Montana Medicaid Changes Enter New Enforcement Phase in October

MONTANA NEWS & HEALTH CARE — PUBLIC SERVICE REPORT | October 14, 2026

By Steven Bullcoming Haworth | Truth in Focus

HELENA, Montana — Medicaid Expansion recipients across Montana are facing new eligibility requirements, with October marking an important change in how the state enforces federal community engagement rules.

According to the Montana Department of Public Health and Human Services (DPHHS), many adults between the ages of 19 and 64 receiving coverage through Medicaid Expansion must complete at least 80 hours of qualifying activities each month unless they qualify for an exclusion.

Qualifying activities can include employment, education, job training, internships, and approved community service.

Although Montana began implementing the requirements July 1, the state did not deny or terminate coverage solely for failure to satisfy the new community engagement requirement during the initial July-through-September period. Beginning in October, affected applicants and participants who cannot demonstrate compliance or qualify for an exclusion may face denial or loss of coverage.

Important Exclusions

The state identifies several groups that may be excluded from the requirements, including American Indian and Alaska Native individuals, certain caregivers, pregnant and postpartum women, and people with qualifying medical conditions.

These exclusions are particularly important for Northern Cheyenne communities and other tribal populations. Residents should understand which requirements apply to them rather than assuming every Medicaid recipient faces identical rules.

Additional changes are scheduled for January 2027, including more frequent eligibility reviews for many Medicaid Expansion recipients. The state’s guidance says American Indian and Alaska Native members retain 12-month redetermination rather than the six-month cycle applying to most other expansion members.

What Residents Should Do

DPHHS encourages Medicaid members to keep their mailing addresses and contact information current, review notices carefully, and respond to requests for verification. Individuals who disagree with an eligibility decision have access to an administrative appeal process.

Residents can check their information at apply.mt.gov or contact the Montana Public Assistance Helpline at 1-888-706-1535.

Sources: Montana DPHHS — Medicaid Changes; DPHHS Official Frequently Asked Questions; DPHHS June 30, 2026 announcement.