Medicare Advantage Plans in Montana

Also known as Medicare Part C, Medicare Advantage combines all the benefits of Medicare Parts A and B into a single plan provided by a private insurer. Medicare Advantage plans can offer additional benefits like annual dental cleanings, vision check-ups, telehealth and senior wellness programs, but they must provide the same coverage as Original Medicare as a baseline. This includes covering services such as:

• Hospital stays
• Lab tests
• Home health care
• Ambulance services
• Durable medical equipment (DME)

Most Advantage Plans also include prescription drug coverage , so there’s no need for Medicare Part D supplements in most cases. You’ll be responsible for paying both your Medicare Part B premium and the premium of your Advantage plan unless you choose a zero-premium plan. In Montana, all eligible Medicare beneficiaries have access to a zero-premium plan. 

Medicare Advantage plans have grown in popularity nationwide, with more than 4 in 10 Medicare beneficiaries choosing Advantage plans in 2021. In addition, 24 states have enrollment percentages higher than 40%. Despite the growing popularity of Medicare Advantage plans, they haven’t yet outranked Original Medicare for Montana’s seniors. In fact, only 22% of Medicare beneficiaries in Montana are enrolled in Advantage plans. This is a little more than half of the national average, which is around 42%. 

If you or a loved one are considering a Medicare Advantage plan in Montana, this guide can help you understand exactly what plans are available, what they cover and how much they cost. It also features an easy-to-follow overview of Advantage plan enrollment periods and information you can use to find the right plan for your needs.

The Top Medicare Advantage Plans in Montana

About 1 in 5 people in Montana are age 65 or older, and these residents have their pick of many highly rated plan options and providers. The table below lists the top Medicare Advantage Plans in Montana in terms of enrollment. For each plan, the Medicare Star Rating, average monthly cost and plan type are included as well. Because many insurance companies offer multiple Medicare Advantage plans, average monthly costs are presented as a range rather than a set number. 

Note that all plan information below is accurate as of May 2022, but some figures may have changed since publication. You can always go to Medicare.gov to find the most up-to-date information about Medicare Advantage plans in your area. 

How Medicare Advantage Plans Work in Montana

The four main types of Medicare Advantage Plans in Montana are health maintenance organization (HMO), preferred provider organization (PPO), private fee-for-service (PFFS) and special needs plan (SNP). Each one varies in price and differs when it comes to the referral requirements and the network of physicians that is available to you as an enrollee. An insurer may also offer more than one plan type. 

You can compare and contrast the four plan types below. 

What Medicare Advantage Plans Cover in Montana

Medicare Advantage plans cover the same services as Original Medicare, excluding hospice care which remains covered under Medicare Part A. This includes services like preventative screenings, hospital care and durable medical equipment such as wheelchairs and other mobility devices.

Medicare Advantage plan providers can also choose to offer additional benefits like dental, vision, hearing aids and prescription drug coverage. These extra benefits vary by plan, so carefully review your plan documents to find out exactly what extra benefits are available to you. 

*Select plans offer this coverage

** Most plans offer this coverage

Eligibility for Medicare Advantage in Montana

In the state of Montana, anyone who’s eligible for Medicare Parts A and B can enroll in Medicare Advantage. However, you’ll need to be enrolled in Original Medicare before you can enroll in Medicare Advantage, 

Some Medicare Advantage plans have additional eligibility requirements. For example, Medicare Special Needs Plans (SNP) are only available to seniors with specific diseases or chronic conditions. 

You can only enroll in Medicare Advantage during specific enrollment periods. It’s important to keep these in mind when considering Medicare Advantage because you can’t enroll or change plans once the enrollment period is over. Medicare Advantage enrollment periods include:

• Initial Coverage Election Period: This is the initial 7-month period, coinciding with one’s 65th birthday, during which everyone is eligible to enroll in a Medicare Advantage plan.
• Annual Election Period (AEP): Also referred to as the Open Enrollment Period, this the time of year when anyone over 65 can enroll in Medicare Advantage for the first time or change to a new plan.
• Medicare Advantage Open Enrollment Period: During this period, those who are already enrolled in Medicare Advantage can switch to a different plan or switch back to Original Medicare.

Additionally, Medicare Advantage plan participants can change their plan outside of these enrollment periods under certain qualifying circumstances, such as moving to a new state.

How to Find & Choose a Medicare Advantage Plan in Montana

Navigating the many intricacies of Medicare Advantage plan types, insurers, and the specific plan options available by region can be a difficult and time-consuming task. Below are several resources we’ve created to help you through the process.

First is a downloadable PDF that you can use as a guide to help you compare plans as you research. Finally, we have listed a number of organizations that you can contact with experts that will help you determine whether Medicare Advantage is right for you and what plans you should consider.

State-Wide Medicare Advantage Resources

Local Medicare Advantage Resources