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In-Home Care in Montana

Attesting to the state’s desirability as a retirement destination, approximately 19.3% of Montana’s slightly less than 1,105,000 citizens are aged 65 and over, which is nearly 3% higher than the national average of 16.5%. Seniors in Montana enjoy one of the most tax-friendly environments in the country. Montana doesn’t have a state sales tax and state income taxes are capped at 6.75%. Portions of Social Security and other retirement income are not taxed, and federal tax payments can be deducted on Montana state tax returns.

Options for senior care in Montana include in-home care, home health care, adult day health care, assisted living and nursing homes. According to the 2021 Genworth Cost of Care Survey, the average cost of in-home care in Montana is $5,339 per month. In-home care is designed for seniors who choose to age in place in their own homes. In-home care covers basics such as housekeeping, errands, meal preparation and personal care, while home care covers clinical care provided by professionals.

This guide offers an exploratory look at in-home care in Montana, including average cost comparisons and Medicaid and Medicare options. It also includes a list of relevant resources for seniors aging in place.

The Cost of In-Home Care in Montana

At an average cost of $5,339 per month, in-home care in Montana is $382 more than the national average of $4,957, according to the 2021 Genworth Cost of Care Survey. Costs rise slightly to the west in Idaho, where residents pay an average of $5,434 for in-home care. In-home care costs are even lower in Nevada at an average of $5,148 per month but rise again to $5,625 in neighboring Utah. The highest costs in the area are found to the east in North Dakota at an average of $5,689 per month.



The United States






North Dakota


The cost of in-home care within Montana varies by location. The lowest costs are found in Great Falls, where residents pay an average of $4,698 per month for in-home care, while the highest in-home care costs are found in Billings at $5,720. Those in Missoula pay an average of $5,243 per month. Because Montana is sparsely populated, we’re using two cities in neighboring states in our comparison of in-home care costs. Residents across Montana’s southwestern border in Idaho Falls pay a monthly average of $5,720 for in-home care costs, while their counterparts east of Montana in Bismarck pay an average of $7,823 per month.

Great Falls






Idaho Falls




Although in-home care is less expensive than adult day health care at an average of $2,600 per month and assisted living at an average of $4,450 per month, the costs of nursing home beds are much higher at a monthly average of $7,574. However, the average cost of home health care in Montana is the same at $5,339.

In-Home Care


Home Health Care


Adult Day Health Care


Assisted Living


Nursing Home


Does Medicaid Cover Home Care in Montana?

Montana residents who meet income and residency requirements for Medicaid may be able to get assistance with paying for some of the costs of in-home care through the Community First Choice and Personal Assistance Services (PAS) Program. Eligible recipients receive assistance with bathing, grooming, getting dressed, eating and other routine tasks of daily living. The program is person-centered to meet individual needs and preferences. Applicants for the PAS program must meet the following criteria.

Montana residents who need a nursing home level of care but who would prefer to remain living in their own homes may be eligible for the Big Sky Waiver. There is typically a waiting list for this waiver

Home Care Waiver Programs in Montana

Big Sky Waiver

Financially and/or medically needy seniors may be able to get assistance through Montana’s Big Sky Waiver. Specifically, applicants must be:

  • Eligible for Medicaid
  • Aged 65 or ever
  • Physically disabled as determined by the Social Security Administration
  • Meet the minimum requirements for nursing home placement
  • Have unmet needs that can only be resolved through the waiver

Services covered by the Big Sky Waiver include the following:

  • Case management
  • Occupational and physical therapy
  • Skilled nursing
  • Post-Acute rehabilitation services
  • Specialized Medical Equipment
  • Environmental adaptations
  • Specially trained attendants
  • Medical and non-medical transportation 

Seniors can apply for the Big Sky Waiver on the state’s website or call 800-219-7035. 

How to Know if You’re Eligible for Medicaid in Montana

The yearly income limit for those in single-person households is $10,092, and the asset limit is $3,000. In two-person households where only one person is applying for Medicaid, the income and asset limits remain the same at $2,000 and $3,000, respectively, while the non-applicant can have an asset limit of up to $137,000. When two people are applying, the income limit is $20,184, and the asset limit is $3,000. 

2022 Medicaid Income Limits for Seniors in Montana

Income limits*Asset limits
$10,092$2,000 for individual applicants $137,400 for non-applicants 

*per year

How to Apply for Medicaid in Montana

Options for applying for Medicaid in Montana include online portals, telephone and in-person. Most applicants find that visiting is the most convenient. Applicants can call 1 800-318-2596 to apply by telephone or go in person to their local Department of Health and Human Service Office. If you aren’t sure about where the nearest office is, you can find this information on

What Information You Will Need

Applicants for Medicaid are required to provide qualifying information regarding their financial status. Having pay stubs, documentation proving Social Security or other retirement income, copies of tax returns and bank statements makes the application process go more smoothly. You should also be prepared to provide proof of identity such as a driver’s license or a Montana state ID card.

How to Get Help Applying for Medicaid

Because of all the documentation and strict eligibility requirements involved in applying for Medicaid, applicants often need assistance navigating the red tape. If you have questions about the process, are not sure if you qualify or feel that you have been wrongfully denied, the following resources may be able to help.

ProgramContactAreaServedServices provided
Montana Public Assistance Helpline(888) 706-1535Entire StateThe Montana Public Assistance Helpline is open from 8 a.m. until 5 p.m. each week, excluding legal holidays. The Helpline is designed to provide real-time assistance to those with questions about their Medicaid and other public assistance applications.
Cover Montana(844) 682-6837Entire StateCover Montana has a Find Local Help option where applicants with questions can type in their zip code and get free, confidential help with applying for Medicaid or other public assistance issues.
MDPHHS Office of Administrative Hearings(406) 444-2470Entire StateIf you've been denied Medicaid and feel that it was the wrong decision, you can file a request for a Fair Hearing through Montana's Office of Administrative Hearings. By law, you are entitled to a hearing in Montana if benefits have been denied.

Does Medicare Cover In-Home Care in Montana?

In general, Medicare does not cover the cost of non-medical home care. That being said, there are situations in which Medicare provides some coverage for medical home care, referred to as “Home Healthcare.” There are several eligibility restrictions for coverage, including that individuals must be homebound and have a referral from their doctor specifically for home healthcare services.

Below is an overview of some of the skilled medical professionals whose in-home services are typically covered by Medicare – for more in-depth information, refer to our Guide to Home Healthcare.

  • Physical Therapists: Physical therapy is used to help patients recover from injuries (broken bones, knee injuries, etc.), treat ongoing conditions such as arthritis, and assist in recovery from surgeries and procedures such as a knee or hip replacement.
  • Visiting Nurses: Licensed nurses can provide a number of medical services for those who don’t need to stay in the hospital, but do need regular medical services such as wound care, changing feeding tubes, etc.
  • Occupational Therapists: Occupational therapists help seniors regain or maintain the ability to accomplish normal, daily tasks, such as bathing, dressing, eating, and other daily activities.
  • Speech Therapists: Speech therapists help seniors who are struggling to adequately communicate due to a stroke, dementia, or any other cause regain the ability to functionally communicate using a variety of means. Additionally, speech therapists help to keep seniors independent by modifying diets, teaching special techniques to swallow safely, and retraining associated muscles.

As mentioned above, in-home care is distinctly different from home healthcare. But, there can be some overlap in services between the two types of care. So, while Medicare doesn’t cover non-medical in-home care, there are in-home care services that may be covered in special circumstances when they’re provided in conjunction with home healthcare (such as an occupational therapist helping with eating or dressing)

Other Financial Assistance Options for In-Home Care in Montana

While the above programs help many people finance in-home care, they will not cover all costs for everyone. There are other ways to pay for in-home care, including out-of-pocket arrangements with siblings, annuities, reverse mortgages, private insurance and more. Read’s Guide to In-Home Care Costs to learn more about these alternative payment options.

Free and Low-Cost Resources for Seniors in Montana

Montana seniors who choose to age in place experience benefits such as remaining connected to their neighborhoods, family and friends. However, aging in place also comes with a number of challenges, such as getting help with errands, household tasks, and transportation and identifying and accessing community-based programs and services that promote a good quality of life among older adults. Montana seniors can contact the following resources for assistance with these age-related challenges. 

Montana Department of Health and Human Services Home Aging Services(406) 444-4077Entire StateThe Montana Department of Health and Human Services Home and Living Options provides Montana residents aged 60 and over, their families and their caregivers with direct and indirect services designed to promote a good quality of life among senior citizens and to help them retain their independence for as long as possible. Services are delivered throughout the state by a network of 10 local Area Agencies on Aging. Programs and services for those opting to age in place in their own homes include balance workshops, Medicaid and Medicare seminars as well as individual health insurance counseling, Meals on Wheels and health and wellness screenings. Indirect services include referrals to relevant local, state and federal programs.
Montana Veterans Affairs(406) 542-2501Entire StateVeterans of all branches of the U.S. Armed Services with honorable discharges, their dependents and their survivors can receive assistance for a range of issues from Montana Veterans Affairs. Qualified disabled veterans or their unmarried surviving spouses may be able to get a property tax reduction from between 50% to 100%, for instance, and those who hunt and fish receive discounts on licenses. Montana veterans are also eligible for free vehicle registration and license plates. The agency also provides assistance with identifying relevant service-based benefits and filling out the necessary paperwork.
Aging Horizons(800) 332-2272Entire StateThe Montana Department of Public Health and Human Services produces and airs a weekly television program called Aging Horizons that covers a range of issues surrounding aging, such as reverse mortgages, veterans benefits, Medicaid and Medicare and Social Security. They also produce and distribute a newsletter several times per year about aging-related events and issues.

In-Home Care Laws and Regulations in Montana

Home health agencies in Montana that provide services to people receiving Medicaid are licensed by the Department of Public Health and Human Services, Licensure Bureau. Agencies operate under regulations that help protect the safety and well-being of senior Montanans.

Scope of CareHome health agencies can provide services including skilled nursing, occupational, physical and speech therapies and home health aide services.
Care Plan RequirementsAny home health services provided must be based on orders written by a physician and detailed in a plan of care. The orders must include the type of services to be provided and the frequency of the services. It must be reviewed at least every 60 days.
Medication Management RequirementsMedication can be administered by licensed agency staff as ordered by the physician.
Staff Screening RequirementsThere are currently no background check requirements for in-home care workers in Montana.
Staff Training RequirementsStaff must be licensed to perform the service they are providing. There are no specific training requirements detailed for unskilled caregivers performing homemaker or similar services.
Medicaid CoverageThe Community First Choice/Personal Assistant Services and Big Sky Waiver programs will cover some or all of the cost of in-home care for those who qualify.
Reporting AbuseAbuse should be reported to Adult Protective Services online at 844-277-9300.

Frequently Asked Questions

How to Find an In-Home Care Provider in Montana

Whether you are looking for yourself or a loved one, finding a quality home care provider can be a stressful process. When you hire an in-home care aide you’re placing a lot of trust in the hands of the person by inviting them into your home, so you’ll want to be diligent in your search. At, we’re here to help – we’ve created a helpful checklist below that can help guide you through the process of both determining your needs and finding a home care agency that will provide the best care possible.

To find quality home care providers near you, simply input the zip code or city where you would like to start your search. We have an extensive directory of home care agencies all across the nation that includes in-depth information about each provider and hundreds of thousands of reviews from seniors and their loved ones.

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Finding a Home Care Provider Checklist

Home Care in Montana

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Home Care in Montana



Flathead County is a leading online destination for caregivers seeking information and support as they care for aging parents, spouses, and other loved ones. We offer thousands of original articles, helpful tools, advice from more than 50 leading experts, a community of caregivers, and a comprehensive directory of caregiving services.


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