Montana CHIP: Children's Health Insurance Program

Last verified: June 2026

Informational overview of Montana CHIP

For current eligibility thresholds and enrollment, visit https://dphhs.mt.gov/MontanaHealthcarePrograms. CHIP and Medicaid applications are processed together in most states — apply once and both programs are considered.

Montana's CHIP program is called Healthy Montana Kids — covers children up to 261% FPL

Healthy Montana Kids covers children under 19 whose family income is above the standard Medicaid limit but at or below 261% of the Federal Poverty Level. Apply through Montana DPHHS by calling 1-800-362-8312 or visiting a local DPHHS office. A single application covers both Montana Medicaid and Healthy Montana Kids CHIP.

Who qualifies for Healthy Montana Kids

Healthy Montana Kids covers uninsured children under 19 residing in Montana whose household income falls between the standard Medicaid threshold and 261% FPL. Montana's CHIP program provides coverage at income levels well above the Medicaid floor, filling the gap for working families who earn too much for Medicaid but cannot afford private insurance.

Child must be under age 19
Family income at or below 261% FPL
Monthly income limit: approximately $3,276 for household of 1; $6,737 for household of 4 (2026)
Child must be a U.S. citizen, national, or qualifying immigrant
Child must reside in Montana
Child must not have access to affordable employer-sponsored coverage

Source: Montana DPHHS; 2026 HHS Federal Poverty Guidelines. Contact DPHHS at 1-800-362-8312 to verify current limits for your household size.

Healthy Montana Kids benefits and cost-sharing

Healthy Montana Kids provides comprehensive coverage for enrolled children, including the same EPSDT-equivalent benefits that apply to Montana Medicaid children. Children receive preventive, acute, and specialty care. At higher income levels within the 261% FPL ceiling, small monthly premiums and co-pays apply.

Premiums for Healthy Montana Kids are income-scaled — families near the lower end of the CHIP income range pay little or nothing, while families at the upper end pay modest monthly amounts. Per federal CHIP rules, total annual out-of-pocket costs for enrolled families cannot exceed 5% of family income.

Well-child visits and developmental screenings
Immunizations
Doctor visits and specialist referrals
Prescriptions
Emergency and urgent care
Inpatient hospital care
Mental health and substance use services
Dental care (comprehensive EPSDT scope)
Vision care and eyeglasses
Physical, occupational, and speech therapy

How to apply for Healthy Montana Kids

Apply through Montana DPHHS by calling 1-800-362-8312, visiting your local DPHHS office, or using the DPHHS online portal at dphhs.mt.gov. A single application screens for both Montana Medicaid and Healthy Montana Kids CHIP — you do not need to apply separately.

Applications are processed within 45 days under federal rules. Children who are found to be eligible receive a coverage start date of the first of the month they applied.

Montana Medicaid vs. Healthy Montana Kids: a comparison

Program	FPL ceiling	Premiums
Montana Medicaid (children)	Lower income range	None
Healthy Montana Kids (CHIP)	Up to 261% FPL	Modest at higher incomes

Apply even if you think your income is too high

Montana's 261% FPL income ceiling for Healthy Montana Kids is generous. A family of four with a monthly income under $6,737 (2026) likely qualifies. Many families assume they earn too much — it's worth applying to find out.

What CHIP is

CHIP — the Children's Health Insurance Program — is a federal-state partnership that covers children in families whose income is too high for Medicaid but too low to afford private insurance. Congress created CHIP in 1997 under Title XXI of the Social Security Act. Like Medicaid, CHIP is jointly funded by the federal government and each state, and each state administers its own program.

CHIP serves children up to age 19 (some states cover to 21 for children in foster care). It is not available to adults — CHIP is specifically designed to address the coverage gap for children in working families.

Nationally, CHIP covers approximately 7 million children, according to CMS data. In most states, it is a seamless part of the broader children's health coverage system alongside Medicaid.

What CHIP covers

Federal law requires CHIP to cover certain core benefits. States may add to the list. Standard CHIP coverage includes:

Doctor visits, including well-child checkups and sick visits
Hospital care — inpatient and outpatient
Emergency room and urgent care services
Prescription drug coverage
Mental health and substance use disorder services
Dental care — preventive and restorative
Vision care, including eye exams and glasses
Laboratory and imaging services
Physical, occupational, and speech therapy
Medical equipment, such as wheelchairs or hearing aids when medically necessary

How to apply for Montana CHIP

Apply through Montana Medicaid — the same application covers both Medicaid and CHIP. Online applications are typically fastest and allow document uploads. You can also apply by phone or in person at a local eligibility office.

See the how to apply page for the complete application process, required documents, and what to expect during review.

CHIP and Medicaid income ranges overlap — apply regardless

If you're not sure whether your child qualifies for Medicaid or CHIP, apply anyway. The eligibility system determines which program applies based on your income. A child who earns out of Medicaid may qualify for CHIP, and vice versa. Don't let uncertainty about which program applies prevent you from applying.