If you’re in Montana and finding health care costs tough to handle, Medicaid might be the support you need. This program offers vital coverage for doctor appointments, hospital stays, medications, and more to low-income folks.
Income limits are key, they’re linked to federal poverty levels and refreshed yearly to reflect real life. In 2025, it covers kids, pregnant women, parents, childless adults, seniors, and people with disabilities.
This guide gives you the straight facts on 2025 limits, sorted by group, so you can see if it fits your situation and take the next step.
What Is Montana Medicaid? (2025 Overview)
Montana Medicaid, handled by the Department of Public Health and Human Services (DPHHS), steps in for low-income individuals and families who need health help.
It includes Healthy Montana Kids (HMK), blending Medicaid and CHIP to give kids wider access.
The program reaches out to children, pregnant women, parents, working adults, seniors, and those with disabilities.
You’ll get essentials like check-ups, mental health support, kids’ dental care, and long-term options like home aids.
Back in 2016, Montana expanded Medicaid, letting adults up to 138% of the federal poverty level join in a move that’s opened doors for many more people.
Montana Medicaid Eligibility Requirements (2025)
Getting on Montana Medicaid in 2025 starts with a few straightforward checks. You must live in Montana and plan to stick around.
For citizenship or immigration, U.S. citizens, nationals, or eligible immigrants (such as green card holders after five years) qualify; non-citizens might get emergency help. Your income has to stay under the limits for your group, based on the federal poverty level (FPL).
Household size plays a big part, it counts you, your spouse, and dependents, bumping up the limit as it grows. Age makes a difference too: kids under 19 get higher cutoffs, adults 19-64 lean on expansion rules.
If you’re seeking aged, blind, or disabled (ABD) coverage, you’ll need medical proof from Social Security or a doctor. ABD folks also have asset caps, like $2,000 for a single person.
Montana Medicaid Income Limits 2025 Breakdown
Montana bases its income limits on the 2025 federal poverty level (FPL), which is $15,650 a year for one person in the lower 48 states.
For most, it looks at modified adjusted gross income (MAGI) from your taxes. Thanks to expansion, adults can reach an effective 138% FPL.
Bigger households mean higher limits, add about $5,500 yearly for each person past eight. These numbers get a refresh every year with FPL adjustments, so double-check if your income or family changes.
Montana Medicaid Income Limits Tables 2025 (By Category)
Montana Medicaid Income Limits for Adults (2025, 138% FPL)
This covers non-pregnant adults 19-64, even without kids at home.
| Household Size | Monthly Income Limit | Annual Income Limit |
| 1 | $1,735 | $20,820 |
| 2 | $2,344 | $28,128 |
| 3 | $2,954 | $35,448 |
| 4 | $3,563 | $42,756 |
| 5 | $4,173 | $50,076 |
| 6 | $4,783 | $57,396 |
| 7 | $5,392 | $64,704 |
| 8 | $6,002 | $72,024 |
Montana Medicaid Income Limits for Children (HMK) – 2025
For kids 0-18, this includes Medicaid up to 143% FPL and CHIP (HMK) up to about 261% FPL.
| Household Size | Monthly Limit | Annual Limit |
| 1 | $3,404 | $40,848 |
| 2 | $4,600 | $55,200 |
| 3 | $5,795 | $69,540 |
| 4 | $6,993 | $83,916 |
| 5 | $8,189 | $98,268 |
| 6 | $9,385 | $112,620 |
| 7 | $10,581 | $126,972 |
| 8 | $11,777 | $141,324 |
Montana Medicaid Income Limits for Pregnant Women 2025 (Montana)
Up to 157% FPL, with the unborn child counting in your household size.
| Household Size | Monthly Limit | Annual Limit |
| 1 | $2,048 | $24,576 |
| 2 | $2,767 | $33,204 |
| 3 | $3,487 | $41,844 |
| 4 | $4,206 | $50,472 |
| 5 | $4,926 | $59,112 |
| 6 | $5,646 | $67,752 |
| 7 | $6,365 | $76,380 |
| 8 | $7,085 | $85,020 |
Montana Parent & Caregiver Medicaid Income Limits 2025
For parents or caregivers with children under 19; the traditional limit is around 25% FPL (higher via expansion if eligible).
| Household Size | Monthly Limit | Annual Limit |
| 1 | $313 | $3,756 |
| 2 | $423 | $5,076 |
| 3 | $533 | $6,396 |
| 4 | $643 | $7,716 |
| 5 | $753 | $9,036 |
| 6 | $863 | $10,356 |
| 7 | $973 | $11,676 |
| 8 | $1,083 | $12,996 |
Montana Aged, Blind, Disabled (ABD) Medicaid Income Limits 2025
Linked to SSI; assets capped at $2,000 single, $3,000 couple.
| Household Size | Monthly Income Limit | Annual Income Limit | Asset Limit |
| 1 (Single) | $967 | $11,604 | $2,000 |
| 2 (Couple) | $1,450 | $17,400 | $3,000 |
Montana Long-Term Care Medicaid Income Limits 2025
For nursing homes or HCBS waivers. No firm limit for nursing homes (you pay a share after allowances). HCBS tops at 300% SSI.
| Category | Monthly Income Limit (Single) | Asset Limit (Single) | Spousal Income Allowance (Min-Max) | Spousal Asset Allowance (Min-Max) |
| Nursing Home | No cap (pay liability after $72.80 allowance) | $2,000 | $2,644 – $3,948 | $31,584 – $157,920 |
| HCBS Waiver | $2,901 | $2,000 | $2,644 – $3,948 | $31,584 – $157,920 |
What Counts as Income for Montana Medicaid in 2025?
Montana mostly uses MAGI for calculations, like your tax income. Earned stuff includes paychecks, tips, bonuses, and net self-employment earnings after deductions.
Unearned includes interest, dividends, alimony, pensions, and taxable Social Security. Good news: things like child support, tax refunds, gifts, loans, SNAP aid, and certain scholarships don’t count.
For ABD or long-term care, almost everything counts except extras like VA benefits.
How Montana Calculates Household Size in 2025
Montana sticks to tax rules for this: count yourself, your spouse, and tax dependents. If you don’t file taxes, include folks you support more than half.
Simple examples: A single parent with one kid? Size two. A pregnant couple without other children? Size three (unborn included).
Grandparents claiming their grandchild? Size two. Shared custody? Usually, the tax-filing parent claims the child. If pregnant with multiples, each unborn adds one. Confused? Try DPHHS’s online checker for clarity.
How to Apply for Montana Medicaid in 2025
Ready to start? Go online at apply.mt.gov it’s quick and easy.
Prefer talking? Call 1-888-706-1535. You can mail a form to your local DPHHS office (locations at dphhs.mt.gov) or drop by in person at a county spot.
Bring ID, Social Security info, pay stubs or tax returns for income, utility bills for residency, and immigration docs if applicable.
Most get a decision in 45 days; disability cases take up to 90.
Montana Medicaid Renewal Requirements 2025
Keep your coverage going with a yearly renewal. DPHHS mails a notice 45 days ahead. Share updates on income, address, or family with proof like recent pay stubs. Lots of folks get auto-renewed if everything lines up. Skip it, and coverage stops, but reapply fast to bridge the gap.
Why Your Montana Medicaid Application May Be Denied
- Your income tops the limit for your category.
- Household size got listed wrong.
- Docs are missing or not complete.
- Immigration status doesn’t line up.
- You didn’t reply to DPHHS follow-ups.
FAQs for Montana Medicaid Income Limits 2025
What are the Montana Medicaid income limits for 2025?
They differ by group: Adults up to $1,735 monthly for one person; kids to $3,404; pregnant women $2,048. Check the tables for details.
How does Montana calculate Medicaid income in 2025?
It uses tax-based MAGI, skipping things like child support and refunds.
What is the income limit for a family of 2 for Montana Medicaid in 2025?
Adults: $2,344 monthly; children: $4,600; pregnant: $2,767; parents: $423.
Do pregnant women get higher Medicaid income limits in Montana in 2025?
Yes, up to 157% FPL, higher than standard adult levels.
Does Montana Medicaid count rent, bills, or expenses in 2025?
No, it’s based on gross income minus deductions; living costs don’t subtract directly.
What is the asset limit for Montana Medicaid in 2025?
For ABD and long-term care: $2,000 single, $3,000 couple. Others usually skip asset checks.
Do adults without children qualify for Montana Medicaid in 2025?
Absolutely, through expansion up to 138% FPL for ages 19-64.
What happens if my income is slightly over the Montana Medicaid limit in 2025?
Look into the 5% disregard or spend-down for medically needy, it might still work.
Does Montana Medicaid have a spend-down program in 2025?
Yes, spend extra income on medical bills to hit the limit and qualify.
Does Montana Medicaid cover dental and vision in 2025?
Kids get full dental and vision; adults mainly emergencies for dental, limited vision.
Can seniors get Medicaid in Montana in 2025?
Sure, via ABD with income under $967 monthly for singles and low assets.
How often do Montana Medicaid income limits update?
Once a year, typically in January with FPL changes.
Final thoughts
Montana Medicaid is there for low-income residents, qualifying if your earnings match limits like 138% FPL for adults ($1,735 monthly single) or up to 261% for kids ($3,404). Parents have tighter traditional rules at lower levels, while ABD is $967 monthly. Head online to apply.mt.gov or dial 1-888-706-1535 to apply or renew. Since FPL tweaks happen yearly, stay on top of changes, reach out to DPHHS for advice tailored to you.
