Montana Residents! Compare thousands of Montana health insurance plans.

Get instant Montana health insurance quotes online now!

Numerous state and federal laws make it easier for people with pre-existing conditions to get or keep health insurance, or to change from one health plan to another. A federal law, known as the Health Insurance Portability and Accountability Act (HIPAA) sets national standards for all health plans. In addition, states can pass different reforms for the health insurance plans they regulate (fully insured group health plans and individual health plans), so your protections may vary if you leave Montana. Neither federal nor state laws protect your access to health insurance in all circumstances. So please read this guide carefully.

The following information summarizes how federal and state laws do — or do not — protect you as a Montana resident.

How am I protected?
In Montana, as in many other states, your health insurance options are somewhat dependent on your health status. Even if you are sick, however, the laws protect you in the following ways.

• Coverage under your group health plan (if your employer offers one) cannot be denied or limited, nor can you be required to pay more because of your health status. This is called nondiscrimination.

• All group health plans in Montana must limit exclusion of pre-existing conditions. There are rules about what counts as a pre-existing condition and how long you must wait before a new group health plan will begin to pay for care for that condition. Generally, if you join a new group health plan, your old coverage will be credited toward the pre-existing condition exclusion period, provided you did not have a long break in coverage.

• Your health insurance cannot be canceled because you get sick. Most health insurance is guaranteed renewable.

• If you leave your job, you may be able to remain in your old group health plan for a period of time. This is called COBRA continuation coverage. It can help when you are between jobs or waiting for a new health plan to cover your pre-existing condition. There are limits on what you can be charged for this coverage.

• If you lose your group health insurance and meet other qualifications, you will be federally eligible. If so, you can buy an individual health plan from the Montana Comprehensive Health Association (MCHA) high risk pool. All your pre-existing conditions will be covered immediately under the benefits provided. Premiums will vary based on your age.

• You can also buy insurance from MCHA if you have been turned down by at least two health insurance companies or have a serious health condition and meet other qualifications. In this case you may face a new pre-existing condition exclusion period if you haven’t had coverage lately.

• If you lose your group coverage under a fully insured group health plan and meet other qualifications, you also can buy a conversion policy. There are limits on what you can be charged for a conversion policy, although they tend to be costly.

• If you are a small employer buying a group health plan, you and your employees and dependents cannot be turned down because of the health status, age, or any factor that might predict the use of health services of those in your group. This is called guaranteed issue.

• If you are a small employer buying a group health plan, there are limits on what you can be charged because of health status, age, or other characteristics of those in your group.

• If you have low or modest household income, you may be eligible for free or subsidized health coverage for yourself or members of your family. The Montana Medicaid program offers free health coverage for pregnant women, families with children, elderly and disabled individuals with very low incomes.

• If your children are 18 years old or younger, do not have health insurance and meet other qualifications, you may be able to buy insurance for them through the Montana Child Health Insurance Plan (MT CHIP).