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Healthy Montana Kids (HMK) (CHIP)
If you want more direct information, click here to find less organized, but more direct information.
  1. What is Healthy Montana Kids?
  2. Who qualifies for HMK?
  3. How does HMK work?
  4. What services does HMK cover?
  5. Do I have to be a US Citizen for my child to get HMK?
  6. Does it matter how long I have lived in Montana?
  7. What are resources? Is there a resource limit for HMK?
  8. How do I apply?
  9. What is the application like?
  10. Do I have to apply in person?
  11. Are there co-payments (co-pays)?
  12. What is a co-payment (co-pay)?
  13. How soon will I know if my child/children qualify for HMK?
  14. How often do I need to renew coverage for HMK?

1. What is Healthy Montana Kids?
Healthy Montana Kids is low-cost health coverage for children and teenagers up to age 19.

2. Who qualifies for HMK?
Children and teenagers up to age 19, who are Montana residents and U.S. citizens or eligible aliens, and whose families meet income guidelines are eligible for HMK. Depending on family income and circumstances, most children have to be uninsured for three months before qualifying for HMK coverage. But, there are exemptions. Check with the Department of Public Health and Human Services or an enrollment partner to learn more – your child may qualify for immediate enrollment. Eligibility guidelines are listed below. Children may qualify for HMK even if their family income is higher than listed depending on the number of household members working, the cost for dependent care or other extenuating circumstances.  Household assets are not considered when determining HMK eligibility. Check with a reliable source to confirm your eligibility status.

Healthy Montana Kids Guidelines

Yearly Gross Income
Income Guidelines as of 02/01/15
Household Size (Children and Adults)
Monthly Household Income
Family of 1
$2,560
Family of 2
$3,465
Family of 3
$4,370
Family of 4
$5,274
Family of 5
$6,179
Family of 6
$7084
Family of 7
$7,989
Family of 8
$8,894
Some employment-related and child care deductions apply.
The HMK Income chart is based on Federal guidelines that are adjusted every year.
 

3. How does HMK work?
The easiest way to apply is to visit the HMK website and apply on-line. You can also download an application and send the completed application (you will have to create an account if you do not already have one), along with income verification documentation and proof of citizenship documentation to:
Healthy Montana Kids Plan P.O. Box 202951 Helena MT 59620
You will receive a letter from the Department of Health and Human Services confirming receipt of your application and informing you of the next steps for enrollment.  Once your child is enrolled in HMK, you will receive an insurance ID card, a member handbook and a provider directory from Blue Cross Blue Shield. If your child is already enrolled and is renewing his or her enrollment, he or she will use the same insurance card unless there is a change in co-payment status. Bring your child's HMK ID card with you to all medical appointments, as well as to your pharmacy, dentist, eye doctor, etc.   Based on family income and size, some parents do have to make a small co-payment. No family pays more than $215 a year in co-payments.  There are no co-payments for well-child checkups, immunizations, dental visits or eyeglasses.  Families pay no monthly premiums or deductibles. 

4. What services does HMK cover?

Covered Services

  • Office and clinic visits
  • Emergency services
  • Hospital services
  • Sports or employment physicals
  • Anesthesia services
  • Surgical services
  • Well-child checkups
  • Ambulance
  • Prescription drugs
  • Laboratory and X-ray services
  • Mental health services
  • Substance abuse services
  • Dental services
  • Vision exams and eyeglasses
  • Hearing exams/hearing aids
  • ... and more
HMK covers pre-existing medical conditions
For questions regarding covered services call the HMK Medical Benefits Blue Cross Blue Shield of Montana at 1-855-258-3489.

5. Do I have to be a US Citizen for my child to get HMK?
If you are not a U.S. Citizen, but you are a Montana resident and a legal alien, your children may still qualify for HMK. Check with an enrollment partner or call Eligibility Public Assistance Helpline at 888-706-1535 or Medical Benefits Blue Cross Blue Shield of Montana at 855-258-3489.

6. Does it matter how long I have lived in Montana?
No, however you must be a Montana resident to receive Healthy Montana Kids (HMK) coverage.

7. What are resources? Is there a resource limit for HMK?
Resources are money in a bank account or other things of value that you or your family own.  
There is no resource limit for Healthy Montana Kids.

8. How do I apply?
  1. Click here to download a HMK application,
  • You can now apply for Healthy Montana Kids online, click on this link to go start applying now.
  • or contact one of the enrollment partners listed on the state website to help you apply,
  • or call 1-855-258-3489 and ask to have an application mailed to you.  
2.    Print, fill out, sign and mail or fax your competed application with the required documentation to the HMK office in Helena.  Don't forget to include income verification documentation and citizenship documentation, i.e, birth certificate, if children were not born in Montana. If you need assistance, call 1-855-258-3489. 3.    Mail completed applications to: 
Healthy Montana Kids Plan PO Box 202951 Helena, MT  59620-2951
Applications are also available at Offices of Public Assistance, public health departments, health care facilities, WIC offices, Head Start facilities, tribal health providers, Indian Health Service (IHS) facilities, and many other community locations. Community enrollment partners are available to assist you. See a list of enrollment partners on the Department of Health and Human Services Healthy Montana Kids Website.

9. What is the application like?
The 8 page application asks 19 questions to help the Healthy Montana Kids staff qualify your children for insurance coverage. You are asked the names, ages, birth date, place of birth and gender of all the people who live with you more than 50% of the year.  Social security numbers and citizenship information are only required for children.  You will be asked about your family’s assets and income, expenses and bills, as well as past and present health insurance coverage.  Click here to view the application. If you have trouble understanding the questions, call 1-855-258-3489 for assistance or ask an enrollment partner. 

10. Do I have to apply in person?
No, you can download an application from one of the sites listed above, or request to have one mailed to you. Mail the application and required documents into the Healthy Montana Kids office in Helena at:
Healthy Montana Kids Plan
PO Box 202951
Helena, MT  59620-2951

If you need help filling out the application, call 1-855-258-3489 or contact one of the enrollment partners listed on the Department of Health and Human Services –Healthy Montana Kids webpage. We are available to help you and want to be sure your children have health coverage.
 

11. Are there co-payments (co-pays)?
Yes, for some services. There are no co-pays for well-baby or well-child care, including age-appropriate immunizations, dental services or eyeglasses. There are no co-pays for services provided to American Indian children. Services that require copays for those below the poverty line include:
  • $4 for outpatient services
  • $75 for inpatient services
  • $4 for pharmacy - preferred brand drugs
  • $8 for pharmacy - non-preferred brand drugs

and if you are above the poverty line, you will be responsible for a 10% copayment of the provider’s reimbursed amount for any Medicaid-covered service, except for pharmacy, which will be at:
  • $4 for pharmacy – preferred brand drugs
  • $8 for pharmacy – non-preferred brand drugs

Copayments may not exceed a combined limit of 5% of the family’s household income quarterly. Copayments may not be applied once the household has met the quarterly cap.

12. What is a co-payment (co-pay)?
It is a small amount you pay when your child receives a healthcare service, sees a provider, fills a prescription, etc.

13. How soon will I know if my child/children qualify for HMK?
With more families eligible for children's health care insurance assistance through Healthy Montana Kids, the demand has grown rapidly.  If you have not heard back from the Department of Health and Human Services within 3 weeks of submitting your application, call and check with them.

14. How often do I need to renew coverage for HMK?
You will need to renew your coverage once a year.  Healthy Montana Kids will send you a renewal application 60 days prior to the renewal date.  Be sure to return it promptly to avoid any interruption in your child’s health coverage.