Covering Idaho, Montana, and Wyoming
Frequently Asked Questions
CO-OP stands for Consumer Oriented and Operated Plan. It’s a nonprofit insurance company operated by the people it serves. CO-OP members must be a majority of the board of directors, ensuring that it will always meet the needs of the members at large.
The Affordable Care Act established CO-OPs to foster competition among health plans by providing a nonprofit alternative to current health insurance companies. Ultimately, the goal of a CO-OP is to help lower health insurance costs for individuals and families, create more competition in each state-based health insurance exchange, and expand insurance choices in markets dominated by a few insurance companies.
Montana Health CO-OP is one of the initial seven co-ops funded on February 21, 2012, as a result of the Affordable Care Act. Through a loan from the Department of Health and Human Services, we established a consumer-oriented and -operated (CO-OP) health insurance company in Montana. Today, we are focused on providing affordable health insurance plans for individuals and families throughout the state. As a local CO-OP, we are a member-controlled and -operated organization. Open Enrollment for our 2020 plans begin on Novmeber 1, 2019 and coverage starts on January 1, 2020. Open Enrollment ends on December 15, 2019.
CO-OPs do help manage increasing healthcare costs in three main ways:
Cost savings through prevention, disease management, screening, appropriate pharmacy benefits and use of high-value providers.
Enhance competition in the state health insurance exchange, which is especially important in areas currently dominated by a few insurance companies.
Greater primary care access and care coordination for members.
About 20 percent of Montana’s population does not have insurance. As the Health Insurance Marketplace (the online tool to help individuals choose a health insurance plan) becomes more widely used, we will be there as a viable, affordable option for this group.
At the same time, we will not focus solely on the state’s uninsured population. We are also a competitive option for small businesses and others who currently have insurance.
We can have lower prices because we are a true nonprofit. By federal law, we have to return our profits to our members in the form of lower prices, better expanded benefits or programs to improve health. And we keep our administrative costs low.
Montana Health CO-OP offers a choice of the Catastrophic, Bronze, Silver, and Gold coverage levels. We negotiate discounts with the doctors, hospitals and other providers so you will save money with all our plans. If you want to know if your doctor is in our networks, view our lists of participating providers. To learn more about our products, explore our plansor talk to your insurance agent.
The premiums are lowest for the Bronze plans, and highest for our Gold plans, but you may get help with your monthly premium from the federal government. Depending on your income and family size, you may also qualify for a reduction in your deductible and other out-of-pocket expenses. Check out our tax credit estimator that can show you whether you qualify, and how much your monthly premium would be.
Yes. When traveling outside of Montana, you’re covered for emergency services throughout the United States.
Choose us because we offer quality healthcare coverage at affordable prices – from a company that returns the profits to you, the member. Montana Health CO-OP is a homegrown, nonprofit company, and we are here to stay.
Healthcare.gov is the online health insurance marketplace—also called the exchange—where you can make apples-to-apples comparisons of competing health insurance plans. The Affordable Care Act created these exchanges to help residents of each state find a health insurance plan that fits their needs and budget.
You can fill out an application on the health insurance exchange and find out if you’re eligible for a low-cost health insurance premium (the amount you pay for insurance each month). You can also find out what your premium, deductibles and out-of-pocket costs will be before you sign up.
A tax credit is financial assistance from the government to help with insurance costs. Since 2014, the government has been providing tax credits to millions of individuals and families. The only way to get and use a tax credit is through the health insurance marketplace/exchange at Healthcare.gov.
You can find out if you qualify for a tax credit with our Tax Credit Calculator here, call us at 1-855-447-2900 or talk to your insurance agent. We’re here to help.
We selected the University of Utah Health Plans (UUHP), a proven and reliable claims administrator, as our third party administrator (TPA) to process our claims, handle your monthly premium, and issue your contract and ID cards.
Through the University of Utah Health Plans (UUHP), Montana Health CO-OP offers many online services for our members through our secure member web portal. This portal puts you in control of your personal health benefits information 24/7, so you never need to call to find out answers to claims questions. An easy-to-use dashboard gives you fast and easy access to:
Recent claims
Summary of current drugs
A search tool to find a doctor or pharmacy
Links to useful tools for health risk assessments
Drug and health information
If our online services don’t provide the information you need, we also have live customer service representatives who are available 8 a.m. – 5 p.m., Monday through Friday, at 844-262-1560.
No, the special Silver Cost Share variance plans are only available for those that purchase insurance through the Individual Marketplace or Exchange. This is also true of the Native American Cost Sharing options.
Companies with fewer than 50 employees have two penalty-free options:
1. Continue to sponsor your current group plan, and budget for large cost increases.
2. Cancel your group plan and direct your employees to the Health Insurance Marketplace. The Marketplace compares competing plans on a level playing field, allowing individuals to make well-informed decisions about which plan is best for them. The Marketplace will also help your employees determine their eligibility for federal tax credits to reduce the cost of monthly premiums.
We offer wonderful options for your group plan, with excellent service. Talk to your insurance agent about how our competitive rates can save you money or call us at 855-447-2900.
The premiums are lowest for the Bronze plans, and highest for our Gold plans, but you may get help with your monthly premium from the federal government. Depending on your income and family size, you may also qualify for a reduction in your deductible and other out-of-pocket expenses. Check out our tax credit estimator that can show you whether you qualify, and how much your monthly premium would be.
We selected University of Utah Health Plans (UUHP), a proven and reliable claims administrator, as our third party administrator (TPA) to process claims, handle your monthly premium, and issue your contract and ID cards.
Through University of Utah Health Plans (UUHP), Montana Health CO-OP offers many online services for our members through secure member web portal. This portal puts you in control of your personal health benefits information 24/7, so you never need to call to find out answers to claims questions. An easy-to-use dashboard gives you fast and easy access to:
Recent claims
Summary of current drugs
A search tool to find a doctor or pharmacy
Links to useful tools for health risk assessments
Hospital and physician quality scores
Drug and health information
Personalized wellness coaching
A library of children’s health information
If our online services don’t provide the information you need, we also have live customer service representatives who are available 8 a.m. – 6 p.m., Monday through Friday, at 844-262-1560.
The online Health Insurance Marketplace offers a single website for visitors to compare competing health insurance plans on a level playing field. Since October 2013, your employees have been able to fill out an application and find out if they’re eligible for a low-cost health insurance premium. They can also find out what their premium, deductibles and out-of-pocket costs will be before they sign up.
If you do not offer health insurance to your employees, they will have access to quality plans in the Health Insurance Marketplace. Depending on their income, employees may be eligible for federal tax credits, making monthly premiums more affordable.
A tax credit is financial assistance from the federal government to help with insurance costs. The government provides tax credit to millions of individuals and families. The only way your employees can get a tax credit is by purchasing their insurance through the Health Insurance Marketplace.
If you are purchasing group coverage, we can begin the first of any month. For individual coverage, enrollment begins November 1, 2019 and coverage starts January 1, 2020. Open Enrollment ends on December 15, 2019.
Contact your insurance agent, or call us at 855-447-2900 or email us here. We’re here to answer your questions!
Montana Health CO-OP embraces an innovative health insurance model that keeps healthcare local and affordable. Due to our insurance being affordable and available, many previously uninsured Montanans are now insured—and you will be reimbursed for the care you provide to them. Learn more here.
At Montana Health CO-OP, we offer two networks based on our coverage plans:
Connected Care, a POS (Point of Service) network emphasizing preventive healthcare to maintain affordability. (Limited provider choices in Billings and Missoula).
Access Care, a PPO (Preferred Provider Organization) network. Our widest network.
We have selected University of Utah Health Plans (UUHP), a proven and reliable claims administrator, as our third-party administrator (TPA). UUHP’s wide range of online services simplifies claims processing and data flow, making information readily available to busy providers. UUHPis dedicated to meeting provider needs for ease and convenience through:
Prompt and accurate claims payment
Electronic funds transfer
Provider Portal
Live customer service representatives, available 8 a.m. – 6 p.m., Monday through Friday.
Enrollment for all Montana Health CO-OP plans begins November 1, 2019 and coverage starts January 1, 2020.
Call us at 855-447-2900 or shoot us an email at provider@mhc.coop. Can't wait to hear from you!