Southwest Montana News

The Montana Department of Public Health and Human Services (DPHHS) has announced a $3.7 million investment over the next 18 months to assist more than 1,300 Medicaid recipients in Montana who have significant medical needs.

“This investment puts money back in the pockets of over 1,000 vulnerable Montanans with challenging health care needs,” stated Governor Greg Gianforte. “This will not only help these individuals with their health care costs but will also ease everyday living expenses for those who need it most.”

Beneficiaries are part of the state's Medically Needy Program, which provides coverage for aged, blind, disabled individuals, pregnant women, and children whose income exceeds Medicaid limits but face substantial medical expenses.

Through this program, participants can qualify for Medicaid benefits by "spending down" their income through paid medical expenses or a cash payment to DPHHS. This process helps them meet Medicaid eligibility standards.

DPHHS Director Adam Meier explained that the announcement includes an increase in the income eligibility limit by $169 per month—from $100 to $269—for qualifying individuals. This change takes effect on January 1, 2022. “This increase will lower the amount these individuals will have to spend to cover their monthly contributions and will thus free up more money for basic everyday necessities,” he said.

Meier noted that such an adjustment has not been made in 15 years.

The funding was allocated by the 2021 Montana Legislature with $2.8 million dedicated to changing the spend down requirement. The department is also utilizing state savings from enhanced federal match for Medicaid provided through the American Rescue Plan Act to further benefit eligible Montanans.

For example, under previous rules, if Sara received $1,250 per month in Social Security benefits, she would need to pay $605 per month toward her healthcare costs to qualify for Medicaid. With changes effective January 1, 2022, her contribution decreases to $436 per month due to a higher medically needy income limit of $814.