Almost 20% of Montana’s one million residents are classified as senior citizens, and the Department of Public Health and Human Services, in connection with local providers, has a range of resources available that help them stay independent as they age. In addition to clean air and wide, open spaces, Montana also has a well-regulated in-home care industry to protect seniors who wish to age in place. The average monthly cost of in-home care is $4,576, slightly higher than the national average.

Read on for more information about the cost of in-home care in Montana, financial assistance options in the state and other free and low-cost resources available to seniors.

The Cost of In-Home Care in Montana

In-Home Care Costs in Nearby States

According to the Genworth Cost of Care 2019 Survey, seniors pay an average of $4,576 per month for in-home care. This is slightly higher than the national average of $4,290 but is lower than most neighboring states. Idaho is the only nearby state that has more affordable in-home care, with a cost of $4,195 a month. At $5,148 monthly, the price in North Dakota is $572 higher than in Montana, and seniors in both South Dakota and Wyoming pay $5,339 each month.




United States Average




North Dakota


South Dakota



Cost of Other Types of Care in Montana

The cost of in-home care in Montana is relatively low, but seniors in the state can find more affordable care options. Adult day care averages just $2,167 a month, while prices in assisted living facilities are $756 lower than in-home care, at $3,820. The average price of home health care in the state is $4,576, equal to the price of in-home care. Nursing home care is the least affordable option, at $7,459 per month.


In-Home Care


Home Health Care


Adult Day Care


Assisted Living Facility


Nursing Home Care

The Cost of In-Home Care in Montana’s Top Cities

The difference in in-home care costs between Montana’s most affordable city and the state’s least affordable city is almost $400. The lowest average price is found in Billings, where seniors pay $4,376 per month. Missoula is slightly higher, at a cost of $4,576, while Great Falls has the highest average of $4,767. There is a large difference between cities close to the state. In Idaho Falls, Idaho, the average cost is lower than the national average, at just $4,004, while prices further north in Coeur d’Alene run $4,290. In Rapid City, South Dakota, costs are significantly higher at $6,673 per month.






Great Falls


Idaho Falls, ID


Coeur d’Alene


Rapid City, SD

Financial Assistance for In-Home Care in Montana

Community First Choice/Personal Assistant Services

The Community First Choice (CFC) and Personal Assistant Services (PAS) program provides long-term supportive care to elderly and disabled residents who wish to remain living at home. The type of care available is tailored to an individual’s needs but can include help with activities of daily living, such as grooming, eating and medication assistance. Instrumental activities of daily living, such as housekeeping, laundry and meal preparation, may also be provided.

Participants in the CFC/PAS program can choose to receive care through a state agency or can self-direct their care. The self-directed option allows seniors to hire and train their own care providers who are then paid by the program. Some family members, including adult children and ex-spouses, can be hired as caregivers through the program.

Who Is Eligible?
Applicants must be financially eligible to receive Medicaid and have a medical condition that necessitates them receiving in-home assistance to remain living at home. People choosing the self-directed option must also be capable of directing their own care or have someone available who can direct care on their behalf.

How to Apply
Seniors can apply for the program through their local Office of Public Assistance Field Office, or by contacting the helpline on 1-888-706-1535..

Montana Big Sky Waiver

The Montana Big Sky Waiver, also known as the Home and Community Based Services Waiver, helps people who require a nursing home level of care to receive that care in their home. A large range of care services and other support, including minor home modifications, can be provided to participants and their primary caregiver. The waiver has a self-directed option that allows seniors to choose their own caregivers. Some family members, including adult children, can be hired to provide care through the program. However, all care providers must be qualified, so the type of care family members can be hired to provide is generally limited to homemaker services or personal care.

All participants can receive case management services, while other types of support available depend on an individual’s needs and circumstances. Benefits include personal care, home-delivered meals, respite care and transportation assistance.

Who Is Eligible?
There are no age requirements for the program, but those under 65 must be physically disabled. All applicants undergo a medical review, and those who need the level of care provided by a nursing home are eligible for the program. There are different financial eligibility requirements based on the applicant’s circumstances, and some seniors who are deemed medically needy may be able to spend down their income on medical expenses to meet income limits.

How to Apply
Seniors can apply by calling Mountain-Pacific Quality Health on 1-800-219-7035.

More Ways to Pay for In-Home Care

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 and private insurance. Read’s Guide to In-Home Care Costs to learn more about these alternative payment options.

Free and Low-Cost In-Home Care Resources in Montana

There is a wide range of resources available to Montana seniors to support in-home care and independent aging. These include meal delivery and options counseling, among others.

ContactArea ServedServices Provided
Big Sky Rx866-369-1233Entire StateBSRx helps Montana Medicare recipients pay for prescription drug insurance, or Medicare Part D, premiums. Eligible residents receive cash payments to put towards their premiums and depending on the individual and their plan, it may cover the entire monthly premium.
MonTECH877-243-5511Entire StateMonTECH helps people across Montana access information and support about assistive technology. It has an equipment loan program so people can try technology before making a financial commitment and also lists available second-hand equipment. Technology can be sent anywhere in the state. Financial assistance is also available to people seeking to purchase new equipment.
Area Agencies on Aging800-551-3191Entire StateMontana has eight Area Agencies on Aging that provide advocacy for older Americans as well as a range of services that help seniors live active, independent lives. Many have senior centers that provide opportunities for socialization and education. AAAs also provide information and referrals to local services and resources available for seniors.
Big Sky Senior Services406-259-3111Carbon, Stillwater and Yellowstone CountiesBig Sky Senior Services is a not-for-profit organization that provides in-home care services to low-income seniors. It also has programs that help prevent elder abuse and a volunteer companionship program that provides phone and in-person support to isolated elders.
Adult Protective Services844-277-9300Entire StateAdult Protective Services investigates abuse, neglect and exploitation of vulnerable adults, including seniors. The program also connects individuals with local resources to help prevent abuse.
Nutrition ServicesContact a local Area Agency on Aging on 800-551-3191Entire StateMontana offers a number of nutrition services to support people aged 60 and over and still living independently. Congregate and home-delivered meals are available and a number of Montana farmer’s markets are part of the Senior Farmers Market Nutrition Program. Nutrition consultations are also available.
Montana Options CounselingContact a local counselorAvailable in limited countiesOptions counseling is available to seniors aged 60 and over and provides individualized support to people making decisions about long-term care. Specialized counselors use a person-centered approach that takes into account a senior’s strengths, preferences and values.

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 Much Does In-Home Care Cost in Montana?

The Genworth Cost of Care 2019 Survey calculates that the average cost of in-home care in Montana is $4,576 a month, which is slightly higher than the national average of $4,290. Home health care, which includes skilled nursing and other medical services, has the same average cost in the state.

Does Montana’s Medicaid Pay for In-Home Care?

Montana Medicaid has two programs that pay for in-home care for eligible seniors. The Community First Choice/Personal Assistant Services and Big Sky Waiver programs cover some or all of the costs associated with in-home care. Both programs have age-related and financial eligibility requirements, and seniors must also be assessed as needing a nursing home level of care.

Are There Programs to Cover Home Modifications in Montana?

Montana doesn’t have any programs that concentrate on home modifications, but seniors in the Big Sky Waiver program may be able to receive minor home modifications through the program. The modifications must help the beneficiary increase independence in the home.

What Support Can Help Me Age at Home?

There are a wide variety of resources that can help seniors remain living in their home as they age. Homemaking is a common option that takes over general chores such as laundry, cleaning and gardening. Many seniors also receive help with meal preparation or get meals delivered. Personal care helps seniors who struggle with activities of daily living, such as grooming, bathing and mobility. Seniors can also get help with transportation, shopping, running errands and other tasks that help them lead a fulfilling life.

What Are “Activities of Daily Living”?

Activities of daily living, or ADLs, are a set of basic daily tasks that are essential for an individual to thrive. They are generally broken down into personal hygiene, continence management, dressing, feeding and ambulating. The ability of a person to accomplish these tasks is commonly used to assess whether a person is eligible for assistance and the type of assistance they can receive. Instrumental activities of daily living, or IADLs, are also necessary for independent living and include tasks such as meal preparation, shopping, housekeeping and communicating with others.