Known for its wide-open spaces and rugged natural beauty, Montana is one of the most popular states to live in for the nation’s retirees. It boasts the sixth-highest senior population in the country, with more than 19% of residents aged 65 and up. Montana’s many small cities and towns offer seniors a strong sense of community paired with the laid-back pace of country living.

Montana was ranked 26th in the nation in the 2022 Senior Living Report, scoring high marks in categories such as Health Care and Community Involvement. Seniors throughout the state have access to top-rated hospitals such as Providence St. Patrick and Benefis Health System. The state scored lowest in the Affordability category, but Montana’s assisted living prices are slightly cheaper than the national average, and a lack of sales tax can help seniors keep more money in their pocket.

This guide covers the cost of assisted living in Montana compared to nearby states, plus average prices for other types of care. It also gives an overview of financial assistance options, helpful resources and regulations for care facilities throughout the state.

The Cost of Assisted Living in Montana

According to the Genworth 2021 Cost of Care Survey, assisted living in Montana costs an average of $4,450 per month, which is $50 less than the national average of $4,500. It’s one of the priciest states for care compared to surrounding states, though. On average, seniors pay $3,838 in Idaho, $4,169 in Wyoming, $3,350 in South Dakota and $3,391 in North Dakota.

$4450

Montana

$4500

The United States

$3838

Idaho

$4169

Wyoming

$3350

South Dakota

$3391

North Dakota

Assisted living prices in Montana can vary by city. Missoula is the most expensive, with rates averaging $4,650. In Billings, the state’s largest city, prices are slightly lower at $4,564. Great Falls is the cheapest option, averaging $4,150. Cities in neighboring states are generally less expensive, with rates averaging $3,500 in Idaho Falls, Idaho, $3,914 in Rapid City, South Dakota and $3,710 in Bismarck, North Dakota. Casper, Wyoming is pricier at $4,844.

$4650

Missoula

$4564

Billings

$4150

Great Falls

$3500

Idaho Falls, ID

$3914

Rapid City, SD

$3710

Bismarck, ND

$4844

Casper, WY

Montana’s seniors have other options for care depending on their preferences, needs and level of independence. They can get personal assistance at home for $5,339 and home health care, which includes skilled nursing and other medical services, costs the same. People who only need supervision during the daytime may consider adult day health care, which is the most affordable option at $2,600. Nursing home care is ideal for those who need 24-hour supervision and is priced the highest with an average of $7,574.

$4450

Assisted Living

$5339

Home Care

$5339

Home Health Care

$2600

Adult Day Health Care

$7574

Nursing Home Care (semiprivate)

Does Medicaid Cover Assisted Living in Montana?

While Medicaid doesn’t directly cover the cost of assisted living in Montana, certain seniors may be eligible for the Big Sky Home and Community Based Services Waiver Program. The Big Sky Waiver is a Medicaid-based program that covers the cost of care in approved assisted living facilities throughout the state. It’s open to people who meet income and asset eligibility requirements, which can make assisted living accessible for retirees of limited financial means.

 What Assisted Living Services Are Covered by Medicaid in Montana?

Montana’s Senior & Long-Term Care Division (SLTC) and Department of Public Health & Human Services (DPHHS) cover a number of assisted living services for qualifying residents. Services are limited to those approved by the resident’s care plan, and can include:

  • Personal assistance with activities of daily living
  • Medication assistance and administration
  • Other health and nursing services

Assisted Living Waiver Programs in Montana

Big Sky Home and Community Based Waiver Program

The Big Sky Waiver Program allows eligible seniors, who would otherwise require institutionalization, to receive care in their home or an approved assisted living facility. Services are provided by a case management team consisting of social workers, nurses and other medical professionals. Montana’s case management teams can only serve a certain number of people each year, so program applicants may be placed on a waiting list before they can receive assistance. Services that may be provided by the Big Sky Waiver include:

  • Adult day health care
  • Adult residential living
  • Case management
  • Chemical dependency counseling
  • Dietitian and nutrition counseling
  • Personal assistance
  • Private duty nursing
  • Personal emergency response system
  • Physical, speech and occupational therapies
  • Transportation
  • Specialized medical equipment and supplies

To qualify for the Big Sky Waiver, seniors must meet the minimum level of care requirements for nursing home placement and be eligible for Medicaid in Montana. Seniors can determine their eligibility and start the application process by contacting Mountain Pacific Quality Health at (800) 219-7035.

How To Know If You’re Eligible for Medicaid in Montana

Eligibility for Medicaid is determined by the Montana Department of Public Health & Human Services. In Montana, any aged, blind or disabled individual who qualifies for Supplemental Security Income (SSI) is automatically eligible for Medicaid. In general, seniors may be eligible for Medicaid if they are:

  • 65 years older and up
  • In need of medical care
  • Blind or disabled
  • Low-income

As of 2022, single applicants must have a pre-tax income of $10,092 per year or less ($841 per month) and assets valued at $2,000 or less.

Annual Income Limits

Asset Limits

Single Applicant

$10,092

$2,000

Married (Only One Person Applying)

$10,092

$2,000 for applicant, $137,400 for non-applicant

Married (Both Spouses Applying)

$20,184

$4,000 ($2,000 per spouse)

In addition to these income and asset limits, seniors must meet additional requirements to receive services under the Big Sky Medicaid Waiver Program. They are required to undergo a medical assessment that demonstrates a level of impairment that would otherwise require placement in a nursing home facility. Applicants can demonstrate this need if they require help with:

  • Medication administration
  • Personal care
  • Instrumental activities of daily living, such as eating, grooming, toileting and dressing

How to Apply for Medicaid in Montana

Seniors can apply for Medicaid through HealthCare.gov. To apply by phone, call (800) 318-2596.

Information You Will Need

The following information is required to apply for Medicaid in Montana:

  • Name, birth date, address and contact information for everyone in the applicant’s household
  • Information about current health care coverage for household members, including Medicare, coverage through an employer or through a spouse’s employer
  • Income information for everyone in the household
  • Information about SSI/SSA payments
  • Social Security Number and/or immigration documents, for applicants only

How To Get Help Applying for Medicaid

Montana’s seniors can get free Medicaid counseling and other types of assistance through one of several resources and programs. These resources help Montanans learn about benefits, find the right plan and appeal Medicaid applications that have been denied.

Resource

Contact

Description

(800) 551-3191

Managed by the Montana Office of Aging, this statewide program provides free assistance to help seniors understand Medicaid benefits, eligibility requirements and what they'll need to apply. It also maintains a directory of current Medicaid providers throughout the state.

(800) 332-2272

Montana's long-term care ombudsman advocates for seniors when Medicaid refuses to cover necessary prescription drugs and other medical services they need. In the event of a denial, the ombudsman can work with Medicaid on a senior's behalf.

(844) 682-6837

Cover Montana provides Medicaid education services and can help seniors apply online or over the phone. On the Cover Montana website, residents can enter their zip code to find in-person assistance near them.

Does Medicare Cover Assisted Living in Montana?

The short answer is that no, Medicare does not cover the cost of assisted living in Montana. Assisted living facilities are considered to be a “residential setting” and not a “clinical setting,” (think nursing homes). While Medicare doesn’t cover the cost of care received in an assisted living community, it does still cover things like approved medications, doctor visits, medical equipment, etc., just like it would if you lived at home.

For more information about when Medicare can be used to pay for senior living in a nursing home, and for Medicare-related resources, see our guide to Nursing Homes in Montana.

Other Financial Assistance Options for Assisted Living in Montana

Seniors who are not eligible (due to location, financial situation, or other factors) for other types of financial assistance, do still have some options. See the table below for an overview of some of the most common ways to make Assisted Living affordable.

How to Apply

How It Works

Aid and Attendance

Learn more and apply online at va.gov.

Veterans who receive a VA pension may also be eligible for the Aid and Attendance benefit, a monthly cash allowance that veterans receive in addition to their standard pension amount. The benefit is intended for veterans in need of long-term care services and may be used towards paying for Assisted Living.

Reverse Mortgages

Learn more about your options and how to apply at ftc.gov

If you own a home, you may be able to use a reverse mortgage to help pay for Assisted Living. Reverse mortgages are loans that one can take out against the value of their home, essentially converting some of the home's equity into cash. Reverse mortgage loans do need to be repaid with interest, typically within 12 months of receiving the loan.

Long-Term Care (LTC) Insurance

Learn more about Long-Term Care Insurance and how to apply for a policy at acl.gov.

Seniors who already have long-term care insurance may be able to use it to pay for Assisted Living. Most policies cover at least a portion of the cost, but it depends on the specific policy terms. Note that older adults who are already in need of Assisted Living will not typically be eligible to sign up for a LTC insurance policy.

Free and Low-Cost Resources for Seniors in Montana

Montana’s seniors have access to a number of free programs, resources and services through government organizations and nonprofit agencies. These resources can provide financial assistance, legal aid, help for veterans and more.

Resource

Contact

Service

(406) 444-4077

Montana's nine ADRC offices serve as a vital resource for the state's seniors and their loved ones. It provides counseling regarding assisted living, as well as other care options, and helps them choose the right facility to suit their needs. Individuals can also contact the ADRC to learn about Medicaid benefits and more ways to pay for care. Each ADRC office maintains a directory of helpful local resources for seniors, including many aimed at low-income older adults.

(406) 324-3742

(800) 273-8255 (Crisis Line)

Montana residents who served in the military can contact the Department of Military Affairs to get information on a variety of benefits they may have earned. Benefits could include disability compensation, employment assistance, tax breaks and discounted licenses for fishing and hunting. Seniors can call its 24-hour crisis line to find support for PTSD, depression and other mental health concerns.

(800) 551-3191

Statewide Area Agencies on Aging offices answer questions about long-term care, help low-income people find support and provide referrals to other local agencies residents might find helpful. AAAs serve as a point of contact for long-term care ombudsmen, who investigate and resolve complaints for people in assisted living. Many AAA services are offered at senior centers throughout Montana.

(800) 666-6899

This nonprofit organization offers free legal aid to low-income Montana residents who can't afford a lawyer by themselves. It accepts noncriminal cases, including wrongful evictions, family law, public benefits denials and other issues that may affect older adults. It also provides a directory and interactive map of self-help legal resources that are accessible to anyone regardless of income level.

(800) 551-3191

Montana's State Health Insurance Assistance Program provides free Medicare counseling that helps seniors choose the right plan for them. Counselors educate individuals on prescription drug plans, long-term care options, Medigap insurance and what to expect during the application process. SHIP counselors can assist seniors over the phone or meet with them in their homes or assisted living facilities.

COVID-19 Rules for Assisted Living in Montana

The following information is based on research done on several government websites, including dphhs.mt.gov and cdc.gov. These rules apply to nursing homes and other types of senior living facilities. We’ve most recently updated this data on 3/22/2022, but since COVID-19 is a rapidly evolving pandemic, contact your local senior living facility or Area Agency on Aging for more specific and up-to-date information.

Visitation Policies

Rules for Montana Communities

Are loved ones allowed to visit to provide emotional support?

Yes (Conditions Apply)

Are relatives allowed to visit for end-of-life care?

Yes

Are residents required to quarantine after visiting with a loved one?

No

Are visitors required to wear PPE (including masks) in order to visit residents?

Yes

Are non-medical contractors (such as hairdressers and entertainers) allowed in senior living facilities?

Yes

Are visitors checked for elevated temperatures?

Yes

Are visitors required to answer questions about health, travel, and potential virus contact?

Yes

Outings & Social Activities

Rules for Montana Communities

Are residents allowed to leave (errands, visiting family, etc.) for non-medical reasons?

Yes

Are residents who leave required to quarantine when they return?

No (Conditions Apply)

Are senior living communities required to cancel all group outings?

No

Are residents allowed to eat meals together in a common area?

Yes (Conditions Apply)

Are residents allowed to gather in common areas for group activites?

Yes (Conditions Apply)

COVID-19 Safety Measures for Staff and Residents

Rules for Montana Communities

Are staff members regularly required to do a temperature check?

Yes

Are staff members regularly tested for COVID-19?

Yes (Conditions Apply)

Are staff members members regularly required to do a health and safety screening, including questions about travel, contact with positive cases, etc?

Yes

Are residents regularly screened for COVID-19 symptoms?

Yes

Are residents regularly checked for elevated temperatures?

Yes

Are residents regularly tested for COVID-19?

Yes (Conditions Apply)

Assisted Living Laws and Regulations in Montana

In Montana, assisted facilities must comply with rules and regulations set by the Department of Public Health and Human Services. These regulations ensure quality of care by setting minimum standards for staffing, caregiver training and medical services.

MONTANA LAWS AND REGULATIONS

Assisted Living Service Plan Requirements

All assisted living facilities must conduct an assessment of each resident's needs and create an individual care plan prior to or within 60 days of admission. The plan will contain information about services to be delivered, health care practitioner information and desired outcomes, if applicable. Facilities with a Category B or C license endorsement must also conduct a resident health care assessment within 21 days of admission. Plans must be reviewed and updated annually, or whenever the resident's needs change significantly.

Assisted Living Admissions Requirements

All prospective assisted living residents must undergo an assessment to determine their eligibility for care at the facility. In general, residents must require a certain level of help with their activities of daily living (ADLs), which can include mobility, eating, bathing and getting dressed.

Assisted Living Scope of Care

Facilities are required to provide or make provisions for assistance with ADLs, help with mobility, transportation, personal care services, 24-hour supervision, assistance with self-administration of medication and help with arranging medical appointments. Depending on the facility's license, it may also provide medication administration and skilled nursing.

Assisted Living Medicaid Policy

Montana's Blue Sky Waiver Program covers the cost of assisted living services for eligible individuals. The Blue Sky Waiver can only be used with licensed assisted living facilities throughout the state.

Assisted Living Facility Requirements

No more than four residents may reside in a single bedroom in facilities licensed prior to 2004. Facilities that were licensed after 2004, or those that serve residents with severe cognitive impairment, are limited to no more than two residents per room. There must be one bathing facility for every 12 residents and one toilet room for every four residents. Apartment-style units aren't required.

Medication Management Requirements

All residents of Category A facilities must be capable of self-administering their own medication. Staff can give some assistance, including medication reminders, removing medications from secure storage, guiding the resident's hand to take medication and assisting them in drinking fluid to swallow medication. Residents of Category B and C facilities must have medications administered by a licensed health care professional, such as a licensed practical nurse (LPN), registered nurse (RN), certified nurse practitioner, physician's assistant or licensed physician.

Staffing Requirements

Montana's assisted living facilities must employ a qualified person as administrator. The administrator is responsible for the daily operations of the facility and must ensure 24-hour supervision for residents. The administrator must ensure there is sufficient staff to meet the health, safety and well-being needs of residents at all times. Category B facilities are required to employ or contract with a registered nurse for nursing assessments, health monitoring and development of resident health care plans.

Staff Training Requirements

New staff must receive training and orientation for their responsibilities and duties, which includes an overview of services provided at the facility, as well as the facility's procedures and policies manual. Annually, administrators must undergo at least 16 contact hours of continuing education relevant to their duties. All staff must be trained in basic first-aid procedures.

Background Checks for Assisted Living

Facilities must have procedures for screening, hiring and assessing staff. A facility cannot employ any individual with adverse findings in the Nurse Aide Registry, including reports of neglect, abuse, resident mistreatment or theft of resident property. 

Requirements for Reporting Abuse

All staff members of assisted living facilities are considered mandated reporters who are required to report suspected or observed neglect, abuse and exploitation. Reports must be made to the Adult Protective Services hotline at (844) 277-9300. Reports can also be submitted online.