On October 1, the grace period for the new Medicaid work and reporting requirements will end, meaning those who do not complete the required paperwork and meet the community engagement standards could lose their Medicaid coverage.
What you need to know
- This is a new regulation that was in the House Reconciliation bill (H.R. 1), also known as “H.R. 1” or the “One Big Beautiful Bill,” that Congress passed in the summer of 2025. Since this is the first time work requirements have been allowed under federal law, and since Montana is still adjusting the process and requirements, this may be a confusing time for patients covered by Medicaid.
- New rules require anyone on the adult Medicaid Expansion program to have worked 80 hours a month for 3 of the last 6 months. (If you are newly applying for Medicaid coverage as an “able-bodied” adult, you will need to document that you worked 80 hours the month before enrolling.)
- There are exemptions for caregivers, family members with disabilities, or children 13 and under, American Indians (based on IHS eligibility), those determined to be medically frail, and pregnant or postpartum women.
- There will be paperwork requirements for both individuals who worked the required hours and those who qualify for an exemption.
What you need to do
- Read your mail. DPHHS will send notices about your eligibility and renewal. Missing a notice could result in losing coverage – always open your mail even if it seems like you don’t need to do anything.
- Sign up for email notifications. Use the self-service portal to sign up for email and mail notifications so you receive updates or requests for information as quickly as possible.
- Keep your contact information up to date. Update your mailing address, phone number, and email using this link, in the self-service portal, or by calling 1-888-706-1535.
- Find your Medicaid program and upcoming renewal date. This information is in online self-service portal accounts at apply.mt.gov. Knowing your Medicaid program helps you understand whether changes affect your coverage, and knowing your next renewal date helps you prepare to provide DPHHS with eligibility information ahead of time.
- Track and save documentation of your activities. Save pay stubs, hours worked, school enrollment letters, and volunteer logs. You may need to show them at renewal. If you don’t have hard copies, take screenshots or photos.
- If you are already working, that likely counts. You can mix activities — work, school, and volunteering can all be combined to reach 80 hours. For example, if you work 60 hours per month and volunteer 20 hours per month, that counts.
- You may not have to work, but you may still need to fill out forms or provide proof. DPHHS may already have enough information about your exemption, but others require paperwork and documentation. If you have an exemption, keep track of any proof you have in case you need it.
- You have the right to appeal. If your Medicaid is denied or closed and you believe you should still qualify, you can appeal the decision. Find more information about that process on Montana Law Help.
We are here to help.
If you need help, contact Holly McCamant, Tina Crummet, or your care manager here at Blacktail Health at 406-723-4075 and schedule an appointment. They can help guide you through the documentation process.
Blacktail Health is committed to ensuring people in Butte, Dillon, Anaconda, and the surrounding communities have access to the health care they need and the insurance coverage they are eligible for. We are here to help you keep your health insurance and provide the outstanding care we are known for.