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.

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 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.

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.

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

Options for applying for Medicaid in Montana include online portals, telephone and in-person. Most applicants find that visiting heathcare.gov 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 covermt.org.

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.

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)