Health Center Eligibility
Health Center Eligibility
State of Montana Benefit Plan (State Plan)
Eligibility
The following may use Montana Health Center Services:
- Active State of Montana employees or non-Medicare retirees covered on the State Plan
- Dependents covered by the State Plan age two or older
- Medicare retirees on the State Plan may only use the Health Center for flu shots and health screenings.
No Cost Services
- Only services provided at the Montana Health Center have no out-of-pocket cost. Services provided by another facility or provider will apply to regular State Plan benefits, even if you are referred by a Montana Health Center provider except specific radiology services as noted in the next bullet.
- X-rays and ultrasounds prescribed by a Montana Health Center provider. These services must be performed at one of the radiology partners listed at Radiology (mt.gov).
- See Services for further detail.
May Have Out-of-Pocket Costs
Regular benefits (copay, deductible, coinsurance) may apply for:
- All MRIs and CT Scans - see Radiology (mt.gov)
- All visits to specialists (even if referred there by a Health Center provider)
- All medications
Important Notice
If your contact information changes, you must let the State of Montana know as soon as possible. Any changes to your contact information made at the Montana Health Center will be overridden by the State of Montana system periodically, so it is very important that the State has your most current information.
- State Employees-Notify your payroll personnel
- Dependents, spouses, domestic partners, retirees, and COBRA members- Health Care and Benefits Division (HCBD) 1-800-287-8266 (406-444-1421 TTY for hearing impaired).
Eligibility
The following MMIA participants have access to any Montana Health Center facility:
- Active City or Town employees and spouses who are covered under an MMIA plan
- Dependents covered by MMIA ages two and older
- Retired City or Town employees and spouses under 65 who are covered on a MMIA plan.
Cost
- No cost for standard plan participants
- High Deductible Health Plan (HDHP) participants must pay a $55 copay for services
Services
Eligible participants may receive all available services at any Montana Health Center location. Available services and Locations and clinic hours near you.
If you are seeing a provider outside of the Montana Health Center, lab orders can be taken to the Montana Health Center and sent back to your provider at no cost for standard plan participants and $55 for High Deductible Health Plan (HDHP) participants.
Outside Referrals
The Montana Health Center does not accept orders from non-Health Center providers in an effort to receive no-cost radiology.
Wellness Screenings
Please remember, if you have a Montana Health Center location in your city or town you can complete your wellness screening at that facility between July 1 and September 30 at your convenience. If you do not have access to a Montana Health Center facility in your city or town, your wellness screenings are completed with It Starts With Me.
For more information about your MUS benefits, go to Montana University System Benefits Plan (MUS Plan) or contact the MUS Benefits Office at 1-877-501-1722.
Eligibility
The following MUS Plan participants have access to the Helena Montana Health Center facility only.
- Active MUS employees and their legal spouses who are covered under the MUS Medical Plan.
- Dependent children who are covered under the MUS Medical Plan (age two and older).
- Non-Medicare retirees and their covered dependents (legal spouse/children) who are covered under the MUS Medical Plan.
No Cost Services
Eligible participants may receive all available services at the Helena Montana Health Center location.
Available services and Helena Location & Clinic Hours- No cost for MUS Medical Plan participants for services provided at the Helena, Montana Health Center location.
- X-rays/ultrasounds prescribed by a Helena Montana Health Center provider.
Outside Referrals
The Montana Health Center does not accept orders from non-Health Center providers in an effort to receive no-cost radiology.
Out-of-Pocket Services
MUS Medical Plan benefits (copay, deductible, coinsurance) apply for:
- All MRIs and CT Scans.
- All visits to specialists (even if referred by a Helena Montana Health Center provider).
- All medications.