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# Montana State Health Plan Triples Deductible for 2027
- URL: https://www.theamericanquorum.com/state-news-montana-2026-09-18-a/
- Published: 2026-09-18T15:24:13.000Z
- Updated: 2026-09-18T15:24:13.000Z
- Description: Montana’s 2027 state employee health plan triples the in-network individual deductible to $3,000, doubles medical out-of-pocket limits and raises monthly contributions, with open enrollment set for October 21 through November 7.
- Author: News Desk
- Tags: State News, Montana

Montana’s state employee health plan will triple its in-network individual deductible and double its medical out-of-pocket limits on January 1, 2027, while also raising monthly contributions for workers and their families.

The [Department of Administration’s 2027 plan memo](https://doa.mt.gov/HCBD/%5Fdocs/benefits/2027-State-Plan-Changes.pdf?ref=theamericanquorum.com) raises the individual deductible from $1,000 to $3,000\. The medical out-of-pocket maximum will increase from $4,000 to $8,000 for an individual and from $8,000 to $16,000 for a family. Copays for specialist and urgent-care visits will rise from $35 to $60, while the $25 primary-care copay will remain unchanged.

Employees working at least 30 hours a week will also pay more each month. Before wellness incentives, employee-only medical coverage rises from $60 to $120; employee-and-spouse coverage from $318 to $418; employee-and-children coverage from $134 to $234; and family coverage from $397 to $497\. The state’s [published 2027 rate tables](https://doa.mt.gov/HCBD/resources/rates?ref=theamericanquorum.com) list a $1,107 monthly employer contribution for each eligible employee.

The increase is steeper for employees working 20 to 29 hours a week. Their employee-only contribution rises from $60 to $216, while family coverage increases from $397 to $895\. The Live Life Well incentive can reduce monthly costs, but the maximum discount remains $60 for an employee and $60 for an enrolled spouse or domestic partner.

## Prescription costs also rise

For prescriptions, a short-term Tier 1 copay will double from $15 to $30 and Tier 2 from $50 to $100\. The copay for Tier 4 specialty brand medicines rises from $200 to $500\. Annual pharmacy out-of-pocket limits increase from $1,800 to $2,500 for an individual and from $3,600 to $5,000 for a family, according to the [benefit comparison](https://doa.mt.gov/HCBD/%5Fdocs/benefits/2027-State-Plan-Changes.pdf?ref=theamericanquorum.com). Dental, vision, life, accidental-death and long-term disability rates are unchanged.

The state says its self-funded plan is facing nearly double-digit health-cost growth for a fourth consecutive year. Claims exceeding $1 million increased nearly 74% from 2020 through 2025\. In 2025, 2% of the plan’s approximately 28,000 members generated more than 30% of paid claims, primarily through treatment for serious and complex conditions.

A previously approved 2.5% increase in the state’s contribution takes effect in 2027\. The administration says it will ask lawmakers for another 5%, worth about $8 million; if approved, the annual employer contribution would reach $179 million. The request will be decided in the 2027 legislative session, while the employee contribution and benefit changes are already presented as effective January 1.

## What members should watch

The Montana Federation of Public Employees disputes the affordability of the package. In an [August 25 response](https://www.mfpe.org/2026/08/25/release-deductibles-triple-out-of-pocket-costs-double-mfpe-responds-to-skyrocketing-state-health-insurance-plan/?ref=theamericanquorum.com), the union said the higher payroll deductions and point-of-care costs could worsen recruitment and retention, and it made health benefits a priority for bargaining before the legislative session.

Plan members do not need to act immediately. The Health Care and Benefits Division says in its [official enrollment notice](https://content.govdelivery.com/accounts/MTHCBD/bulletins/4268f6b?ref=theamericanquorum.com) that open enrollment runs October 21 through November 7\. That will be the annual window to review elections, change plans or add and remove dependents before the new costs begin.