Medicare AdvantageAdministrativeMedium impact
Montana Market Transition: Information for Providers
PacificSource Health Plans·MT·Medicare
We identified it
Oct 16, 2026
Summary
PacificSource is exiting the Montana market for individual, family, employer-sponsored, and Medicare Advantage plans. Provider contracts remain in effect through December 31, 2027, with no current changes to billing, authorization, or claims processes. Members with coverage ending January 1, 2027, are receiving notification letters, and the practice should expect member inquiries about coverage transitions.
Action Required
Through December 31, 2027: Billing and administrative staff should continue processing claims and authorizations for PacificSource members using standard procedures with no workflow changes. Front desk and clinical staff should be prepared to direct member calls regarding coverage changes to PacificSource Customer Service (Medicare: 888-863-3637; Individual/Family/Employer: 888-977-9299) rather than attempting to resolve coverage end-date questions internally. Verify in billing system that PacificSource credentials and contract terms remain valid through the stated contract end date. Monitor for subsequent communications from PacificSource regarding transition timelines for members with coverage end dates after January 1, 2027.