The Health Insurance Marketplace

Find out what your insurance options are, and if you qualify for help paying for coverage. For local help or in person assistance call us at 406-758-2165
The number to reach the Marketplace directly is 800-318-2596 TTY 855-889-4325

What it is.

It’s a website that was built by the federal government to provide a “one-stop-shop” for people looking for private health insurance.

What it does.

The Marketplace streamlines the processes of applying for help paying for health insurance and shopping for approved private health insurance plans. Help paying for health insurance is available for people that meet certain requirements, but this help can only be accessed by going through the Marketplace. These savings come in the form of premium tax credits (lower premium costs) and cost sharing reductions (lower out of pocket expenses).

How it works.

Enrolling in coverage through the Marketplace begins with creating an account. Once you’ve created an account you can fill out an application for coverage and see if you are eligible for premium tax credits and cost sharing reductions. After you submit your application and receive an eligibility determination, you can proceed to browsing available plans and enrolling in one that meets your individual or family needs.

There are three private insurance companies that have been approved to offer their policies through the Marketplace – Blue Cross/Blue Shield, Pacific Source, and Montana Co-op.

There are different levels or “tiers” that insurance plans will fall under according to their overall value. The percentages for each tier represent the expected amount of costs that both the insurance company and the consumer will be responsible for paying during a calendar year. This is referred to as the “actuarial value” of each plan tier, and the purpose of breaking it down as such is to give the consumer a general idea of the value of the plan they are paying for.

Enrolling Through the Marketplace Outside of Open Enrollment

Special Enrollment Periods:

Special Enrollment Periods are timeframes outside of the Open Enrollment period when consumers can enroll in health coverage through the Marketplace due to certain circumstances and events.

Certain changes in your life will give you access to enrolling in coverage through the Marketplace outside of Open Enrollment.

Here is a list of those life changes called “qualifying life events”:

  1. Loss of certain types of health coverage in the last 60 days, or expect to lose in 60 days.
  2. Getting married.
  3. Getting divorced (and losing coverage as a result)
  4. Having a baby.
  5. Adopting a child, or placing a child in foster care.
  6. Moving to a new coverage area.
  7. When your income changes (if you’re already enrolled in coverage through the Marketplace or have applied for and exemption).
  8. Granted U.S. Citizenship or Lawful Presence
  9. Released from incarceration
  10. Members of federally recognized tribes or Alaskan Natives.

Health Insurance Assistance Contact Info

1035 1st Ave West
Kalispell, MT 59901 – 3rd Floor

406-758-2165 main line
855-396-3837 fax