Shopping for Health Insurance FAQs

You can enroll in a health plan during certain times of the year. In Montana, you may be able to enroll during:

• Open Enrollment: Happens once a year. You can update your plan or choose a new one.
  • Individual and Family Open Enrollment starts Nov. 1 for coverage beginning the next year.
  • Group plan Open Enrollment is set by your employer.
  • The Medicare Advantage Open Enrollment Period lets you switch or leave Medicare Advantage or Part D plans. Medicare Open Enrollment is Jan. 1 – March 31.
• Annual Enrollment (Medicare): Runs Oct. 15–Dec. 7 each year. Anyone who has Medicare can update or change coverage.
• Special Enrollment: If you have a major life change—like getting married, having a baby, moving or losing job-based coverage—you may qualify to enroll outside Open Enrollment.

Read more about:

• Open Enrollment vs. Special Enrollment
• How to shop for a plan

Many life changes trigger a Special Enrollment Period to let you to enroll without waiting for annual Open Enrollment in the fall.

Common qualifying life events are:

• Getting married
• Having or adopting a child
• Moving to a new address
• Losing job-based coverage by leaving a job or becoming self‑employed

For most Individual and Family plans in Illinois, you have 60 days after your life event to enroll. Your window for Group Special Enrollment varies by employer—often 30, 31 or 60 days.

Learn more about:

• Individual and Family Special Enrollment 
• Group plan enrollment periods
• Medicare enrollment periods
• How to shop for a plan                                                                                                                Premium tax credit savings                                                                                                        What subsidies are based 

Both on- and off-Exchange plans follow the Affordable Care Act (ACA) and cover essential benefits. However, there are a few key differences:

· On-Exchange (Marketplace) plans: These plans are sold on the Marketplace. In Montana, that's Cover Montana. On-Exchange plans let you use any premium tax credits (subsidies) you qualify for.

· Off-Exchange plans: These plans are sold directly by insurers like BCBSMT. They don't let you claim your subsidies but often include more flexible benefit and network options.

Have a subsidy and want to use it on your plan? BCBSMT will guide you from our shopping platform to the Marketplace to finish your application.

Learn more about: • Premium tax credit savings • What subsidies are based on

The type of plan you qualify for depends on your life; your age, family income, health needs and whether your employer offers health insurance all determine your plan type.

• Medicare: You may qualify if you're 65+, or about to turn 65. You may also qualify if you have certain disabilities.
• Individual and Family plans: Most people qualify. Consider an Individual and Family plan if you don't get coverage through work and don't qualify for Medicare or Medicaid.
• Group (employer-sponsored) plans: You can enroll if your job or certain family members' jobs offer health insurance coverage.

HMO, PPO and POS plans are all common plan types. Depending on your care and cost needs, you might find that one works better for you and your family:

• HMO (Health Maintenance Organization): Normally, HMOs have lower monthly costs. You'll choose a primary care provider (PCP) to rely on for most care and give you specialist recommendations. You must use in-network doctors or you could end up paying  out of pocket for some or all of the provider’s bill
• PPO (Preferred Provider Organization): With PPOs, you don't need specialist referrals. You can see out-of-network doctors but may have to pay more. PPOs offer more flexibility when you need care.
• POS (Point of Service): For a balance between an HMO and PPO, consider a POS. You'll choose a PCP but can also visit out-of-network doctors if you're okay with the higher cost.

Read more about:

• Types of plans
• What in-network care means

Affordable Care Act (ACA) plans have different metal levels; Gold, Silver and Bronze. These metal levels can help you understand each plan's costs. The quality of care will always be the same because metal levels do not impact the benefits offered.

• Bronze: We cover roughly 60% of care costs while you cover 40%. Bronze plans may have your lowest monthly premium. Consider them if you don't normally need a lot of health care.
• Silver: We cover roughly 70% of care costs while you cover 30%. Silver level plans offer a middle-of-the-road approach when it comes to monthly costs and costs for care. You must get a Silver plan to use certain types of savings, like Cost-Sharing Reductions.
• Gold: We cover roughly 80% of care costs while you cover 20%. If you need a lot of health care, Gold level plans could help you save despite their higher premiums.

Yes. Making sure you have the right documents nearby makes finishing your application easier and faster. Depending on the plan you enroll in and the enrollment period you're using, you might need:

• Social Security numbers for yourself and anyone else to be covered by the plan
• Birthdates
• Your home address
• Annual income and/or employer information
• Citizenship or immigration documents, like a passport, birth certificate or green card
• Your plan policy numbers if you’re updating or changing coverage
• Records of current health coverage
• Documentation of your life event, if you're enrolling through Special Enrollment

This list includes the most common documents needed for enrolling. but not all of them. Please be sure to double check the instructions when applying to make sure you don't miss anything.

Read more about

• Valid Special Enrollment documents
• How to shop for a plan

We want you to have the health care plan that fits you, your care needs and your life. That's why we offer different plan types, often at different cost levels. Before you enroll, start thinking about:

• How often you visit the doctor or other health care professionals
• The prescriptions you regularly take
• If you have a preferred doctor or hospital and what networks cover them
• How much you want to spend on a plan
• Whether you qualify for financial help

Then, start shopping to compare your options.

Read more about:

• What should I ask when shopping for a plan?
• Finding in-network care
• 2026 covered drug lists