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.
Frequently Asked Questions
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.