Montana Medicaid income limits

Last verified: June 2026

Montana Medicaid income limits by coverage group (2026)

Montana expanded Medicaid under the HELP Act, effective January 1, 2016. The expansion covers adults 19–64 at or below 138% FPL. Children qualify at significantly higher income levels through either Medicaid or the Healthy Montana Kids CHIP program.

Source: Montana DPHHS Montana Healthcare Programs; 2026 HHS Federal Poverty Guidelines. Income amounts are approximate monthly gross figures. The 5% MAGI income disregard applies to the adult expansion group — if your income is within 5 percentage points of the limit, you may still qualify.

No asset test for MAGI-based Montana Medicaid

Montana does not use an asset test for MAGI-based Medicaid — the category covering adults 19–64, children, and pregnant women. Savings, vehicles, and home equity are not counted. This is the same rule across all ACA expansion states.

Montana Medicaid long-term care programs — nursing facility coverage and home-based waiver services for seniors and people with disabilities — do apply asset limits. These follow the federal spousal impoverishment rules. Contact DPHHS Aging Services Division for current long-term care asset limits.

Montana's HELP Act expansion: adults without children included

Before the HELP Act expansion took effect in January 2016, Montana Medicaid generally did not cover adults 19–64 who did not have dependent children, except through narrow disability-based pathways. The HELP Act changed this — all adults at or below 138% FPL now qualify, regardless of parental or disability status.

Per DPHHS, approximately 100,000 Montanans gained coverage when the HELP Act expansion took effect. Montana voters reinforced this expansion when they approved a ballot initiative in November 2018 to make the HELP Act permanent, removing the sunset provision from the original legislation.

Healthy Montana Kids: income limits for children

Children up to age 19 qualify for coverage at significantly higher income levels than adults. The Healthy Montana Kids CHIP program covers children whose family income falls between the standard Medicaid threshold and 261% FPL. Monthly premiums apply for families at higher income levels within the Healthy Montana Kids range — typically modest amounts. Both programs accept a single application and are administered through DPHHS.

How Medicaid income limits work

Medicaid eligibility is tied to the Federal Poverty Level (FPL), a measure the Department of Health and Human Services updates each January. States set their income limits as a percentage of FPL — so when FPL increases, the dollar thresholds for Medicaid also shift.

The Affordable Care Act established a standard income methodology called Modified Adjusted Gross Income (MAGI) for most Medicaid applicants. Under MAGI, the agency counts wages, salaries, self-employment income, Social Security benefits, and most other taxable income. Assets — a savings account, vehicle, home — are not counted for MAGI-based programs. That changed with the ACA and applies in all states.

States that expanded Medicaid under the ACA cover most adults at or below 138% FPL. In non-expansion states, income limits for adults without dependent children are far lower — sometimes as low as a few hundred dollars per month — or eligibility for that category simply doesn't exist.

What counts as income under MAGI

MAGI (Modified Adjusted Gross Income) is the income standard for most Medicaid applicants — children, adults under 65, pregnant women, and parents. It includes wages, salary, tips, self-employment income, unemployment benefits, Social Security retirement and disability benefits (SSDI), and most other taxable income.

It does not count child support received, gifts, loans, inheritances that are not generating income, or Supplemental Security Income (SSI) payments. One key MAGI rule: the ACA added a 5% FPL income disregard for most adults, which effectively raises the usable threshold by that amount. So a state with a 133% FPL limit effectively covers adults to about 138% FPL after the disregard.

Assets — a bank account, car, or home — are not counted for MAGI-based programs. That's a major difference from old-law Medicaid, where asset tests were common. If you previously didn't qualify because of assets, your eligibility may have changed after the ACA.

Asset limits and long-term care Medicaid

MAGI-based programs have no asset test. But Medicaid programs that cover long-term care — nursing home care, home and community-based services for seniors — use the old income and asset methodology, which does include asset limits.

Asset limits for long-term care Medicaid vary by state and are updated periodically. Generally, countable assets above the limit must be spent down before an applicant qualifies. Exempt assets — the primary home (in most circumstances), one vehicle, and certain personal property — are not counted.

Specific asset limits for Montana's long-term care programs are on the seniors and long-term care page. The thresholds change, so verify current figures with Montana Medicaid directly.