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

Based on this year's plans, every Montana county will have two marketplace companies for 2027: Blue Cross and Blue Shield of Montana and Mountain Health CO-OP. Nobody here ends up with a single company, but two is a short list, and the right choice comes down to networks. Look up your doctor, your hospital and any specialist you drive to, whether that's in Billings, Missoula or across the line in Idaho or Wyoming, before you pick.

If you do nothing, the marketplace may move you to a similar plan from one of those two companies, but it isn't required to, and the match isn't based on your doctors. I'd much rather you choose.

PPOs are one thing Montana doesn't lose. PacificSource's plans were EPOs, and both of the remaining companies sold marketplace PPO plans in all 56 counties in 2026. If you're healthy and earn too much for the credit, I'd still put a nationwide PPO next to those. You can get one in Montana through me, and its network isn't built around one state, which suits ranch families, contractors and anyone whose care already crosses state lines.

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

When an insurance company leaves, your plan doesn't stop overnight. It runs through December 31, 2026, and the company has to tell you in writing first. Federal rules require at least 90 calendar days notice when a company drops a plan, and at least 180 calendar days when it leaves a state's individual market entirely. If your company is leaving and you haven't seen that letter, call the company and ask for it.

What happens next is the part people get wrong. If no plan from your company is left on the marketplace, the federal rule (45 CFR 155.335) says the marketplace may move you to a plan from a different company. It doesn't say it will. The move has to fit state law, it follows the state regulator's direction, and without that direction the marketplace picks a "similar" plan. Nothing in that rule checks your doctors or your prescriptions.

If you bought your plan straight from the company, off the marketplace, the marketplace's re-enrollment rule doesn't reach you at all. You need to pick a new plan yourself.

Open enrollment on HealthCare.gov starts November 1. By then you should get 2 letters: one from your current company and one from the marketplace. The marketplace letter tells you which plan, if any, you'll be moved into if you do nothing by December 15. HealthCare.gov is plain that in some cases you won't be automatically re-enrolled.

Pick by December 15 and your new plan starts January 1. Pick between December 16 and January 15 and it starts February 1, which leaves January uncovered if your old plan ended December 31.

Miss open enrollment and you may still have a way in. Losing a plan because it's discontinued is on HealthCare.gov's list of qualifying events, and the federal rule gives you 60 days before and 60 days after the day your old coverage ends to pick a new plan. Don't build your plan around that window. Confirm you qualify before you count on it.

What to do now

Here's how I'd think about it, depending on where you are. Each path ends the same way: a call with me before the deadline.

Scenario 1 of 2

Your income qualifies you for help with the premium

If your household income qualifies you for the premium tax credit, the marketplace is usually where your most affordable coverage is, because that's the only place the credit can be used. So don't let the marketplace pick for you. Re-shop before December 15, look at every company still selling in your county, and check your doctors and prescriptions against the network of the plan you choose, not the one you had.

Next step: Send me your doctors, your prescriptions and your income estimate, and I'll help you pick the right Montana marketplace plan before the deadline.

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

Scenario 2 of 2

You pay full price and you're healthy

If you earn too much for the credit, you're paying the full marketplace price, and now you're paying it for whatever is left in your county. You have another option. Private plans with medical underwriting run on nationwide PPO networks and are priced on your health, which is how the price for a healthy person can come in under the marketplace's full rate. They ask health questions up front, and the company can decline you or leave out a past condition, so we go through the details together before you choose.

Next step: Call me and I'll price a nationwide PPO for your household next to the Montana marketplace plans in your county.

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

You can still get a nationwide PPO in Montana

Whatever the marketplace looks like in your county, you can still get a nationwide PPO in Montana through me. 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.

Private PPO plans with medical underwriting use networks that work across the country, and for a healthy person who pays full price on the marketplace, they're often worth pricing. I'm licensed in 36 states, and Montana is one of them.

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?

Maybe, but don't count on it. The federal rule says the marketplace may move you to a similar plan from a different company, as state law and your state regulator allow. HealthCare.gov says that in some cases you won't be automatically re-enrolled, and if you bought off the marketplace, nobody moves you. Pick your own plan.

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

On HealthCare.gov, pick by December 15 for coverage that starts January 1. Open enrollment runs to January 15, but a plan picked after December 15 starts February 1.

Can I still get a PPO in Montana?

Yes. You can still get a nationwide PPO in Montana through me. 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

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.

Tell me your county, who's on your plan and what your letter says. I'll show you what's left on the Montana marketplace, price a nationwide PPO next to it, and help you pick before the deadline. I'm licensed in 36 states and work by phone.

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