What Does Montana Medicaid Cover

Montana Medicaid, a health insurance program, provides a wide range of medical services to eligible Montana residents. These services include doctor visits, hospital stays, prescription drugs, mental health care, substance abuse treatment, and more. Montana Medicaid also covers some long-term care services, such as nursing home care and home health care. The program is funded by a combination of state and federal funds. To be eligible for Montana Medicaid, you must meet certain income and asset limits.

Medicaid Services for Pregnant Women and Children

Montana Medicaid provides comprehensive health coverage for pregnant women and children, ensuring access to essential medical care. This coverage includes a wide range of services to support the health and well-being of both the mother and the child.

Prenatal Care

  • Regular checkups with a doctor or midwife to monitor the health of both the mother and the baby.
  • Prenatal vitamins and other supplements to support a healthy pregnancy.
  • Laboratory tests and ultrasounds to monitor the baby’s growth and development.
  • Education and counseling on pregnancy, childbirth, and parenting.

Labor and Delivery

  • Hospitalization for labor and delivery, including the cost of anesthesia, medications, and medical supplies.
  • Care for any complications that may arise during labor and delivery.

Postpartum Care

  • Regular checkups with a doctor or midwife to monitor the health of both the mother and the baby.
  • Support and resources for breastfeeding mothers.
  • Treatment for any postpartum complications.

Well-Child Care

  • Regular checkups with a doctor or pediatrician to monitor the child’s growth and development.
  • Immunizations to protect the child from preventable diseases.
  • Treatment for any illnesses or injuries that the child may experience.
  • Dental care, including cleanings, fillings, and extractions.
  • Vision care, including eye exams and eyeglasses.
  • Mental health care, including therapy and counseling.

In addition to the services listed above, Montana Medicaid also covers a variety of other services for pregnant women and children, including:

ServiceDescription
Family PlanningServices to help women prevent or plan pregnancies, including contraception, counseling, and education.
Early Intervention ServicesServices for children with developmental delays or disabilities to help them reach their full potential.
Hospice CareCare for terminally ill children to help them live comfortably and with dignity.

What Essential Health Benefits Does Montana Medicaid Cover?

Montana Medicaid, also known as Healthy Montana Kids, provides comprehensive health coverage to eligible low-income individuals and families. The program covers a wide range of essential health benefits, including:

Ambulatory Patient Services

  • Office visits
  • Outpatient hospital services
  • Clinic visits
  • Laboratory and X-ray services
  • Physical therapy
  • Occupational therapy

Hospitalization

  • Inpatient hospital care
  • Critical care services
  • Short-term hospital stays
  • Long-term hospital stays

Maternity and Newborn Care

  • Prenatal care
  • Labor and delivery
  • Postpartum care
  • Newborn care

Mental Health and Substance Abuse Services

  • Inpatient psychiatric care
  • Outpatient mental health care
  • Substance abuse treatment
  • Counseling
  • Medication

Prescription Drugs

  • Generic and brand-name drugs
  • Prescription drug coverage
  • Medical supplies
  • Durable medical equipment

Preventive and Wellness Services

  • Routine checkups
  • Immunizations
  • Screenings
  • Health education
  • Nutrition counseling

Pediatric Services

  • Well-child visits
  • Sick child visits
  • Immunizations
  • Dental care
  • Vision care

Dental and Vision Care

  • Routine dental exams
  • Cleanings
  • Fillings
  • Extractions
  • Vision exams
  • Eyeglasses

Long-Term Care Services

  • Nursing home care
  • Assisted living facilities
  • Home health care
  • Personal care services

In addition to the essential health benefits listed above, Montana Medicaid also covers a number of other services, including:

  • Transportation to medical appointments
  • Interpreter services
  • Family planning services
  • Case management services

The specific benefits covered by Montana Medicaid may vary depending on the individual’s eligibility and the type of coverage they have. For more information, please visit the Montana Department of Public Health and Human Services website.

Montana Medicaid Coverage Summary
CategoryCovered Services
Ambulatory Patient ServicesOffice visits, outpatient hospital services, clinic visits, laboratory and X-ray services, physical therapy, occupational therapy
HospitalizationInpatient hospital care, critical care services, short-term hospital stays, long-term hospital stays
Maternity and Newborn CarePrenatal care, labor and delivery, postpartum care, newborn care
Mental Health and Substance Abuse ServicesInpatient psychiatric care, outpatient mental health care, substance abuse treatment, counseling, medication
Prescription DrugsGeneric and brand-name drugs, prescription drug coverage, medical supplies, durable medical equipment
Preventive and Wellness ServicesRoutine checkups, immunizations, screenings, health education, nutrition counseling
Pediatric ServicesWell-child visits, sick child visits, immunizations, dental care, vision care
Dental and Vision CareRoutine dental exams, cleanings, fillings, extractions, vision exams, eyeglasses
Long-Term Care ServicesNursing home care, assisted living facilities, home health care, personal care services
Other ServicesTransportation to medical appointments, interpreter services, family planning services, case management services

Montana Medicaid Eligibility Requirements

To apply for Montana Medicaid, individuals must meet certain eligibility requirements, including:

  • Being a Montana resident.
  • Being a U.S. citizen or qualified non-citizen.
  • Meeting income and asset limits.
  • Not being enrolled in Medicare.

Depending on an individual’s situation, they may be eligible for one of the following Medicaid programs:

  • Montana Medicaid Primary Care (MPC): Available to individuals and families with incomes up to 138% of the federal poverty level (FPL).
  • Montana Children’s Health Insurance Program (CHIP): Available to children and pregnant women with incomes up to 200% of the FPL.
  • Montana Medicaid for the Aged, Blind, and Disabled (ABD): Available to individuals aged 65 and older, blind, or disabled with incomes up to 100% of the FPL.
Montana Medicaid Income Limits (2023)
Program100% FPL138% FPL200% FPL
MPC$13,590 (individual)
$27,750 (family of 4)
$18,765 (individual)
$38,295 (family of 4)
N/A
CHIPN/AN/A$27,180 (individual)
$55,500 (family of 4)
ABD$13,590 (individual)
$27,750 (family of 4)
N/AN/A

Individuals can apply for Montana Medicaid online or by mail. They can also get help applying at a local Medicaid office.

Benefits for People with Disabilities

Montana Medicaid offers comprehensive healthcare coverage to individuals with disabilities. These benefits aim to provide essential medical services and support to help individuals manage their conditions and improve their quality of life. While the exact benefits may vary depending on the specific needs and circumstances of the individual, some common benefits covered by Montana Medicaid for people with disabilities include:

  • Medical Services:
    • Inpatient and outpatient hospital care
    • Physician visits
    • Prescription medications
    • Lab and X-ray services
    • Emergency medical services
    • Durable medical equipment
  • Long-Term Care:
    • Nursing home care
    • Assisted living facilities
    • Home and community-based services (HCBS)
  • Mental Health Services:
    • Inpatient and outpatient mental health treatment
    • Counseling and therapy
    • Medication management
  • Substance Abuse Treatment:
    • Inpatient and outpatient substance abuse treatment
    • Counseling and therapy
    • Medication management
  • Dental Services:
    • Routine dental care
    • Emergency dental care
    • Dental surgery
  • Vision Services:
    • Eye exams
    • Glasses or contact lenses
    • Surgery for eye conditions
  • Hearing Services:
    • Hearing exams
    • Hearing aids
    • Cochlear implants

Additionally, Montana Medicaid may also provide coverage for specific services and supports tailored to the needs of people with disabilities, such as:

  • Personal care assistance
  • Home modifications
  • Assistive technology
  • Vocational rehabilitation services
  • Transportation services
  • Respite care
Additional Services and Supports for People with Disabilities
ServiceDescription
Personal care assistanceHelp with activities such as bathing, dressing, eating, and using the bathroom
Home modificationsChanges to the home to make it more accessible and safe for someone with a disability
Assistive technologyDevices and equipment that help people with disabilities perform tasks more easily
Vocational rehabilitation servicesHelp with finding a job, getting job training, and keeping a job
Transportation servicesHelp with getting to and from medical appointments, work, and other activities
Respite careTemporary care for a person with a disability so that the caregiver can take a break

To learn more about the specific benefits and services available to people with disabilities through Montana Medicaid, you can contact the Montana Department of Public Health and Human Services or visit their website.

Well folks, there you have it – a comprehensive guide to what Montana Medicaid covers. From medical doctor visits to prescription drugs, from pregnancy care to mental health services, Medicaid has got you covered. If you’re a Montana resident who qualifies for Medicaid, I encourage you to take advantage of these valuable benefits. They’re there for you, and they can make a real difference in your health and well-being. Thanks for reading, y’all. If you have any more questions, feel free to reach out to the Montana Medicaid office. In the meantime, take care and I hope to catch you next time with more helpful information.