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Presumptive Eligibility

Presumptive Eligibility is available to hospitals and their affiliated facilities that participate with Medicaid in Montana. Personnel from these facilities must be trained and certified to make Presumptive Eligibility determinations for short-term, temporary coverage for the following coverage groups:

  • Healthy Montana Kids Plus;
  • Healthy Montana Kids;
  • Parent/Caretaker Relative Medicaid;
  • Pregnant Women (ambulatory prenatal care);
  • Adults between the ages of 19 and 64;
  • Adults between the ages of 18 and 26 who were in Foster Care and receiving Medicaid at age 18; and
  • Women between the ages of 19 and 64 who have been screened and diagnosed with Breast or Cervical Cancer.

Please contact us at any time if you have questions, need training or supplies, or need to verify information about presumptive eligibility.

To take the Presumptive Medicaid training and become certified, click on the following link: Montana DPHHS eLearn: Log in to the site. Thereafter, Click Employee Development; Click Human and Community Services Division (HCSD); scroll down and click on Presumptive Medicaid; and please follow the instructions as given.

For information on Presumptive Eligibility, see  https://medicaidprovider.mt.gov/presumptiveeligibility.
Contact Presumptive Eligibility via email at hhshcsdmedicaid@mt.gov.  

Presumptive Eligibility Income Calculation Tool Effective 04/01/2023

Presumptive Eligibility Guide