Medicaid

Medicaid

Local Office Address: 206 N. Broadway Red Lodge at Office of Public Assistance

Mailing Address: PO Box 1410 Red Lodge, MT 59068

Phone Number: (406)446-1302

Montana Medicaid Hotline: (800) 362-8312

Website: http://www.dphhs.mt.gov/medicaid/

Fax Number: (406) 446-1680

Hours of Operation: Monday-Friday 9AM-5PM

Eligibility: To be eligible for Medicaid in Montana, you must meet income and resource limits. You must also fit into at least one of these groups:

  • Families with dependent children
  • Pregnant women
  • Children and youth 18 and under will receive Healthy Montana Kids if eligible (no resource limits)
  • Women with breast or cervical cancer or pre-cancer
  • People 65 and over
  • People who are disabled (based on Social Security standards

Income limits vary depending what coverage is requested:

Child – Newborn No income limit

HMK Plus (under age 19) 133% of Federal Poverty Level (FPL)

Child – Medically Needy 33% FPL

Family 33% FPL

Family – Transitional No income limit

Pregnancy 150% FPL

Qualified Pregnant Woman 33% FPL

Breast & Cervical Cancer Treatment 200% FPL

Frequently Asked Questions

Services Offered: Medicaid is health care coverage for some low income Montanans. Medicaid is run by DPHHS (the Montana Department of Public Health and Human Services). The State of Montana pays about one-third of the cost of Medicaid and the federal government pays the rest. Medicaid does not pay money to you. Instead, it sends payments directly to your health care providers. Medicaid will only pay for services that are a medical necessity and provided by a Montana Medicaid health services provider.

What is covered by Medicaid: Services covered depend on whether client receives full or basic benefits.  Full benefits means that you are eligible for all services that Medicaid covers if medically necessary. The following individuals may be eligible for full benefits: pregnant women, children age 20 and under, and adults who are blind, age 65 or older or disabled and anyone receiving Supplemental Security Income (SSI).

Basic benefits means that some services are not paid for by Medicaid, except in the case of an emergency, or where a job requires the services (“essential for employment” – check with your eligibility case manager). This includes adults receiving Medicaid over age 20 who are: not pregnant, not blind, under age 65, and not disabled or receiving SSI.

Some covered services may (depending on Full or Basic benefit status) include: ambulance, anesthesiology, blood lead testing, dialysis, durable medical equipment, prescription drugs, emergency room (emergencies only), eyeglasses, family planning, hearing specialists, home health services, hospital outpatients, nursing home care, immunizations, lab work, mental health services, nutrition services, occupational therapy, outpatient surgery, physical therapy, podiatry, physician services, pregnancy and childbirth care, social worker services, speech therapy, tobacco cessation, transportation to appointments, well-child checkups, x-rays.

Costs of Services: Cost share with program

Applying for Medicaid: Applicants for medicaid must submit an application either by mail, at their local public assistance office (see address above) or submit an Online Application.  Following the submission of the application there is an interview that will be conducted either at the local office or can also be done by telephone.  For conducting the medicaid interview applicants should have: proof of age (birth certificate), proof of citizenship or legal alien status, a form of identification, proof of income from sources like Social Security, Supplemental Security Income (SSI), Veteran’s Benefits (VA), retirement, any bank statements and insurance policies that you may have, proof of where you live and insurance or policy information for any other coverage currently held.

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