Medicaid work rule · Montana · checked 2026-10-20
Medicaid work requirement in Montana: what applies to you in 2027
Starting no later than January 2027, most adults 19 to 64 on Medicaid expansion must show 80 hours a month of work, school, volunteering or a work program, or $580 of income, unless the rule does not apply to them. Below is what Montana has published about how it will check, with a link to each source. Montana decides; this page only explains.
What Montana has published
- When it starts
- Early start: 2026-07-01 for new Expansion applications. Existing clients: redeterminations dated 2026-08-31 onward. No denials or disenrollments for noncompliance Jul-Sep 2026; enforcement began October 2026.Sources: 1 2 3 4 (Montana's own pages, listed below) · checked 2026-10-20
- Whether your own word counts in 2027
- Limited. New applicants may self-declare medical frailty on the Appendix B Self-Declaration form, mailed with the noncompliance notice. Existing clients must use a provider attestation for frailty. Activities and other exclusions need the documentation in DPHHS's verification matrix after ex parte checks fail. Presumptive-eligibility screening uses self-declaration only, with verification at full application. No broad 2027 self-attestation is published.Sources: 1 2 3 4 (Montana's own pages, listed below) · checked 2026-10-20
- How many months it looks back
- Application: 1 month, the month before applying. Renewal: 3 months, not necessarily consecutive, within the redetermination review period.Sources: 1 2 3 4 (Montana's own pages, listed below) · checked 2026-10-20
- How often you renew
- 6 months beginning January 2027; American Indian/Alaska Native members stay at 12 months.Sources: 1 2 3 4 (Montana's own pages, listed below) · checked 2026-10-20
- How it checks medical frailty
- Claims-based from 2026-10-01: the CHIMES eligibility system scans 12 months of Medicaid claims for ICD-10 codes on DPHHS's Medically Frail Condition List. The list has two tiers (Tier 1 aligned to the CMS categories, Tier 2 frailty indicators), and a code in either tier exempts. Fallbacks: provider attestation (existing clients), self-declaration (new applicants), and an exception-request form for unlisted conditions. List: dphhs.mt.govSources: 1 2 3 4 (Montana's own pages, listed below) · checked 2026-10-20
In Montana's own words
“From July through September 2026, DPHHS will review community engagement for applications and redeterminations, but people will not be denied coverage or disenrolled for not meeting the requirement during this time.”dphhs.mt.gov
“Starting October 1, 2026, DPHHS will begin using Medicaid claims data to automatically identify individuals who qualify for this exclusion.”dphhs.mt.gov
“New Applicants may submit a self-declaration of their medically frail status using the Self-Declaration form in Appendix B, mailed with their notice of non-compliance.”dphhs.mt.gov
Not published yet
Montana has not said this yet on the pages checked. Ask your Medicaid office, and keep copies of what you send.
- whether any self-attestation for activities, income or student status will be accepted in calendar 2027
- whether the Tier 1/Tier 2 list is formally the CMS Sept 8 optional 3-tier model
Sources
Montana's own Medicaid pages, read on 2026-10-20. The federal rule behind every state is in rules.json, with its own sources.