatient coverage, like doctor visits. Parts A and B make up Medicare’s core coverages. Part C is provides private-market Medicare plans, called Medicare Advantage Plans. Part C coverage often includes additional benefits. Medicare Part D provides coverage for prescription drugs. Get a Medicare Insurance Quote through the top providers here.
Q: Is Medicare free?
Because there are 4 parts to Medicare, there can be different cost structures. Most people won’t have to pay for Medicare Part A (hospitalization). Eligibility for premium-free Part A is based on your work history during which you paid Medicare taxes. Many people do pay a monthly premium for Medicare Part B, however, which covers outpatient medical services, like doctor visits. Deductibles also apply to services covered under Medicare Parts A and B, so you’ll pay a part of the annual cost.
Medicare Parts C and D are optional coverages and have premium costs of their own. Medicare Part C refers to Medicare Advantage Plans that offer additional coverage in exchange for a monthly premium. Part D, the prescription plan, reduces the cost of medications but also requires a monthly premium. Subsidies may be available for low income households to help reduce overall Medicare costs.
Q: Do I need to sign up for Medicare?
If you signed up for Social Security before age 65, you were enrolled in Medicare automatically but benefits will begin at age 65. In most cases, there are penalties for not enrolling at age 65, so it pays to sign up on time. Click here to get a medicare quote in minutes from the best providers.
If you have employer coverage, you may be able to delay Medicare coverage while your work plan is still in force. However, the size of the employer determines whether you’ll pay a penalty for not enrolling at age 65. Employees (and their spouses) of companies that offer group health insurance to 20 or more people are usually exempt from late sign-up penalties if they are covered by the employer’s plan.