MSU News Service

06/25/2021 Contact: Marsha Goetting, MSU Extension family economics specialist, This email address is being protected from spambots. You need JavaScript enabled to view it.


BOZEMAN — Montana State University Extension has updated its MontGuide “Montana Medical Care Savings Accounts (MSAs) for the 2021 Tax Year.” The revised guide is available at, and paper copies are available from county or reservation Extension offices.

A medical care savings account is an account used to reduce the cost of saving for medical expenses and long-term health care. According to Marsha Goetting, MSU Extension family economics specialist, an MSA offers individuals several benefits, including a reduction in state income taxes.

For example, if a person has taxable income over $18,400, they could save approximately $276 in state income taxes by opening an MSA and depositing up to $4,000. The MSA earns interest-free from Montana income taxation and the balance at the end of the year rolls over for use in the future.

Goetting added that an MSA can also be passed to others after death. By placing a payable-on-death (POD) designation on the account, individuals can provide a legacy for spouses, children, or grandchildren to use on their medical expenses. There are also no inheritance taxes on MSAs, and as long as an individual’s estate is valued at less than $11.7 million, there is no federal tax either.

“Without a POD beneficiary, the money passes to your heirs according to your written will,” said Goetting. “If you do not have a written will, the MSA passes by Montana law to your heirs with priority given to a spouse. Either way, a legacy is provided. If you do not have heirs, you could name your favorite nonprofit as the POD beneficiary.” 

Although the maximum amount used to reduce a Montanan’s taxable income annually is $4,000, Goetting said a person can also put less than $4,000 in an MSA. The amount used to reduce income for Montana residents is the total deposit in the MSA during the tax year, not the amount withdrawn for eligible medical care expenses during the year.

Eligible expenses include medical insurance premiums; prescription drugs; medical, dental, and nursing home care; eyeglasses; crutches; and transportation for medical care.

“Montana considers eligible medical care expenses as any items the IRS accepts,” Goetting said. IRS publication 502 provides a detailed list of eligible expenses and can be found at 

All resident taxpayers are eligible to establish an MSA, even if they have another health care plan provided by their employer, a Section 125 Flexible Spending Account or a Federal Health Savings Account. A taxpayer does not have to be in a high deductible health insurance plan to be eligible for the MSA.


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