Montana’s Medicare sales market is one of the most unique in the country. While Medicare Advantage enrollment has surged nationally—reaching 54% of eligible Medicare beneficiaries in 2024—Montana remains a state where Medicare Supplement (Medigap) plans still play a dominant role.
With lower-than-average Medicare Advantage penetration, Montana presents a compelling opportunity for insurance agents and independent insurance agents looking to sell Medicare Supplement plans.
But success in this market isn’t just about selling Medicare products—it’s about understanding the complex relationship between Medicare Advantage plans and Medigap. Partnering with the right FMO, general agency, or brokerage can help you navigate the market, grow your book of business, and maximize your sales potential.
Montana’s Medicare Market: A Landscape Favoring Medigap
According to KFF’s latest Medicare enrollment data, Montana is one of the states with the lowest Medicare Advantage plan enrollment rates in the country. Unlike Florida or California, where 60% or more of Medicare beneficiaries have opted into Medicare Advantage plans, Montana remains a stronghold for traditional Medicare and Medicare Supplement plans.
There are several key reasons for this:
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Rural Challenges & Limited Provider Networks: Medicare Advantage plans often struggle in rural states like Montana, where provider networks are sparse, and hospitals may not always accept MA plan terms. Medicare Supplement plans, on the other hand, allow beneficiaries to see any provider that accepts Medicare, which is a critical selling point in areas with fewer healthcare options.
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Limited Medicare Advantage Plan Availability: While the average Medicare beneficiary in the U.S. has access to 43 different Medicare Advantage plans, Montana has significantly fewer options. Many counties have little to no Medicare Advantage competition, making Medicare Supplement the default choice for those seeking comprehensive healthcare coverage.
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Out-of-Pocket Protection & Flexibility: While Medicare Advantage plans offer out-of-pocket maximums, Medicare Supplement plans provide greater cost predictability. This appeals to Montana’s older population, many of whom prefer to avoid unpredictable copays and network restrictions due to the geography.
The Challenge: Educating Consumers About Their Options
Many licensed insurance agents in Montana face an uphill battle when educating consumers about the differences between Medicare Advantage and Medigap.
With constant insurance marketing around $0 premium Medicare Advantage plans, some consumers assume these are their best or only option—only to later find out that network restrictions and cost-sharing structures aren’t a good fit.
Because of this, insurance agencies and insurance agents should focus on marketing materials, webinars, and social media initiatives to educate consumers and stand out from their competition.
The Role of Montana’s Health Systems in Medicare Coverage Choices
Montana’s healthcare landscape is dominated by a few major health systems, which play a key role in the success or limitations of Medicare Advantage plans. Unlike states with dense urban hospital networks that readily contract with Medicare Advantage plans, Montana’s hospitals and provider networks present challenges for Medicare Advantage expansion.
Major Health Systems in Montana
- Billings Clinic: The largest health system in Montana, providing care across a wide range of specialties. However, Medicare Advantage plan acceptance varies, creating uncertainty for enrollees.
- Benefis Health System (Great Falls): A major hospital and clinic network, but not all Medicare Advantage plans include Benefis providers in-network, making Medicare Supplement a safer option.
- Providence St. Patrick Hospital (Missoula): A key provider in western Montana, where Medicare Supplement plans offer greater provider flexibility.
- Kalispell Regional Healthcare: A critical healthcare access hospital network serving northwestern Montana, an area with limited Medicare Advantage presence.
How Montana’s Health Systems Influence Medicare Plan Choices
- Medicare Advantage Plans May Have Limited Network Coverage: Because many of Montana’s hospitals and doctors don’t contract with every Medicare Advantage carrier, beneficiaries choosing an MA plan may face restrictions on where they can receive care.
- Medicare Supplements Offer More Freedom: With a Medigap plan, beneficiaries aren’t restricted to specific networks—they can see any provider nationwide who accepts Medicare. This is a major selling point for Montana’s rural and semi-rural population.
- Providers May Be Hesitant to Accept MA Plans: In some cases, Montana’s health systems prefer traditional Medicare and Medigap over Medicare Advantage due to reimbursement differences and administrative burdens.
For insurance agencies, understanding which hospitals and clinics accept which plans can help drive better recommendations for clients. This is where a knowledgeable FMO, general agency, or brokerage can help insurance agents position their Medicare Supplement offerings effectively.
How an FMO Can Help You Scale in the Montana Market
Insurance agencies looking to expand their Medicare Supplement sales in Montana should consider partnering with a Field Marketing Organization (FMO) that understands the dynamics of this specific market.
A strong FMO partnership can provide:
- Market Data & Strategic Insights: Understanding where Medigap demand is highest in Montana and how to differentiate from your competition.
- Lead Generation & Marketing Support: Helping insurance agents reach high-intent consumers consistently.
- Access to Top Insurance Carriers & Competitive Contracts: Ensuring agencies offer the best Medicare Supplement plans available based on quality metrics, not just premiums.
- Compliance & Regulatory Guidance: Navigating CMS rules, Montana-specific regulations, and AEP strategies to stay compliant.
- Ongoing Training & Agent Support: Helping insurance agents position Medicare Supplement plans effectively against Medicare Advantage to best educate the customer.
- Lead Programs & Co-op Opportunities: FMOs often provide co-op marketing programs, social media support, and lead programs that can help independent insurance agents maximize sales.
Conclusion
Senior Market Advisors is an insurance FMO with a proven track record of helping insurance agencies scale growth. Whether you’re looking to expand your insurance business, grow your book of business, or tap into Medicare sales, our team provides the tools, training, and partnerships you need.
Montana is a prime opportunity for insurance agencies selling Medicare Supplements. With low Medicare Advantage penetration, rural healthcare challenges, and a consumer base that values provider choice and stability, Medicare Supplement plans will continue to be a dominant product in this state.
However, breaking into this market requires deep expertise in health insurance, effective insurance marketing strategies, and strong carrier relationships. That’s why partnering with the right FMO isn’t just helpful—it’s essential.
If you’re an insurance agency in Montana looking to expand into the Medicare business or searching for a new upline, now is the time to align with an FMO, general agency, or brokerage that understands how to help you win in a Medigap-first market.
Get started today and let us help you grow your Medicare business in Montana!
