In 2026, most people in Montana pay $0 for Medicare Part A and $202.90 a month for Part B, and if your income is limited, a Medicare Savings Program can cut that Part B premium to zero., Free, unbiased counseling through Montana SHIP can walk you through which parts and programs fit your situation.

In This Guide

About these numbers: The premiums and deductibles below come from CMS for calendar year 2026, effective January 1. Medicare costs change every year, and the current figures are posted at medicare.gov. To reach a person, call 1-800-MEDICARE (1-800-633-4227), staffed 24 hours a day, 7 days a week except some federal holidays; TTY users call 1-877-486-2048. For free one-on-one help in Montana, call Montana SHIP at 1-800-551-3191.

Original Medicare: Parts A and B

Original Medicare is run directly by the federal government. The mechanics and costs are the same in Montana as in every other state.

Part A (Hospital Insurance)

Part A covers inpatient hospital stays, limited skilled nursing facility care, hospice, and some home health care.

Cost Amount
Monthly premium $0 for most people (40+ quarters of work history)
Hospital deductible $1,736 per benefit period
Hospital coinsurance, days 61-90 $434 per day
Lifetime reserve days $868 per day
SNF coinsurance, days 21-100 $217 per day

The $1,736 hospital deductible applies per benefit period, not per calendar year. A benefit period starts the day you're admitted and ends once you have gone 60 days in a row without inpatient hospital care or skilled care in a skilled nursing facility; get readmitted after that gap and the deductible resets.

Part B (Medical Insurance)

Part B covers doctor visits, outpatient care, preventive services, durable medical equipment, and mental health care. Routine dental, vision, and hearing are not covered.

  • Monthly premium: $202.90 (higher if your 2024 income exceeded $109,000 single or $218,000 married, under the income-related adjustment)
  • Annual deductible: $283
  • After the deductible: 20% of the Medicare-approved amount for most outpatient services

Delay Part B without qualifying for a Special Enrollment Period or a Medicare Savings Program and you'll owe a permanent 10% premium penalty for every 12-month period you could have had it.

Medicare Advantage in Montana (Part C)

Medicare Advantage plans are offered by private insurers as an alternative to Original Medicare. They cover everything Parts A and B do, except hospice, which Original Medicare continues to cover. Most plans bundle Part D drug coverage along with extras like dental, vision, and hearing.

Montana is a large, predominantly rural state. Billings, Missoula, Great Falls, and Helena typically have some Medicare Advantage plan options. In rural counties, the choices narrow sharply, and many areas have very few or no plans available. Before enrolling, check the Medicare Plan Finder for your specific county.

How These Plans Work

In rural Montana, where MA plans are scarce or absent, Original Medicare plus a Medigap policy often provides the most predictable cost structure.

Medicare Part D: Prescription Drugs

Part D covers outpatient prescription drugs. You can add a standalone Part D plan to Original Medicare or get drug coverage built into a Medicare Advantage plan.

The Inflation Reduction Act restructured Part D. The coverage gap (donut hole) no longer exists starting in 2025. The redesigned benefit has three phases:

  1. Deductible: you pay full price until you meet your plan's deductible (up to $615 in 2026).
  2. Initial coverage: you pay copays or coinsurance while your plan and drug manufacturers cover the rest.
  3. Catastrophic: once your out-of-pocket costs reach $2,100, you pay $0 for covered drugs for the rest of the year.

The $2,100 cap is the figure that matters most in 2026 Part D. The average standalone Part D premium is about $34.50 a month, though plan premiums vary. Every plan must offer the Medicare Prescription Payment Plan, which lets you spread out-of-pocket drug costs into monthly payments across the year instead of paying in full at the pharmacy.

People who qualify for Extra Help pay much less.

Not sure which Part D plan fits your prescriptions? Chat with Brevy's care navigator at brevy.com.

Medigap in Montana

Medigap policies fill the gaps in Original Medicare: the deductibles, coinsurance, and copays. They pair with Original Medicare only: a Medigap policy can't pay your Medicare Advantage copayments, coinsurance, deductibles, or premiums, and while you're in an Advantage plan it's illegal for anyone to sell you one unless you're switching back to Original Medicare.

Montana offers the federally standardized plans, lettered A-D, F, G, and K-N. Plans C and F are closed to anyone who first became Medicare-eligible on or after January 1, 2020. Plan G is the most common choice for people newly eligible: it covers the Part A deductible, Part A and Part B coinsurance, and skilled nursing coinsurance, leaving only the $283 Part B deductible out of pocket.,

Your best window is the federal Medigap Open Enrollment Period: six months that begin the month you are 65 and enrolled in Part B. During that window an insurer must sell you any plan at the standard rate, with no medical underwriting. Outside it, Montana insurers may use medical underwriting.

Montana does not have a birthday rule or other state-added Medigap guaranteed-issue protections beyond the federal standard. For rural Montanans with limited Medicare Advantage options, the Medigap open-enrollment window is especially worth protecting.

If You Missed Your Medigap Window

Once your six-month open-enrollment window closes, Montana insurers may apply medical underwriting. In practice, that means the insurer can review your health history, charge you a higher premium based on your conditions, or decline your application outright, unless a federal guaranteed-issue right applies (for example, if your Medicare Advantage plan leaves your area or you lose other coverage through no fault of your own). It is worth applying anyway and comparing carriers, because underwriting rules and pricing vary by company. If no Medigap carrier will take you, your practical fallbacks are a Medicare Advantage plan (where one is available in your county) or staying on Original Medicare and budgeting for the coinsurance yourself. A Montana SHIP counselor can tell you which guaranteed-issue rights you may have before you assume the door is closed.

Medigap or Medicare Advantage?

You cannot run the two together. Medigap means staying on Original Medicare with the freedom to see any provider who accepts Medicare nationwide, at a typically higher monthly premium. Medicare Advantage means trading some of that flexibility for a plan network. The door back isn't sealed, though. If you join a Medicare Advantage plan for the first time and it isn't right, a federal trial right lets you return to Original Medicare within 12 months of joining and buy a Medigap policy; if you dropped a Medigap policy to join and have been in the plan under a year, you may be able to get that same policy back. Outside that trial window, dropping Medigap is usually one-way, which matters more in Montana than in most states because insurers here can underwrite you afterward. For a side-by-side comparison, see our guide to Original Medicare vs. Medicare Advantage.

Help Paying for Medicare in Montana

If you have limited income and resources, two programs can cut your Medicare costs significantly.

Medicare Savings Programs

Montana administers the Medicare Savings Programs through the Montana Department of Public Health and Human Services (DPHHS), the state's Medicaid agency. The federal standards below are the statutory floor: Montana cannot apply limits tighter than these, though a state is allowed to be more generous. Every figure below is a limit on countable income and countable resources, not on your gross income or on everything you own.

Program Individual Couple What it pays
QMB Up to $1,350 Up to $1,824 Part A and B premiums, deductibles, coinsurance
SLMB Up to $1,616 Up to $2,184 Part B premium
QI Up to $1,816 Up to $2,455 Part B premium

QMB is the most generous tier: it pays your Part B premium plus your deductibles and coinsurance, and federal law bars providers from billing a QMB enrollee for that cost-sharing. CMS adds two qualifiers that matter if you are holding a bill: in some cases a patient may owe a small Medicaid copayment, and CMS reports that people in the QMB group are still wrongly billed despite the law. QI has to be applied for again every year, because being selected one year does not carry you into the next. For all three programs the 2026 federal resource standard is $9,950 for one person and $14,910 for a couple. Montana's own most recently published MSP figures come from a 2024 DPHHS eligibility refresher and are lower ($9,430 and $14,130), so ask DPHHS what the state is applying this year rather than ruling yourself out on either number. Income figures tie to the Federal Poverty Level and move each year as it updates. Treat none of these numbers as an absolute cutoff: states can effectively raise both the income and the resource limits by disregarding certain income and resources, so someone somewhat over should still apply. Apply through Montana DPHHS, and enrolling in QMB, SLMB, or QI automatically qualifies you for Extra Help with Part D. QDWI, the fourth Medicare Savings Program, is the exception: it pays the Part A premium for certain working people with disabilities who lost premium-free Part A, and it does not confer Extra Help, so a QDWI enrollee who wants Extra Help has to apply through Social Security.,

Sitting just over the income line? Three things are worth knowing. First, QI carries the highest limit of the three programs ($1,816 a month for an individual under the 2026 federal standard), so check it before assuming you earn too much. Second, because the limits rise each year with the Federal Poverty Level, someone a few dollars over this year may qualify after the update, so it is worth trying again. Third, DPHHS compares you against countable income rather than what you earn before deductions: its aged, blind and disabled rules subtract a work disregard, court-ordered child support and/or alimony, and dependent care expenses first. Its materials likewise separate resources that are excluded from those that are countable, though they do not spell out which resources Montana excludes for the Medicare Savings Programs, so DPHHS is the place to settle that. A Montana SHIP counselor can go over the current limits with you at no cost.

How to Apply for a Montana Medicare Savings Program

You apply through Montana DPHHS. A Montana SHIP counselor can talk the program through with you first, at no cost, if you'd rather not go in cold.

1
Step 1

Gather your documents

Have your Medicare card and recent proof of income and assets ready, such as your Social Security award letter, pension or wage statements, and current bank and investment balances (the 2026 federal limit on countable resources is $9,950 for one person and $14,910 for a couple; ask DPHHS which figures Montana is applying).

2
Step 2

Apply through Montana DPHHS

File your Medicare Savings Program application with the Montana Department of Public Health and Human Services, which administers the program statewide as part of Montana Medicaid.

3
Step 3

Or get free counseling first

Call Montana SHIP at 1-800-551-3191 and a counselor will go over the Medicare Savings Programs with you, including the current limits and how your income compares, at no cost.

4
Step 4

Try again after the annual update if you were just over

Because the income limits rise each year with the Federal Poverty Level, confirm this year's figures before you file, and reapply after the update if you narrowly missed.

Extra Help for Part D

Extra Help (also called the Low-Income Subsidy) pays Part D premiums, deductibles, and copays for people with limited income and resources. Since 2024 the partial-subsidy tier is gone; everyone who qualifies now gets the full subsidy.

  • Income limit (2026): up to about $1,995 a month for an individual, $2,705 for a couple, in the 48 contiguous states and DC (Alaska and Hawaii are higher)
  • Resource limits: $16,590 for an individual, $33,100 for a couple; those limits rise to $18,090 and $36,100 if you tell Social Security you expect to use some of your resources for burial expenses
  • Enrollment in QMB, SLMB, or QI qualifies you for Extra Help automatically

To apply, gather the same income and resource records you'd use for an MSP, then apply through the Social Security Administration at ssa.gov or call 1-800-772-1213. Extra Help isn't available in Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands, or American Samoa, where residents apply through their local Medicaid office instead.

Medicare Enrollment Periods

These deadlines are federal and the same in Montana as everywhere else. Miss one and you may face a coverage gap or a permanent penalty.

Period Dates What you can do
Initial Enrollment 7 months around your 65th birthday Sign up for Parts A, B, and D; pick MA or Medigap
Annual Open Enrollment Oct 15 - Dec 7 Switch MA plans, move between MA and Original Medicare, change Part D
MA Open Enrollment Jan 1 - Mar 31 Switch MA plans or drop MA for Original Medicare (if already in MA)
General Enrollment Jan 1 - Mar 31 Sign up for Part B if you missed your initial window
Medigap Open Enrollment 6 months from age 65 + Part B Buy any Medigap plan at the standard rate, no health screening

Changes during Annual Open Enrollment take effect January 1. If you're already receiving Social Security before 65, you're enrolled in Parts A and B automatically. If not, sign up through Social Security. The General Enrollment Period runs January through March; under Section 120 of the Consolidated Appropriations Act, 2021, coverage now starts the first of the month after you sign up. If you delayed Part B because you had employer coverage, you get an 8-month Special Enrollment Period counted from the month that job or coverage ends, whichever comes first (COBRA and retiree coverage do not count), though this Special Enrollment Period does not apply if you're eligible for Medicare based on End-Stage Renal Disease (ESRD). If you're self-employed, or your plan isn't available to everyone at the company, ask your insurer whether it counts as employer group health plan coverage before you delay; if it doesn't, sign up at 65.

Free Medicare Help: Montana SHIP

The Montana SHIP (State Health Insurance Assistance Program) is run by the Montana DPHHS Office on Aging and delivered through local Area Agencies on Aging across the state. Counselors are free, unbiased, and do not sell insurance.

Montana SHIP counselors can help you:

  • Understand your Medicare options and what each part covers
  • Compare Medicare Advantage, Part D, and Medigap plans
  • Understand the Medicare Savings Programs and Extra Help, and what to gather before you apply
  • Sort out billing questions, denials, and appeals
  • Identify and report Medicare fraud

Call the statewide toll-free line at 1-800-551-3191 or visit dphhs.mt.gov/SLTC/aging/SHIP to find your local Area Agency on Aging.

Where to Get Help in Montana

Montana SHIP (State Health Insurance Assistance Program) Free, unbiased Medicare counseling, plan comparison, and help applying for cost assistance. 1-800-551-3191 dphhs.mt.gov/SLTC/aging/SHIP
Montana DPHHS Apply for a Medicare Savings Program (QMB, SLMB, or QI) through Montana Healthcare Programs, and confirm the income and resource limits the state is applying this year. dphhs.mt.gov
Social Security Administration Apply for Extra Help with Part D drug costs, or enroll in Medicare. 1-800-772-1213 ssa.gov
1-800-MEDICARE Questions about Original Medicare, enrollment windows, and the Plan Finder. 1-800-633-4227 medicare.gov

Frequently Asked Questions

What does Medicare cost in Montana in 2026?

Most people pay $0 for Part A. The standard Part B premium is $202.90 a month with a $283 annual deductible. Part D premiums vary by plan (the average runs about $34.50 a month), and many Medicare Advantage plans charge no additional premium. Your total out-of-pocket depends on the plan you choose and the care you use.

Does Montana have a Medigap birthday rule?

No. Montana does not have a birthday rule or other state-added Medigap guaranteed-issue protections. The only guaranteed window is the standard federal six-month Medigap Open Enrollment Period that begins when you turn 65 and enroll in Part B. After that window closes, insurers may apply medical underwriting.

What are the Medicare Savings Program limits in Montana?

Montana cannot set limits tighter than the federal standards. For 2026 those are: QMB countable income up to $1,350/month for an individual ($1,824 for a couple), SLMB up to $1,616 ($2,184), and QI up to $1,816 ($2,455), each with a countable-resource limit of $9,950 per individual and $14,910 per couple. Those limits are measured after the disregards the state applies, so gross income above them does not by itself rule you out. Montana's own most recently published figures date from 2024, so confirm the current state standards with Montana DPHHS when you apply. States can also effectively raise both the income and the resource limits by disregarding certain income and resources, so apply if you are somewhat over rather than ruling yourself out.

Is Medicare Advantage widely available in Montana?

Only in the larger metro areas. Billings, Missoula, Great Falls, and Helena typically have some options. Rural Montana, which covers most of the state's geography, generally has very few or no Medicare Advantage plans. Use the Medicare Plan Finder at medicare.gov to check your specific county.

Who runs Medicare counseling in Montana?

Montana SHIP, through the DPHHS Office on Aging and local Area Agencies on Aging. Call 1-800-551-3191 for free counseling.

Your next step Call Montana SHIP at 1-800-551-3191 for a free appointment with a trained counselor who can compare your Medicare options and talk through whether the Medicare Savings Programs or Extra Help could cut your costs, without ever selling you anything.

Learn More

MedicareMedicare Plans by State: What Varies and What Doesn'tOriginal Medicare is the same in all 50 states. Medicare Advantage, Part D, and Medigap rules are not. See what changes by state, then open your state guide. MedicareOriginal Medicare vs. Medicare AdvantageCompare original Medicare vs Medicare Advantage on cost, networks, the $9,250 cap, and switching back. A neutral 2026 side-by-side to help you choose. MedicareHow Medigap WorksMedigap (Medicare Supplement) explained: how the standardized A-N plans work, Plan G vs Plan N, closed C and F plans, and the 6-month guaranteed-issue window. MedicareMedicare Part D Drug CoverageMedicare Part D in 2026: a $2,100 out-of-pocket cap, no donut hole, three benefit phases, the $615 deductible, premiums, the late penalty, and Extra Help. MedicareBig Sky Rx: How Montana Helps Pay Your Medicare Part D PremiumBig Sky Rx pays up to $50.60 a month toward a Montana resident's Medicare Part D premium. See the income limits, who qualifies, and how to apply. MedicareMedicare Enrollment PeriodsWhen to sign up for Medicare without a lifelong penalty: the 7-month Initial Enrollment Period, working past 65, the GEP, and what each late penalty costs.

Find personalized help with Medicare in Montana at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

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