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

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Montana program

Help with an approved private-plan premium

Montana may help pay an approved private health-plan premium for someone who has Medicaid (HIPP).

What it is

Montana may help pay an approved private health-plan premium for someone who has Medicaid (HIPP).

Private insurance can preserve a treatment network. HIPP can pay or reimburse an approved premium when it saves Medicaid money. Medicaid remains in place.

Eligibility rules
  • HIPP can review eligible employer, individual, Montana-college student and COBRA coverage under its Medicaid and cost-effectiveness rules.
  • The third-party liability unit decides whether paying the premium saves Medicaid money.
What you get
  • Payment or reimbursement of an approved private-plan premium.
What it covers
  • The separate COBRA 75 route names an employer with at least 75 employees and does not require Medicaid. The number 75 is employer size, not a reimbursement percentage.
  • That is not the general HIPP employer-size test.
If you decide to apply
  1. Your social worker can help you talk with the HIPP unit about a premium-payment review.
  2. Bring the Medicaid number, premium amount and plan booklet.

HIPP: 1-800-694-3084 · Official page ↗

After you ask
  • The office explains how approved premiums are paid or reimbursed.
  • Call the HIPP unit for the form. Keep paying the premium and keep receipts; reimbursement starts only after written approval.
Good to know

Medicaid alone does not guarantee premium help. The state must approve the cost comparison.

Other details
  • Your benefits office can supply the premium and plan summary used in the comparison.

Federal background: Medicaid premium assistance.

Official sources
Ask your social worker

“Could Montana help with our private-plan premium if our child has Medicaid? What would keeping both involve, and could you help request a review if it fits?”

Why I’m asking: I want to preserve treatment access while understanding whether premium help is available.

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

Send form HCS-449 with the premium figure and the plan booklet.

Your social worker

The benefits office gives you the premium amount and the plan summary the state needs.

The care team

Records and letters when the application asks for them.

Who decides
The state’s third-party liability unit runs the cost test.
Ask the agency
“My child is on Montana Medicaid and there is an employer plan. Can you run the premium-payment cost test, and what is form HCS-449?”

How to apply

First step: Your social worker can help you talk with the HIPP unit about a premium-payment review.

  1. Your social worker can help you talk with the HIPP unit about a premium-payment review.
  2. If you decide to pursue this option, your social worker can help review the current form, premium amount and written decision.
  3. If you decide to pursue this option, your social worker can help review the current form, premium amount and written decision.

Official application / program page ↗

Where it starts: Call the programme line and ask for the premium-payment application.

What to gather

  • The premium amount from your payslip or benefits office
  • The plan booklet
  • Your child’s Medicaid number

How long: The HIPP unit confirms its current decision timetable and gives the approval in writing.

What a yes looks like

The premium paid or reimbursed, with the work plan still in force.

What a no looks like, and the next move

The cost test failed. Ask which figures were used, and keep Medicaid.

Watch out

  • Ask before you decline the work plan at open enrolment.
  • No decision deadline is published, so ask for the answer in writing.

The numbers and the rules

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

What it is worth

HIPP may pay or reimburse approved employer, individual, Montana-college student or COBRA coverage when the program’s Medicaid and cost-effectiveness rules are met.

  • $75 — Minimum employer size named for the separate continuation route on the programme page

Covers: Payment or reimbursement of the group premium

Legal protection: A family can ask about it before signing up for offered insurance

What it costs the family: None when it is approved.

The eligibility facts, as published

Coverage
Eligible employer, individual, Montana-college student or COBRA coverage under the applicable HIPP route; Medicaid is not required for the separate COBRA75 route.
Test
the state decides whether paying the group premium is cost-effective
Form
The HIPP unit confirms the current form and submission route at 1-800-694-3084 or HHSHIPPProgram@mt.gov. The posted July2016 procedure names HCS-449.

The trap: The programme page says a family can ask about it even when the insurance is offered but not yet signed up for. Ask before you decline the work plan at open enrolment.

Where I read this

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