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  • Passport To Health Member ''s Provider Change/enrollment Form

Get Passport To Health Member ''s Provider Change/enrollment Form

Passport to Health Member s Provider Change/Enrollment Form To complete this form: To change a Passport provider: Fill out this form and put a check (?) next to the reason for changing (see 1. Write.

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Member Resources. Need help finding your local Office of Public Assistance, Enrolled Medicaid Provider, or Passport Provider? Call Montana Healthcare Programs, Member Help Line 1-800-362-8312, M-F, 8am-5pm, for assistance.

Adults, age 19-44 with an annual household income 0 to 138% FPL may qualify for more comprehensive coverage through the HELP Medicaid plan, also known as Medicaid Expansion. There is also coverage available for pregnant women with an annual household income up to 157% FPL. Find out if you qualify at Apply .

The amount one must “spend down” is the difference between one's monthly income and MT's Medically Needy Income Limit (MNIL). This can be thought of as a deductible. In 2023, the MNIL is $525 / month for single applicants, as well as married couples.

To change a Passport Provider: Fill out this form and put a check (✓) next to the reason for changing (see below) or you can call the Montana Health Care Programs Member Help Line at 1(800) 362-8312 to change.

Adult members of Montana families whose household countable income equal is between than 25% and 138% FPL are eligible for Medicaid Expansion. Montana families whose household countable income equal is between than 25% and 138% FPL are eligible for Medicaid Expansion.

Passport to Health is for people in Montana who have Medicaid. People in the Passport Program can be sure to get good health care because each person has a Passport provider who manages his or her health care. In Passport to Health, you get exactly the same Medicaid benefits that you would get in regular Medicaid.

Eligibility levels for parents are presented as a percentage of the 2023 FPL for a family of three, which is $24,860. Eligibility limits for single adults without dependent children are presented as a percentage of the 2023 FPL for an individual, which is $14,580.

Approximate Monthly Income to Qualify for Montana Medicaid, 2023 Family SizeAdults 19-64Children 0-181$1,616$3,1712$2,186$4,2893$2,749$5,3944$3,325$6,5252 more rows

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232