Montana Medicaid Income Limits 2026: HELP and HMK

Applying is free, and Medicaid pays medical bills rather than giving cash. To compare Montana with other states, see our national Medicaid income limits guide.

Montana Medicaid Income Limits by Household Size (2026)

DPHHS publishes 5 family-coverage income tables, and 4 of them were refreshed on April 1, 2026. According to the DPHHS ACA Adult Medicaid table, a household of three can have up to $3,028 a month on the 133% standard, while the pregnancy table allows $3,574, Healthy Montana Kids Plus $3,256 and Healthy Montana Kids $5,942. Montana prints these tables without the 5% disregard, so the last column adds it for adults.

Sources: DPHHS eligibility manual tables ACA 003 (opens in a new tab) (parents and caretakers, effective April 1, 2025, the current version), ACA 007 (opens in a new tab), ACA 004 (opens in a new tab) and ACA 005 (opens in a new tab) (all effective April 1, 2026). The tables continue to 16 people. Grantsights computed the disregard column by adding 5% of the 2026 HHS poverty guideline for each household size to DPHHS's 133% figure; the federal disregard can also lift the pregnancy and children's lines by about 5 points when it decides eligibility.

Yearly equivalents for Medicaid Expansion adults

DPHHS publishes monthly figures. These yearly amounts are Grantsights calculations: the published 133% figure times 12, and 138% of the 2026 poverty guideline.

Seniors, disability and long-term care limits

Montana runs aged, blind and disabled (ABD) Medicaid on SSI-based standards, with a medically needy spend-down for people over them.

Sources: DPHHS ABD manual tables ABD 008 (opens in a new tab), ABD 009 (opens in a new tab), ABD 010 (opens in a new tab) and ABD 013 (opens in a new tab); Combined Medicaid tables CMA 001 (resources) (opens in a new tab) and CMA 002 (medically needy income) (opens in a new tab).

People who receive SSI are treated as meeting the categorically needy income test without a separate check, according to ABD 008.

How Montana Counts Your Income

Montana uses 2 sets of income rules, and they differ on both what counts and whether savings matter.

MAGI rules cover ACA Adult (HELP Plan), parents and caretakers, pregnancy coverage, Healthy Montana Kids Plus and Healthy Montana Kids. Income follows federal tax definitions: wages, net self-employment income, unemployment and taxable Social Security count, while child support received and SSI don't. Household membership follows tax-filing relationships. According to the DPHHS CMA 001 resource table, there's been no resource limit for any ACA Medicaid or HMK program since January 1, 2014. The 5% disregard, worth 5% of the poverty guideline for your household size ($66.50 a month for one person and $137.50 for four in 2026), is applied in the eligibility system rather than printed in the tables.

SSI-related rules cover people who are aged, blind or disabled, Medicare Savings Programs, the medically needy program and nursing home care. These count resources, allow SSI-style deductions and, for medically needy cases, let you meet a spend-down with medical bills or by paying the difference to the department.

For example, a family of three in Montana earning $3,300 a month gross (a married couple and their 8-year-old) lands in three places. The parents are specifically $158 over the roughly $3,142 adult line even after the disregard, so they don't qualify for the HELP Plan. Their child is over HMK Plus at $3,256 but well under the $5,942 Healthy Montana Kids line, so the child is covered through HMK. The parents would shop on HealthCare.gov, which Montana uses for its marketplace.

Montana Medicaid Asset Limits

$2,000 for one person and $3,000 for a couple is the resource limit for categorically needy and medically needy ABD Medicaid, unchanged since July 1, 2001, according to the DPHHS CMA 001 resource data. Adults, children and pregnant women on ACA coverage have no asset test.

The other programs use different numbers:

• Medicare Savings Programs: $9,950 for one person and $14,910 for a couple, effective January 1, 2026.
• Medicaid for Workers with Disabilities: $15,000 for one person and $30,000 for a couple.
• Family medically needy coverage: $3,000 per filing unit, regardless of size.

For nursing home couples, ABD 013 sets the at-home spouse's income allowance at up to $4,067 a month (January 1, 2026), built from a basic needs standard of $2,705 plus shelter costs above $811 (both July 1, 2026). Giving away money or property for less than fair value during the look-back period can trigger a penalty, so families should talk with Montana Legal Services Association or an elder law attorney before moving assets.

Expansion vs Non-Expansion: Montana's Position in 2026

Montana expanded Medicaid through the Montana Health and Economic Livelihood Partnership (HELP) Act, which the 2015 Legislature passed and which is still in the 2025 Montana Code Annotated at Title 53, chapter 6, part 13. Coverage under MCA 53-6-1304 (opens in a new tab) follows the federal expansion group, adults under 65 up to 133% of poverty plus the disregard. Our Texas Medicaid income limits guide shows the gap adults face in a state that didn't expand, while Idaho's guide and Washington's guide cover neighboring expansion states, and Colorado's guide adds another Mountain West comparison.

Continuation and the federal match. The program had a June 30, 2025 end date. Montana Free Press and other news outlets reported that Gov. Greg Gianforte signed House Bill 245 on March 28, 2025, removing that sunset; Grantsights couldn't open the bill record on the Legislature's site, so that detail rests on news coverage. Separately, MCA 53-6-1313 (opens in a new tab) says that if the federal match for expansion adults is set below the level in federal law, continued coverage depends on extra state money from the Legislature, higher HELP premiums or both. That condition hasn't been triggered.

Community engagement, already in effect. According to the DPHHS Medicaid changes page (opens in a new tab) (current as of September 30, 2026) and its FAQ:

• Montana started the requirement on July 1, 2026, ahead of the federal January 2027 date, after CMS let it proceed through a state plan amendment.
• Expansion adults 19 to 64 need 80 hours a month of work, community service, approved job training, an internship or apprenticeship, or half-time school, or household income of at least $580 a month.
• New applicants must show compliance, or an exclusion, for the month before applying. At renewal, members must show it for at least 3 months since their last renewal; the months don't have to be in a row.
• Renewals due August 31, 2026 were the first to include the check. From July through September 2026, nobody was denied or disenrolled for it. Since October 2026, people who don't meet it can lose coverage.
• Six-month renewals begin January 2027 for most members; American Indians and Alaska Natives stay on 12 months.

Exclusions DPHHS lists include American Indians and Alaska Natives, pregnant and postpartum women, parents or caretakers of a child under 14 or of a person with a disability, people who are medically frail, people in treatment at ASAM Level 2.1 or higher, former foster youth under 26, veterans with a 100% disability rating, and people meeting SNAP or TANF work rules. People receiving SSI or SSDI, and members of Medicaid for Workers with Disabilities, aren't subject to the rule.

Noncitizen change: starting October 1, 2026, federal Medicaid and CHIP funding generally covers only citizens, lawful permanent residents, Cuban/Haitian entrants and COFA migrants, according to CMS State Health Official letter 26-001 (opens in a new tab) (April 8, 2026). None of these changes move the dollar limits above.

What DPHHS Doesn't Tell You About the Income Limits

Grantsights compared DPHHS's manual tables with its public pages and found 5 points a family can miss:

1. The adult table looks lower than it is. DPHHS prints the HELP Plan line at 133% of poverty ($1,769 for one person). The federal 5% disregard adds $66.50 for one person and $137.50 for four, so someone earning $1,800 a month is still potentially eligible. Grantsights analysis of the April 2026 tables against the 2026 HHS guidelines puts the effective one-person line at about $1,835.
2. Healthy Montana Kids reaches far past the adult line. Grantsights analysis of the same tables shows HMK for a family of four ends at $7,178 a month, $3,520 more than the published $3,658 adult figure. Parents often underestimate how much they can earn while their kids stay covered.
3. Pregnancy coverage sits below what neighbors offer. At 157% of poverty, Montana's pregnancy line for three is $3,574. Washington's published line for three is $4,896, so a family that crossed the state line shouldn't assume the same answer.
4. Nursing home eligibility isn't a fixed number. Many states cap nursing home income at $2,982 a month, 300% of the SSI rate, and it's easy to assume Montana does too. DPHHS's ABD 013 table instead says a resident is income-eligible whenever monthly nursing home costs equal or exceed income. Don't rule a parent out because their pension is over $2,982.
5. Some manual tables lag. The parent/caretaker and Workers with Disabilities tables still carry April 1, 2025 effective dates, while the adult and children's tables moved on April 1, 2026. If a number looks off, ask the Public Assistance Helpline which table your case uses.

Common Mistakes and Red Flags

These errors account for most wrong eligibility answers in Montana:

• Reading the 133% table as the final word. A common mistake is stopping at $1,769 and missing the 5% disregard, which matters most for people within about $70 of the line.
• Counting take-home instead of gross. Montana's tables are before-tax income; pre-tax retirement and health premiums are the deductions that lower it.
• Not saving proof of hours. With the community engagement rule now enforced, keep pay stubs, volunteer logs and school schedules. DPHHS checks data sources first but can ask for documents.
• Skipping the kids after a parent is denied. Each person is tested separately, and HMK covers children at much higher incomes.
• Paying someone to apply. Montana Medicaid and HMK applications are free. A red flag is any website, caller or "enrollment helper" that asks for a fee, gift cards or your bank login. The Office of Public Assistance never charges.
• Letting mail pile up. Starting January 2027, many Expansion adults renew every 6 months, so a missed letter can end coverage you still qualify for.

How to Apply for Montana Medicaid and How Long It Takes

DPHHS has 45 days to decide most Montana applications and 90 days when the application rests on a disability, the outer limits set by 42 CFR 435.912 (opens in a new tab). DPHHS first tries to verify income and community engagement from existing data, so answering any request for documents quickly keeps the timeline short.

1. Online: through the self-service portal at apply.mt.gov (opens in a new tab).
2. By phone: call the Public Assistance Helpline at 1-888-706-1535.
3. By mail: Human and Community Services Division, PO Box 202925, Helena, MT 59602-2925.
4. In person: at your local Office of Public Assistance.

Have pay stubs or a tax return, Social Security numbers, identification and immigration documents if they apply. Expansion applicants can attach the Appendix A activity form or Appendix B exclusion form, though DPHHS says they're optional at application. For senior, disability or nursing home applications, add bank statements and property records. Montana doesn't have its own Grantsights SNAP guide yet; our SNAP income limits guide covers the national food program rules.

What to Do If You're Denied

You have 90 days from the date DPHHS mails an adverse action notice to request a hearing, according to section 1505-1 of the DPHHS Combined Medicaid manual (opens in a new tab) (July 1, 2016 version, the latest posted). The request must be in writing, but your signature isn't required. A dispute over how much a nursing home resident must pay toward care has a shorter 30-day limit. If you file between the notice date and the date the action takes effect, your benefits continue automatically until the decision, though you may have to repay them if you lose.

An administrative review usually comes before the hearing, and it's a chance to fix errors such as a wrong household size or an outdated pay stub. If the issue is community engagement, check whether an exclusion applied in the months under review. Montana Legal Services Association can help at no cost.

If You're Over the Montana Medicaid Limit

Being over the HELP Plan line still leaves at least 5 other routes, and for families the best bet is usually Healthy Montana Kids, which covers children up to $7,178 a month for four.

• HealthCare.gov: adults over 138% can buy a plan with premium tax credits; see HealthCare.gov's savings page (opens in a new tab) for how the credits work.
• Medically needy spend-down: people who are aged, blind or disabled and over $994 can still get coverage once medical bills cover the spend-down.
• Medicare Savings Programs: QMB pays Medicare premiums and cost sharing up to $1,330 a month for one person.
• Medicaid for Workers with Disabilities: income up to $3,261 for one person with a monthly cost share of $35 to $135.
• WIC: Montana mothers and young children can get food benefits up to 185% of poverty, a higher line than Montana's 157% pregnancy limit; our WIC income limits guide explains it.
• Montanans who are older or living with a disability can find cash and home-care options in our SSI income limits guide and help for seniors programs guide.

Montana winters push heating costs up, so our LIHEAP income limits guide is worth a look, and our federal poverty guidelines guide converts any percentage in the tables above into dollars for your household. If rent or utilities are the bigger worry, Grantsights' free eligibility checker suggests official programs to contact. It doesn't decide Montana Medicaid eligibility and doesn't submit anything for you; it shows where to apply.

FAQ: Montana Medicaid Income Limits

What is the income limit for Montana Medicaid in 2026?

$1,769 a month for one adult on DPHHS's 133% table, about $1,835 with the disregard.

How much can a family of 4 make and get Medicaid in Montana?

About $3,795 a month for the adults; HMK for the kids up to $7,178.

What is the Montana Medicaid income limit for pregnant women?

$2,831 a month for two and $3,574 for three.

What is the Healthy Montana Kids income limit?

$3,256 a month for three on HMK Plus and $5,942 on HMK.

What are the Montana Medicaid income and asset limits for seniors?

$994 a month and $2,000 in resources for one person.

What is the nursing home Medicaid income limit in Montana?

No fixed cap; income must not exceed the monthly cost of care.

Does Montana have Medicaid work requirements?

Yes, since July 1, 2026, with enforcement since October 2026.

How long do I have to appeal a Montana Medicaid decision?

90 days from the notice mailing date; 30 days for cost-of-care disputes.

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Sources

1. Montana DPHHS: ACA 007, ACA Adult Medicaid income table (opens in a new tab), effective April 1, 2026
2. Montana DPHHS: ACA 004, Pregnancy income table (opens in a new tab), effective April 1, 2026
3. Montana DPHHS: ACA 005, Healthy Montana Kids income table (opens in a new tab), effective April 1, 2026
4. Montana DPHHS: ACA 003, Parent/caretaker relative income table (opens in a new tab), effective April 1, 2025
5. Montana DPHHS: ABD 008, Categorically needy income (opens in a new tab), effective January 1, 2026
6. Montana DPHHS: ABD 009, Medicare Savings Program income (opens in a new tab), effective April 1, 2026
7. Montana DPHHS: ABD 010, Medicaid for Workers with Disabilities (opens in a new tab), effective April 1, 2025
8. Montana DPHHS: ABD 013, Nursing home residents (opens in a new tab), effective July 1, 2026
9. Montana DPHHS: CMA 001, General resource limits (opens in a new tab)
10. Montana DPHHS: CMA 002, Medically needy income (opens in a new tab)
11. Montana DPHHS: CMA 1505-1, Fair hearings, administrative reviews and appeals (opens in a new tab)
12. Montana DPHHS: Medicaid changes (opens in a new tab), current as of September 30, 2026
13. Montana DPHHS: Medicaid changes FAQ (opens in a new tab) - community engagement timeline, exclusions, six-month renewals
14. Montana DPHHS: Healthy Montana Kids (opens in a new tab) - postpartum coverage and contacts
15. Montana Code Annotated 2025: 53-6-1304, HELP Act eligibility (opens in a new tab)
16. Montana Code Annotated 2025: 53-6-1313, Reduction in federal medical assistance percentage (opens in a new tab)
17. CMS: State Health Official letter 26-001, Alien Medicaid Eligibility (opens in a new tab), April 8, 2026
18. eCFR: 42 CFR 435.912, Timely determinations (opens in a new tab)
19. HHS ASPE: 2026 Poverty Guidelines (opens in a new tab)
20. HealthCare.gov: Lower costs on Marketplace coverage (opens in a new tab)