2027 marketplace changes in Montana

Which insurance companies are leaving the Montana marketplace in 2027

Who is leaving, what's left in your county, and what to do before the deadline. Last checked October 5, 2026.

The short answer

One insurance company is leaving the Montana marketplace for 2027.

PacificSource (confirmed). PacificSource is ending its Montana insurance operations and keeps its individual plans only through December 31, 2026. In 2026 it sold marketplace plans in 56 of Montana's 56 counties. That's about 11,000 individual members, according to information PacificSource gave Montana's insurance commissioner. source

Altogether, 56 of Montana's 56 counties lose at least one marketplace insurer.

Two companies in every county

You won't be limited to one company in Montana. Based on this year's plans, every county will have two marketplace companies in 2027: Blue Cross and Blue Shield of Montana and Mountain Health CO-OP. That's still a limited choice, so I'd focus on the provider networks. Before enrolling, check whether your doctor, hospital and specialists participate, especially if you travel from Billings or Missoula into Idaho or Wyoming for care.

The marketplace might place you into a comparable plan from either remaining company if you take no action. But that transfer isn't guaranteed, and it doesn't account for which doctors you use. I'd prefer to help you make that decision yourself.

Coverage is getting more expensive, too. Montana's final 2027 rates are reported to be up 23.3% on average before subsidies. Even with a subsidy, shop again because what you pay depends on your plan. Paying full price? That increase hits your wallet, so get another quote.

Montana isn't losing its marketplace PPO options. PacificSource offered EPOs, while both remaining insurers sold marketplace PPO coverage throughout all 56 counties in 2026. For healthy people earning too much for a tax credit, I'd also compare a nationwide PPO. I can arrange one in Montana, with a network extending beyond state borders, which can work well for ranch families, contractors and people receiving care in other states.

What's left in your county

These are the 56 Montana counties where at least one marketplace insurer is leaving. For each one you can see who's leaving, how many marketplace insurers are left, and which ones.

On the marketplace, PPO plans were sold in 56 of Montana's 56 counties in 2026, and all 56 of those counties still have one after the exits. Those PPO plans come from Blue Cross and Blue Shield of Montana and Mountain Health CO-OP.

See every county that loses an insurer

County	Insurer leaving	Insurers left	Who's left (2026 plans)	Marketplace PPO after
Beaverhead	PacificSource Health Plans	2	Blue Cross and Blue Shield of Montana; Mountain Health CO-OP	Yes
Big Horn	PacificSource Health Plans	2	Blue Cross and Blue Shield of Montana; Mountain Health CO-OP	Yes
Blaine	PacificSource Health Plans	2	Blue Cross and Blue Shield of Montana; Mountain Health CO-OP	Yes
Broadwater	PacificSource Health Plans	2	Blue Cross and Blue Shield of Montana; Mountain Health CO-OP	Yes
Carbon	PacificSource Health Plans	2	Blue Cross and Blue Shield of Montana; Mountain Health CO-OP	Yes
Carter	PacificSource Health Plans	2	Blue Cross and Blue Shield of Montana; Mountain Health CO-OP	Yes
Cascade	PacificSource Health Plans	2	Blue Cross and Blue Shield of Montana; Mountain Health CO-OP	Yes
Chouteau	PacificSource Health Plans	2	Blue Cross and Blue Shield of Montana; Mountain Health CO-OP	Yes
Custer	PacificSource Health Plans	2	Blue Cross and Blue Shield of Montana; Mountain Health CO-OP	Yes
Daniels	PacificSource Health Plans	2	Blue Cross and Blue Shield of Montana; Mountain Health CO-OP	Yes
Dawson	PacificSource Health Plans	2	Blue Cross and Blue Shield of Montana; Mountain Health CO-OP	Yes
Deer Lodge	PacificSource Health Plans	2	Blue Cross and Blue Shield of Montana; Mountain Health CO-OP	Yes
Fallon	PacificSource Health Plans	2	Blue Cross and Blue Shield of Montana; Mountain Health CO-OP	Yes
Fergus	PacificSource Health Plans	2	Blue Cross and Blue Shield of Montana; Mountain Health CO-OP	Yes
Flathead	PacificSource Health Plans	2	Blue Cross and Blue Shield of Montana; Mountain Health CO-OP	Yes
Gallatin	PacificSource Health Plans	2	Blue Cross and Blue Shield of Montana; Mountain Health CO-OP	Yes
Garfield	PacificSource Health Plans	2	Blue Cross and Blue Shield of Montana; Mountain Health CO-OP	Yes
Glacier	PacificSource Health Plans	2	Blue Cross and Blue Shield of Montana; Mountain Health CO-OP	Yes
Golden Valley	PacificSource Health Plans	2	Blue Cross and Blue Shield of Montana; Mountain Health CO-OP	Yes
Granite	PacificSource Health Plans	2	Blue Cross and Blue Shield of Montana; Mountain Health CO-OP	Yes
Hill	PacificSource Health Plans	2	Blue Cross and Blue Shield of Montana; Mountain Health CO-OP	Yes
Jefferson	PacificSource Health Plans	2	Blue Cross and Blue Shield of Montana; Mountain Health CO-OP	Yes
Judith Basin	PacificSource Health Plans	2	Blue Cross and Blue Shield of Montana; Mountain Health CO-OP	Yes
Lake	PacificSource Health Plans	2	Blue Cross and Blue Shield of Montana; Mountain Health CO-OP	Yes
Lewis and Clark	PacificSource Health Plans	2	Blue Cross and Blue Shield of Montana; Mountain Health CO-OP	Yes
Liberty	PacificSource Health Plans	2	Blue Cross and Blue Shield of Montana; Mountain Health CO-OP	Yes
Lincoln	PacificSource Health Plans	2	Blue Cross and Blue Shield of Montana; Mountain Health CO-OP	Yes
Madison	PacificSource Health Plans	2	Blue Cross and Blue Shield of Montana; Mountain Health CO-OP	Yes
McCone	PacificSource Health Plans	2	Blue Cross and Blue Shield of Montana; Mountain Health CO-OP	Yes
Meagher	PacificSource Health Plans	2	Blue Cross and Blue Shield of Montana; Mountain Health CO-OP	Yes
Mineral	PacificSource Health Plans	2	Blue Cross and Blue Shield of Montana; Mountain Health CO-OP	Yes
Missoula	PacificSource Health Plans	2	Blue Cross and Blue Shield of Montana; Mountain Health CO-OP	Yes
Musselshell	PacificSource Health Plans	2	Blue Cross and Blue Shield of Montana; Mountain Health CO-OP	Yes
Park	PacificSource Health Plans	2	Blue Cross and Blue Shield of Montana; Mountain Health CO-OP	Yes
Petroleum	PacificSource Health Plans	2	Blue Cross and Blue Shield of Montana; Mountain Health CO-OP	Yes
Phillips	PacificSource Health Plans	2	Blue Cross and Blue Shield of Montana; Mountain Health CO-OP	Yes
Pondera	PacificSource Health Plans	2	Blue Cross and Blue Shield of Montana; Mountain Health CO-OP	Yes
Powder River	PacificSource Health Plans	2	Blue Cross and Blue Shield of Montana; Mountain Health CO-OP	Yes
Powell	PacificSource Health Plans	2	Blue Cross and Blue Shield of Montana; Mountain Health CO-OP	Yes
Prairie	PacificSource Health Plans	2	Blue Cross and Blue Shield of Montana; Mountain Health CO-OP	Yes
Ravalli	PacificSource Health Plans	2	Blue Cross and Blue Shield of Montana; Mountain Health CO-OP	Yes
Richland	PacificSource Health Plans	2	Blue Cross and Blue Shield of Montana; Mountain Health CO-OP	Yes
Roosevelt	PacificSource Health Plans	2	Blue Cross and Blue Shield of Montana; Mountain Health CO-OP	Yes
Rosebud	PacificSource Health Plans	2	Blue Cross and Blue Shield of Montana; Mountain Health CO-OP	Yes
Sanders	PacificSource Health Plans	2	Blue Cross and Blue Shield of Montana; Mountain Health CO-OP	Yes
Sheridan	PacificSource Health Plans	2	Blue Cross and Blue Shield of Montana; Mountain Health CO-OP	Yes
Silver Bow	PacificSource Health Plans	2	Blue Cross and Blue Shield of Montana; Mountain Health CO-OP	Yes
Stillwater	PacificSource Health Plans	2	Blue Cross and Blue Shield of Montana; Mountain Health CO-OP	Yes
Sweet Grass	PacificSource Health Plans	2	Blue Cross and Blue Shield of Montana; Mountain Health CO-OP	Yes
Teton	PacificSource Health Plans	2	Blue Cross and Blue Shield of Montana; Mountain Health CO-OP	Yes
Toole	PacificSource Health Plans	2	Blue Cross and Blue Shield of Montana; Mountain Health CO-OP	Yes
Treasure	PacificSource Health Plans	2	Blue Cross and Blue Shield of Montana; Mountain Health CO-OP	Yes
Valley	PacificSource Health Plans	2	Blue Cross and Blue Shield of Montana; Mountain Health CO-OP	Yes
Wheatland	PacificSource Health Plans	2	Blue Cross and Blue Shield of Montana; Mountain Health CO-OP	Yes
Wibaux	PacificSource Health Plans	2	Blue Cross and Blue Shield of Montana; Mountain Health CO-OP	Yes
Yellowstone	PacificSource Health Plans	2	Blue Cross and Blue Shield of Montana; Mountain Health CO-OP	Yes

County data: CMS 2026 marketplace plan data source. Insurers are counted by company, and the table uses each company's 2026 service area, so a company that enters or expands for 2027 isn't counted yet. I'll update it when the 2027 plan list publishes in late October.

What happens to your plan

Your coverage doesn't end immediately just because the insurer is leaving. The existing policy continues through December 31, 2026, and you're entitled to written notice beforehand. Federal requirements call for at least 90 calendar days of notice when an insurer discontinues a plan, or at least 180 calendar days when it withdraws completely from a state's individual market. Haven't received anything yet? Contact your insurer and request the notice.

Here's where people often misunderstand the process. Under federal regulation 45 CFR 155.335, the marketplace may place you with another insurer when your current company has no remaining marketplace plan. That's permission, not a guarantee. State law and the regulator's instructions govern the transfer. Without specific direction, the marketplace chooses a "similar" plan. The regulation doesn't require anyone to verify that your doctors or medications are covered.

Purchased your coverage directly from the insurer rather than through the marketplace? Its automatic re-enrollment provisions don't apply to your policy. You'll have to select replacement coverage on your own.

HealthCare.gov opens enrollment November 1. You should receive 2 notices by that point, one from your insurer and another from the marketplace. The marketplace notice identifies any replacement plan you'll be placed in if you haven't acted by December 15. HealthCare.gov also warns that automatic re-enrollment doesn't happen in every situation.

Choose your replacement no later than December 15 to begin coverage January 1. Enrolling from December 16 through January 15 gives you a February 1 effective date. If your previous policy ends December 31, that means going without coverage for January.

You might still qualify to enroll after the regular window closes. HealthCare.gov recognizes discontinued coverage as a qualifying event, and federal regulations allow 60 days before and 60 days after your old plan's termination to select replacement coverage. I wouldn't rely on that as your first choice. Make sure you're eligible before planning around those dates.

What to do now

The way I'd approach this depends on your particular situation and where things stand for you. Whichever route makes sense, the next step is the same: let's talk on the phone before the deadline.

Scenario 1 of 2

Your income qualifies you for help with the premium

When your household qualifies for a premium tax credit, marketplace coverage is generally the more affordable route because you can't apply that credit anywhere else. Still, don't accept an automatic plan selection without checking it. Compare every remaining insurer in your county before December 15, and verify your prescriptions and doctors against the new plan's network. Your old plan's network doesn't determine what the new one covers.

Next step: Share your estimated income, medication list and doctors with me. I'll help you choose a Montana marketplace policy that fits before enrollment closes.

Talk it through with Sam → Call 813-999-0101

Scenario 2 of 2

You pay full price and you're healthy

If your income puts you outside the tax credit range, you're responsible for the entire marketplace premium, with your choices limited to the insurers serving your county. That's when I'd also consider private coverage. Medically underwritten plans use nationwide PPO networks, and their pricing reflects your health. Healthy applicants may pay less than the marketplace's unsubsidized rate. There are tradeoffs: insurers ask medical questions and can reject an application or exclude a preexisting condition. We'll review those details together before you decide.

Next step: Give me a call, and I'll compare a nationwide PPO quote for your household with the marketplace coverage offered in your Montana county.

Talk it through with Sam → Call 813-999-0101

You can still get a nationwide PPO in Montana

Regardless of which insurers remain on your county's marketplace, I can help you obtain a nationwide PPO in Montana. On the marketplace, PPO plans were sold in 56 of Montana's 56 counties in 2026, and all 56 of those counties still have one after the exits. Those PPO plans come from Blue Cross and Blue Shield of Montana and Mountain Health CO-OP.

For healthy people paying the entire marketplace premium, it's worth comparing private, medically underwritten PPO coverage. These plans offer networks extending nationwide. I carry health insurance licenses in 36 states, including Montana.

Questions about insurers leaving Montana

Straight answers, no sales pitch.

Which insurance companies are leaving the Montana marketplace in 2027?

PacificSource (confirmed). Altogether, 56 of Montana's 56 counties lose at least one marketplace insurer.

If my insurance company leaves, will I be moved to a new plan automatically?

Possibly, but there's no guarantee. Federal rules permit the marketplace to assign a comparable plan from another insurer when state law and regulators allow it. HealthCare.gov specifically cautions that automatic re-enrollment isn't always available. And if your current coverage was purchased outside the marketplace, that process won't apply. My advice is to choose your replacement yourself.

What's the deadline to pick a new Montana plan for 2027?

To start coverage January 1 through HealthCare.gov, enroll by December 15. You have until January 15 before open enrollment ends, but selecting a plan after December 15 means it won't take effect until February 1.

Can I still get a PPO in Montana?

Yes. I can help you find a nationwide PPO available in Montana. On the marketplace, PPO plans were sold in 56 of Montana's 56 counties in 2026, and all 56 of those counties still have one after the exits. Those PPO plans come from Blue Cross and Blue Shield of Montana and Mountain Health CO-OP.

Sources

PacificSource sold individual marketplace plans in 56 of 56 Montana counties in 2026 (CMS 2026 plan data, counted by company) source
PacificSource is ending its Montana insurance operations and keeps its individual plans only through December 31, 2026. source
PacificSource in Montana: about 11,000 individual members, according to information PacificSource gave Montana's insurance commissioner source
After the confirmed and reported exits, 56 of 56 Montana counties lose at least one marketplace insurer and 0 are left with one, counting the 2026 plans of the companies that stay (CMS 2026 plan data) source
Montana marketplace PPO plans in 2026: 56 of 56 counties; after the confirmed exits: 56 (CMS 2026 plan data) source
HealthCare.gov says that by November 1 you should get 2 letters, one from your current insurance company and one from the Marketplace, and that in some cases you won't be automatically re-enrolled source
45 CFR 155.335(j)(3): when no plans from the same insurer are available, the Exchange "may enroll the enrollee in a QHP issued by a different issuer, to the extent permitted by applicable State law", as the state regulator directs or, if it does not, "in a similar QHP from a different issuer, as determined by the Exchange" source
HealthCare.gov open enrollment starts November 1; enroll by December 15 for coverage that starts January 1, or December 16 to January 15 for coverage that starts February 1 source
45 CFR 155.420: losing coverage is a triggering event, the loss date is the last day of the old plan's coverage, and the person has 60 days before and 60 days after it to pick a new plan source
HealthCare.gov lists "Your individual plan or your Marketplace plan is discontinued (no longer exists)" as a qualifying event for a special enrollment period source
45 CFR 147.106: an insurer that drops a product must give written notice at least 90 calendar days before coverage ends; one that leaves a state's individual market entirely must give at least 180 calendar days notice and cannot return to that market for 5 years source
Counting the 2026 plans of the companies that stay, all 56 Montana counties have 2 marketplace insurers for 2027: Blue Cross and Blue Shield of Montana and Mountain Health CO-OP (CMS 2026 plan data) source
Montana's final 2027 individual-market rates average a 23.3% increase before subsidies (reported, Sept. 24, 2026) source

Last checked October 5, 2026. I update this page when the 2027 plan list publishes in late October.

Got a letter? Bring it to the call.

Call me with your county, the people who need coverage and the details of your notice. I'll compare the remaining Montana marketplace plans with a nationwide PPO quote and help you decide before enrollment ends. I'm licensed in 36 states, and we can handle everything by phone.

Book a free call → Call 813-999-0101 Send a message