A Montana Medical Care Savings Account (MSA) is a savings account that allows Montana residents to save for medical expenses while reducing their income tax. In 2025, each taxpayer may contribute up to $4,600 to an MSA for use toward the cost of eligible medical expenses. The law was updated in 2023 to also allow for funds in the account to be used to pay for direct patient care payments and health care sharing ministry costs.

It is not entirely clear whether the literal wording of the law only means monies sent to the ministry, such as start-up fees or continuation fees, are deductible, or if it should include any expenses including your monthly sharing sent to members.

‌However, based on statements the amended law’s sponsor made in committee hearings and also to the Montana (MT) Dept. of Revenue, we believe he intended that it would include all health care sharing ministry expenses paid by a member. Additionally, we have been made aware that at least one Samaritan Ministries MT member’s tax professional believes that it should include all ministry expenses. Also, regarding the wording used by the MT Dept. of Revenue defining what is a qualified expense, “Healthcare Sharing Ministry payments" appears to be broad enough in scope to include Shares sent directly to members.

You can learn more about the MT MSA and deductions using the following:

• MTRevenue.Gov/Montana-Medical-Care-Savings-Account-Deduction-Revived-Tax-News-You-Can-Use/
• Montana.ServiceNowServices.Com/Citizen?Id=Kb_Article_View&Sysparm_Article=KB0013247

This is an informational service only for members of SMI and is not tax advice. For tax advice, please contact your tax adviser.

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