Written by a parent, not a doctor. Nothing here is medical advice.

Childhood Cancer Lantern
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Montana program

Free health insurance for your child (Healthy Montana Kids Plus)

Free Montana health insurance for children under 19 (Healthy Montana Kids Plus). It can sit behind work insurance.

What it is

Free Montana health insurance for children under 19 (Healthy Montana Kids Plus). It can sit behind work insurance.

A drop in pay can open free coverage during treatment. Montana checks your child’s household and this month’s income. Work insurance can stay in place and pays first.

Eligibility rules
  • Your child must live in Montana and be under 19.
  • Montana decides the tax household and which income counts. Yearly income divided by 12 is only an estimate.
  • From April 1, 2026, published monthly limits are $1,902 for one, $2,579 for two, $3,256 for three, $3,933 for four, $4,609 for five and $5,286 for six.
  • If your income is just over the line, the state adds an allowance of 5% of the poverty level before deciding, so a family slightly over can still qualify.
What you get
  • No premium for covered hospital care, cancer treatment and medicines.
  • Home nursing and rides when their service rules are met.
  • Help with eligible earlier bills.
What it covers
  • Your employer plan is billed before Medicaid.
  • The treatment team must accept Montana Medicaid and follow service approval rules.
  • Your work plan is billed first. For covered care, a clinic that takes Montana Medicaid cannot bill you the deductible or copay the work plan left, even when Medicaid pays nothing extra, and its own billing mistakes are not your bill. If a clinic asks you to sign a private-pay agreement before a service, that service is outside the protection. Ask billing to check any unexpected charge before paying.
  • Illustration only: an employer plan allows a $10,000 bill, leaving a $3,000 deductible, and pays $7,000. If Medicaid allows $6,000, it can pay $0. The family still owes $0 on that qualifying claim because the enrolled provider must accept the allowed payments as full payment.
If you decide to apply
  1. Your social worker can help you talk with the hospital’s financial counselor about the application at apply.mt.gov.
  2. Bring this month’s income, household details, insurance information and earlier bills.
  3. Your social worker can check whether a qualified hospital or other authorized Montana entity can arrange temporary coverage while the full application is decided.

1-888-706-1535 — The Office of Public Assistance decides income; the state health department runs the coverage · Official page ↗

After you ask
  • Decisions generally take up to 45 days, or 90 days when a disability decision is needed.
  • Eligible earlier bills can be covered for three months before the application month through 2026. The child lookback becomes two months from January 2027.
  • Children generally keep eligibility for 12 months, with exceptions such as moving out of state or turning 19. The benefits office confirms the actual dates and whether any longer guarantee applies to a younger child.
  • The hospital can start temporary coverage on the day it screens your child. It lasts until the end of the next month unless the full application is in by then, in which case it runs until the decision.
Good to know

Your work insurance stays in place while the state decides. It gets billed first, and for covered care the clinic generally cannot bill you the rest. Give both cards to every clinic and pharmacy.

Other details
  • Keeping both plans means managing two insurers and any work-plan premium. For a denial or reduction of care, your social worker can help identify the notice’s appeal and continued-service deadlines; HMK Plus and HMK do not use the same process.
  • The benefits office can explain what removing your child would save and when they could rejoin.

Federal background: Medicaid and Medicaid as second insurance.

Official sources
Ask your social worker

“Could Medicaid reduce our child’s bills while we keep work insurance? What would managing both involve, and could you help us apply if it makes sense?”

Why I’m asking: I want to reduce treatment bills without disrupting our child’s care.

More background and detailed requirements
Additional program information and published rules

Who does what

The three parts, side by side. The agency decides; nobody on this page does.

You

File at apply.mt.gov today, report this month’s income and any insurance, and name the months with old bills.

Your social worker

The oncology social worker or financial counsellor helps you file, asks the hospital to open temporary coverage that day, and follows the 45-day clock.

The care team

Nothing for ordinary child coverage. Medical records matter only for the waiver route.

Who decides
The Office of Public Assistance checks income. The state health department runs the coverage.
Ask your social worker
“Can you help me file at apply.mt.gov today, and ask whether this hospital can open temporary coverage while we wait? Can we list bills from the three months before?”

How to apply

First step: Your social worker can help you talk with the hospital’s financial counselor about the application at apply.mt.gov.

  1. Your social worker can help you talk with the hospital’s financial counselor about the application at apply.mt.gov.
  2. If you decide to pursue this option, your social worker can help review the current income records, insurance and earlier bills.
  3. If you decide to pursue this option, your social worker can help review the current income records, insurance and earlier bills.

Official application / program page ↗

Where it starts: Apply at apply.mt.gov or by phone. Ask the hospital’s financial counsellor the same day whether it can open temporary coverage for your child while the application is decided.

What to gather

  • Child’s birth certificate or ID and Social Security number
  • Montana address
  • This month’s income for each parent in the tax household
  • Insurance cards, if any
  • Hospital bills from the three months before the application

How long: The office has 45 days, or 90 when a disability decision is part of it. Coverage reaches back up to three months before the month you applied, and two months from January 1, 2027.

What a yes looks like

A notice with coverage dates. Check that the hospital and the oncology group take it before you rely on it, especially if treatment is out of state. Twelve months of continuous coverage follows.

What a no looks like, and the next move

Check whether the office said no on income, a document or a category. If income is the reason, ask about the Big Sky Waiver by name and appeal by the date on the notice.

Watch out

  • Montana counts the tax household and this month’s income, not last year’s return.
  • Your child can keep private insurance and Medicaid; your social worker can help compare both before any change.
  • The printed base line excludes the separate allowance equal to five percentage points of the poverty guideline when applicable. The office checks the final calculation.

Dates that change this

2026-04-01: The income cells are the April 1, 2026 state table. Montana publishes no standing annual adoption rule and no 2027 table was found, so check the current table before relying on a near-the-line figure.

2027-01-01: Coverage now reaches back up to three months before the application month; two months for applications made on or after January 1, 2027.

2026-07-01: Montana started a primary-care case-management programme on July 1, 2026. Claims no longer need a Passport referral number for service dates after June 30, 2026, but referral, medical-order and prior-authorization rules still apply.

The numbers and the rules

The arcane layer, kept on purpose. Checked September 11, 2026.

What it is worth

Full coverage with no premium. The published monthly limits are $2,579 for two people, $3,256 for three, $3,933 for four, $4,609 for five and $5,286 for six.

  • $2,579/month — Household of 2, published line (143% of poverty)
  • $3,256/month — Household of 3, published line
  • $3,933/month — Household of 4, published line
  • $4,609/month — Household of 5, published line
  • $5,286/month — Household of 6, published line
  • $1,902/month — Household of 1, published line

Covers: Hospital and clinic care · Chemotherapy and prescriptions · Other medically necessary services for children under 21 when Medicaid benefit and approval rules are met · Shift nursing and personal care at home when approved · Rides, and meals and lodging on long trips · Dental and vision

Legal protection: Twelve months of continuous coverage once approved, subject to the policy’s exceptions · Other insurance does not bar enrolment; Montana Medicaid pays last

What it costs the family: No premium for a child.

The eligibility facts, as published

Age
under 19
Age max exclusive
19
Income
MAGI budget group at the published 143% of poverty line, plus a separate 5% of poverty disregard (CMA 602.1) for which no dollar column is published
Insurance status condition
none: other coverage is allowed and Montana Medicaid pays last (Member Guide; Third Party Liability)
Residency
Montana
Continuous eligibility
12 months, subject to the policy exceptions (ACA 201.4)
Retroactive months
3 now; 2 from 2027-01-01
Processing standard
45 days; 90 days when a disability determination is needed (CMA 103.1)

Decisions this site cannot make: Office of Public Assistance income determination · Hospital presumptive eligibility for children

Expect friction on: Checking that the oncology team takes the coverage before a plan is chosen

The trap: Montana checks the tax household and current monthly income. When applicable, an allowance equal to five percentage points of the poverty guideline can apply; it is not 5% of earnings. Your social worker can help compare both plans before any coverage change.

Where I read this

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