Healthy Montana Kids income guidelines set the cutoff at 261% of the federal poverty level, which for a family of four in 2026 works out to roughly $86,130 in annual household income.1Montana Department of Public Health and Human Services. Healthy Montana Kids Program-Income (HMK and HMK Plus) Below that ceiling, your child qualifies for one of two coverage groups depending on where your income falls. Households at or below 143% of the FPL are placed in HMK Plus, which is Montana Medicaid. Households above that line but at or below 261% are placed in HMK, which is Montana’s Children’s Health Insurance Program (CHIP).2Legal Information Institute. Montana Administrative Rule 37.79.101 – Healthy Montana Kids (HMK) Plan You apply once, and the state decides which group fits.
2026 Income Limits by Family Size
The percentage thresholds don’t move year to year, but the poverty guidelines they sit on top of do. Using the 2026 federal poverty guidelines, the approximate income ceilings work out this way:3HHS ASPE. 2026 Poverty Guidelines: 48 Contiguous States
- Family of 2: HMK Plus up to about $30,945; HMK (CHIP) up to about $56,480
- Family of 3: HMK Plus up to about $39,068; HMK (CHIP) up to about $71,305
- Family of 4: HMK Plus up to about $47,190; HMK (CHIP) up to about $86,130
- Family of 5: HMK Plus up to about $55,312; HMK (CHIP) up to about $100,955
- Family of 6: HMK Plus up to about $63,435; HMK (CHIP) up to about $115,780
These figures are rounded. If your household income sits within a few thousand dollars of one of the thresholds, the actual determination will hinge on the exact calculation the state runs, not the approximate numbers above.
How the State Counts Your Income
DPHHS uses Modified Adjusted Gross Income to decide eligibility. MAGI starts with the adjusted gross income from your federal tax return and adds back a short list of items such as tax-exempt interest. It is not your gross salary, and it is not your take-home pay. If you’re close to a cutoff, pull last year’s return and look at the AGI line; that’s the starting point for the number DPHHS will use.
Because eligibility runs on MAGI rather than a paycheck snapshot, one-time income events, deductions, and pre-tax contributions can all shift where your family lands. A household that looks over the line based on gross wages may still qualify once retirement contributions and other adjustments come out.
The Other Requirements Besides Income
Income is the main gate, but it isn’t the only one. A child must also meet three basic tests to enroll in either coverage group:
- Age: under 19 at the time of application.
- Residency: a resident of Montana.
- Citizenship or immigration status: a U.S. citizen, U.S. national, or lawfully residing non-citizen.
Montana uses a federal option, created by the Children’s Health Insurance Program Reauthorization Act of 2009, that allows states to cover lawfully residing children without imposing a five-year waiting period.4Medicaid.gov. Medicaid and CHIP Coverage of Lawfully Residing Children and Pregnant Women A lawfully residing child can enroll as soon as the family meets the income and residency rules.
What Each Group Costs You
Which side of the 143% line you land on changes what you pay out of pocket. Children in HMK Plus generally have $0 copays for covered services. Children in HMK (CHIP) whose household income is above 100% of the FPL pay small copays set by state rule:5Legal Information Institute. Montana Administrative Rule 37.79.501 – Cost Sharing Provisions
- Inpatient hospital admission: $25 per admission
- Emergency room visit: $5 per visit
- Outpatient hospital visit: $5 per visit
- Doctor, nurse practitioner, or other provider visit: $3 per visit
Several categories carry no copay at all, including well-child care and immunizations, dental services, lab and X-ray work, pharmacy prescriptions, and extended mental health services for a serious emotional disturbance. Families with at least one member who is Native American or Alaska Native pay no copays for any service.5Legal Information Institute. Montana Administrative Rule 37.79.501 – Cost Sharing Provisions Total copays are capped at $215 per family per benefit year. Once you reach that ceiling, covered services are free for the rest of the year.
The benefits themselves are the same broad package on either side: medical care, behavioral health, dental, vision, and prescription drugs.6Montana Department of Public Health and Human Services. Healthy Montana Kids Member Guide The difference between HMK and HMK Plus is cost-sharing, not coverage scope.
How to Apply
You apply once for both coverage groups. There is no separate CHIP application and no need to guess which group your child belongs in. DPHHS reviews the income information you submit and places your child in the appropriate group.7Montana Department of Public Health and Human Services. Healthy Montana Kids
- Online through the state’s self-service portal at apply.mt.gov.
- In person at your local Office of Public Assistance.
- By phone at the Public Assistance Help Line, 1-888-706-1535.
You’ll be asked for information on household income, family size, and Montana residency. Have last year’s tax return, recent pay stubs, and any documentation of other household income ready before you start.
If Your Income Changes During the Year
Income doesn’t have to hold steady for coverage to hold steady. If your household earnings move up or down enough to shift your child between coverage groups, DPHHS moves the child between HMK Plus and HMK without requiring a new application.8Legal Information Institute. Montana Administrative Rule 37.79.120 – Movement Between HMK and HMK Plus Coverage Groups A raise that pushes your family above 143% of the FPL doesn’t end coverage; it just changes which group your child is in and introduces the modest copay schedule.
Coverage lasts up to 12 months at a time, and DPHHS then reviews eligibility. The Office of Public Assistance first tries to renew automatically using information it already has. If it can’t, it mails a renewal packet, and returning that packet on time is the single most common place families lose coverage by accident. Keep your address current with DPHHS so renewal mail reaches you.