Montana residents shop for ACA health coverage through HealthCare.gov, the federal marketplace, since the state has not built its own exchange.
Montana expanded Medicaid under the ACA, so adults earning up to 138% of the federal poverty level generally qualify for the state's Medicaid program instead of needing a subsidized marketplace plan.
Montana's rural geography means plan networks can be spread thin outside of cities like Billings and Missoula, so checking which hospitals and clinics participate in a plan's network is especially important here. Because the individual market has fewer insurers than more populous states, comparing the handful of available plans carefully during enrollment tends to matter more than in states with dozens of options.