Montana Medicaid Program Overview
Enrollment, funding, and managed care facts for Montana Medicaid.
Get Montana's Medicaid Fee Schedule →Enrollment
Montana Medicaid covered approximately 0.20-0.21M people. Two independent sources give close but different-period figures for total Montana Medicaid/CHIP enrollment: KFF's state indicator (202,904, May 2026) and CMS's 2024 Medicaid Managed Care Enrollment and Program Characteristics report (213,159 total Medicaid enrollees, July 1, 2024). Consistent with continued post-pandemic 'unwinding' enrollment decline between mid-2024 and mid-2026, not a data error. Reported as a range rather than a single false-precision number.
Funding & federal match
Montana has adopted ACA Medicaid expansion, effective 2016-01-01.
For FFY2026 (Oct 1, 2025 - Sep 30, 2026), Montana's Federal Medical Assistance Percentage (FMAP) is 61.47%.
Delivery system & managed care
A large share of Montana Medicaid is delivered through managed care organizations (MCOs) rather than fee-for-service — estimates range from 82.1-85.5% of Medicaid enrollees.
Waivers
Montana operates Medicaid managed care under the Montana Health and Economic Livelihood Partnership (HELP) Program, a Section 1115 demonstration waiver. Section 1115 demonstration approved by CMS in November 2015 (effective January 1, 2016) authorizing Montana's Medicaid expansion to adults up to 138% FPL. The original waiver authority expired December 31, 2022; the expansion population has since continued coverage as a standard (non-waiver) Medicaid state plan population. The Montana Legislature permanently lifted the program's recurring reauthorization sunset via HB 245, signed by the Governor in March 2025, and added new community-engagement (work) requirements. Montana DPHHS submitted a new Section 1115 application in July 2025 seeking federal authority for community engagement requirements and premiums; approval status was still pending as of this pass.
Has Montana expanded Medicaid under the ACA?
Yes. Montana has adopted ACA Medicaid expansion. Effective 2016-01-01.
How many people are enrolled in Montana Medicaid?
Approximately 0.20-0.21M people.
What percentage of the federal Medicaid match does Montana receive?
61.47% for FFY2026 (Oct 1, 2025 - Sep 30, 2026) — meaning the federal government pays roughly 61 cents of every Montana Medicaid dollar, and the state pays the rest.
Is most of Montana Medicaid delivered through managed care?
Estimates range from 82.1-85.5% of Medicaid enrollees in managed care.
What Medicaid waivers does Montana operate under?
Montana Health and Economic Livelihood Partnership (HELP) Program, a Section 1115 demonstration waiver. Section 1115 demonstration approved by CMS in November 2015 (effective January 1, 2016) authorizing Montana's Medicaid expansion to adults up to 138% FPL. The original waiver authority expired December 31, 2022; the expansion population has since continued coverage as a standard (non-waiver) Medicaid state plan population. The Montana Legislature permanently lifted the program's recurring reauthorization sunset via HB 245, signed by the Governor in March 2025, and added new community-engagement (work) requirements. Montana DPHHS submitted a new Section 1115 application in July 2025 seeking federal authority for community engagement requirements and premiums; approval status was still pending as of this pass.
Get Montana's Free Medicaid Fee Schedule
Request actual Montana Medicaid reimbursement rates by billing code — free, delivered as a CSV.
Sources
- KFF State Health Facts - Total Monthly Medicaid & CHIP Enrollment
- CMS - Medicaid Managed Care Enrollment and Program Characteristics, 2024
- Federal Register / GPO - Federal Financial Participation in State Assistance Expenditures, FFY2026 FMAP Notice (2024-27910), Table 1
- MACPAC - MACStats Medicaid and CHIP Data Book, Exhibit 6 (FMAPs and E-FMAPs by State, FYs 2023-2026)
- KFF - Status of State Medicaid Expansion Decisions
- healthinsurance.org - Medicaid eligibility and enrollment in Montana
- MACPAC - MACStats Medicaid and CHIP Data Book, Exhibit 29 (Percentage of Medicaid Enrollees in Managed Care by State, July 1, 2022)
- Montana DPHHS - HELP Plan, Medicaid Expansion Information for Stakeholders
- Montana Free Press - Montana governor signs Medicaid expansion bill, lifting 2025 sunset
Data last verified 2026-09-17. Also see our free Medicaid Fee Schedule tool.