As is the case elsewhere in the nation, the number of people with Alzheimer’s in Montana is on the rise. Montana’s population is significantly older than average, however, with almost one in five (19.3%) residents aged 65 or over. There are 22,000 seniors with Alzheimer’s in Montana as of 2020, and this number is expected to rise to 27,000 by 2025. Alzheimer’s ranks sixth in the state’s top causes of death as of 2019, with 326 residents passing away due to the disease and many more hospitalized. Montanans have access to great care at hospitals such as St. Patrick, which has high ratings in several areas of concern for seniors, but this certainly isn’t a long-term solution for those with Alzheimer’s.

Specialized help is available via memory care programs. This level of care is similar to and an extension of assisted living, and it is often provided in a separate area within such a facility. Staff provide personal assistance, supervision, meals and activities. The average monthly cost of memory care in Montana is $5,562, while the U.S. average is just $63 higher.

Memory care can be offered on its own in a community designed for those with dementia or Alzheimer’s. More often, though, it’s provided as a service in a separate wing of an assisted living facility. Memory care programs are designed specifically for those with memory impairment, and the facilities often coordinate social activities and schedules specifically for the needs of those living with Alzheimer’s or dementia.

This guide explores the cost of memory care in more detail, including the possibility of financial assistance, and also lists useful resources.

The Cost of Memory Care in Montana

Note: Memory care is most often provided in an assisted living environment and adds approximately 20-30% to the monthly bill. As such, we’ve accounted for a 25% increase in the assisted living costs reported in the Genworth Financial 2021 Cost of Care Survey.

Residential care for people with Alzheimer’s has an average cost of $5,562 per month in Montana, which is virtually identical to the national average of $5,625. All neighboring states have lower average costs — with the Dakotas each offering average savings of over $1,300 per month — although in nearby Washington the cost is roughly $2,000 higher than in Montana. The average cost in Wyoming and Idaho is lower by $350-$760 per month.

$5562

Montana

$5625

The United States

$4239

North Dakota

$4187

South Dakota

$5211

Wyoming

$4797

Idaho

$7500

Washington

Of the three cities in Montana included in the survey, Great Falls has the most affordable memory care providers at an average of $5,187 per month. Missoula is the most expensive, coming in at $250 per month higher than the state average, while memory care in Billings exceeds the average by $143. Relatively close cities in neighboring states can offer some cost relief. These cities include Idaho Falls to the south, at $4,375 per month. Across the western border in Coeur d’Alene, Idaho, however, the average cost of memory care is $5,844 per month, which is higher than any surveyed city in Montana.

$5705

Billings

$5187

Great Falls

$5812

Missoula

$4375

Idaho Falls, ID

$5844

Coeur d’Alene, ID

Memory care is one of the more expensive levels of care, at $5,562 per month, although in Montana the cost for in-home services is lower by only $223 per month and rarely appropriate for people with Alzheimer’s. Adult day care services cost less than 50% of the memory care average in Montana, but these services are likewise inappropriate for anyone with memory issues. Assisted living facilities are much more comparable, both in terms of cost and level of care. In Montana, assisted living is approximately $1,100 per month cheaper than memory care, whereas the average cost of a nursing home is $2,000 higher.

$5562

Memory Care

$5339

In-Home Care

$5339

Home Health Care

$2600

Adult Day Care

$4450

Assisted Living Facility

$7574

Nursing Home Care

Does Medicaid Cover Memory Care in Montana?

Note: For the purposes of this guide, when we say “Memory Care” we are referring to memory care provided in a “social setting,” such as an Assisted Living Facility. This is the most common way to receive Memory Care and is the best fit for all but the frailest seniors. Sometimes the actual service of memory care can be provided in a Nursing Home (“medical setting”), so the financial assistance options will be very different. To learn more about the financial assistance options available for memory care provided in a nursing home, read our guide to Nursing Home Care in Montana.

Seniors and people with disabilities in Montana who qualify for both Medicaid and its waiver program, Montana Big Sky, can receive coverage for memory care services. These programs are intended to help low-income residents pay for services that are medically necessary.

In many cases, a Medicaid recipient can qualify for additional coverage of what are often referred to as waiver services. These additional services are provided in the home of the individual or elsewhere in the community, such as assisted living and memory care, with the ultimate goal of helping them avoid premature nursing home placement. The entire bill from a memory care facility won’t be covered in any case, however, as the state Medicaid programs don’t cover the cost of room and board.

What Memory Care Services Are Covered by Medicaid in Montana

Medicaid and the Montana Big Sky Waiver Program may cover many services related to memory care. Coverage for each service is granted on an individual basis, however, which requires an assessment by physicians and/or nursing staff. The applicant must be assessed with a need for a particular service while also being financially eligible. We’ve provided a brief summary of potential coverage below.

  • Case management (long-term care planning by nurses and social workers)
  • Residential habilitation and supported living
  • Personal assistance
  • Homemaker services
  • Specially trained attendant caregivers
  • Community supports and transition
  • Accessibility adaptations and personal security/response systems
  • Health and wellness
  • Physical, speech and other therapies
  • Specialized medical equipment and supplies

The official Medicaid.gov website has a complete list of services covered by this waiver.

Memory Care Waiver Programs in Montana

Montana Big Sky Waiver Program

The Montana Big Sky Waiver gives Medicaid recipients expanded coverage of services that are deemed necessary to prevent them from being placed in a nursing home prematurely. In simpler terms, eligible seniors and people with disabilities are covered for more help in their own home or in another residential setting, which can include assisted living and memory care facilities.

Medicaid recipients who meet the additional level of care requirements can still remain where they’re living now if it’s deemed safe to do so, although people with Alzheimer’s generally need full-time residential care relatively quickly.

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

The only way to be certain of eligibility for Medicaid and the services covered by a waiver is to go through the process of applications and assessments. Generally, applicants must qualify by showing both a financial and functional need for available services.The financial eligibility requirements as of 2022 include a limit of $2,000 in assets and a maximum annual income of $10,092 for individuals. This income limit is equal to the SSI Federal Benefit Rate, which changes yearly. Depending on the particular program and service, functional eligibility requirements may include age, disabilities and other factors that cause a need for assistance.

Income Limits*

Asset Limits

Single Applicant

$10,092

$2,000

Two-Person Household (Only One Person Applying)

$10,092

$2,000 (up to $137,400 allowed for spouse)

Two-Person Household (Both People Applying)

$20,184

$3,000

*Per year

  • Aged 65+ or blind/disabled
  • Assessed with a need for services to avoid nursing home placement
  • Resident of Montana and U.S. citizen or with lawful immigration status

Recipients of Supplemental Security Income payments are automatically eligible for Montana Medicaid, although a referral is still required to access waiver services.

How to Apply for Medicaid in Montana

Applications for Montana Medicaid and waiver services can be handled by phone, at local offices or online via Cover Montana. The Cover Montana Help Line can be reached at (844) 682-6837, and its website provides detailed information and tools to estimate eligibility for various programs, as well as a locator to find in-person assistance by zip code.

What Information You Will Need

The following list provides a general outline of what to expect, but the specifics can only be determined once the application process has started. Depending on circumstances, some pieces of information may already be verified and present in the system, particularly for those receiving other state or federal assistance.

  • Valid identification of all household members (name, address, age)
  • Social Security number
  • Immigration documents (for non-citizen applicants only)
  • Documentation of income, assets and expenses
  • Information on any other current health coverage (if applicable)

All sources of income must be assessed, including SSA and SSI payments, as well as insurance policies.

How to Get Help Applying for Medicaid

There are several ways to get help with Montana Medicaid and the approval process for various services. The following programs are available statewide and offer free assistance, advice and information by phone or in person.

Program Name

Contact Information

Services Available

Call (844) 682-6837 or visit the website to find local assistance

Montanans can get in-person assistance with applications and answers to Medicaid-related questions at the local level by calling the nationwide helpline or entering a zip code on the Cover Montana website.

Call (888) 706-1535 during regular weekday business hours

The state Office of Public Assistance can help residents apply for Medicaid and other programs in Montana. Assistance is available by phone or in person at over a dozen field offices throughout the state.

Call (800) 551-3191 to speak with local counselors

Medicare beneficiaries can call Montana SHIP for free and unbiased answers and advice on benefits and other available assistance. Seniors who already have Medicare and need help applying for Medicaid and related programs can find it here.

Does Medicare Cover Memory Care in Montana?

The short answer is that no, Medicare does not cover the cost of memory care in Montana. As was mentioned above, this doesn’t apply to Memory Care received in a Nursing Home. Since it is the most common to receive memory care in a “social setting” (such as an assisted living facility), Medicare won’t be a viable financial assistance option for most seniors who need Memory Care. However, Medicare will 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 Memory Care in a nursing home, and for Medicare-related resources, see our guide to Nursing Homes in Montana.

Other Financial Assistance Options for Memory Care 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 Memory Care 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 toward paying for Memory Care.

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 Memory Care. 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 Memory Care. 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 Memory Care will not typically be eligible to sign up for a LTC insurance policy.

Free and Low-Cost Resources for Seniors in Montana

Seniors and their families can contact the following agencies and nonprofits for help with many aging-related issues, including access to memory care and how to pay for it. Eligibility begins at age 60 to 65 for many free services, while others are available to all.

Program Name

Contact Information

Services Available

Call (800) 551-3191 during regular business hours to connect with the local AAA

Help and services are available for seniors aged 60+ and people with disabilities via the state network of AAAs, which network with state and local governments to connect residents with the care they need. There are 10 offices throughout Montana and a helpline that can handle many issues and questions.

Call the national helpline at (800) 272-3900 or visit the website for local events

The Alzheimer's Association has a presence locally in several areas of Montana, where it hosts support groups and provides education and information on the disease and other types of dementia. The website has a calendar of upcoming events as well as links to clinical trials and other related news.

Call the Montana VA at (406) 324-3742

Veterans and their eligible dependents who need help accessing healthcare services, pensions and benefits should contact the Montana VA and State Veterans Benefits. Staff may be able to help over the phone or in person at offices or healthcare providers in Montana.

Call (800) 666-6899 or visit the website for applications and local office details

Low-income Montanans can receive free legal services and advice on civil legal matters, such as access to benefits and healthcare, family law and safety issues. All of the services provided by MLSA are available statewide to Montana residents who meet the income requirements.

Call the statewide office at (800) 332-2272 during regular business hours

The LTCO program provides advocacy and other support for residents of Montana's long-term care facilities, which include all licensed memory care providers. Ombudsmen can help residents understand their rights, and staff are able to file complaints, investigate the circumstances and follow up with those affected.

COVID-19 Rules for Memory Care in Montana

The following information is based on research done on several government websites, including dphhs.mt.gov/publichealth. These rules apply to nursing homes and other types of senior living facilities. We’ve most recently updated this data on 2/8/2022, 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)

Memory Care Laws and Regulations in Montana

Residential care facilities such as memory care and assisted living communities are licensed and regulated by Montana’s Department of Public Health and Human Services. Category A and Category B assisted living facilities can provide care to those living with mild to moderate Alzheimer’s disease, while Category C facilities can admit and retain residents with advanced dementia.

Memory Care Laws and Regulations in Montana

Scope of Care

All assisted living facilities may admit and retain residents diagnosed with dementia in accordance with licensing standards. Residents who require around-the-clock skilled nursing care or who are incapable of interacting with their environment may not be admitted in any Montana assisted living facility.

Care Plan Requirements

A comprehensive care plan must be prepared within 21 days of admission to a memory care program and reviewed at least once per year.

Medication Management Requirements

All prescription and over-the-counter medications must be stored in a locked container located in a secure room or locked medication cart. Caregivers in Category A and B facilities can assist with self-administration of medications, while only licensed medical staff in Category C facilities can administer medications.

Staff Screening Requirements

Facility administrators are responsible for screening all direct care staff. Screening must include background checks, verification of educational credentials and reference checks.

Staff Training Requirements

Direct care staff in all assisted living and memory care facilities must be trained in CPR and first aid as well as in the policies and procedures of the facility they work in.

Medicaid Coverage

Montana’s Big Sky Medicaid waiver benefits include memory care services, although the waiver does not cover the room and board portion of memory care and assisted living fees.

Reporting Abuse

Situations that present an immediate threat to the health and safety of any vulnerable person, including those living with memory loss, should be reported to the nearest law enforcement agency.

Frequently Asked Questions

How much does Memory Care cost in Montana?

The average cost of memory care in Montana is $4,775 per month. Actual costs vary with each facility, depending on the location, the level of care, amenities and accommodations.

Does Montana Medicaid pay for Memory Care?

Montana’s Big Sky Medicaid waiver provides a wide range of benefits, including residential memory care services, although the waiver does not cover room and board costs within a memory care or assisted living facility.

What is the difference between Memory Care and Assisted Living?

While both memory care and assisted living include room and board, recreational and social programming and 24/7 access to on-site caregivers, there are some major differences between these two types of long-term care. Memory care communities have a much higher staff-to-resident ratio than assisted living, and memory care facilities usually have a number of security features designed to keep residents safe and secure. Memory care programs also offer structured daily programs to help slow the progression of memory loss, reduce aggressive behaviors and address symptoms, such as sundowning.

What types of facilities offer Memory Care?

In Montana, memory care services are offered in assisted living facilities. Facilities that hold a Category A or Category B license may admit and retain residents who have mild to moderate dementia and who can also direct their own care. Facilities with Category C licenses may admit and retain adults who have advanced dementia and who are unable to direct their own care, but who do not require 24/7 skilled nursing care.

What are “Activities of Daily Living?”

Bathing, eating, adjusting prosthetic devices and moving about are among the activities of daily living everyone needs to do in order to maintain basic health and wellness. Also referred to as ADLs, these activities also include taking prescription medications as directed, eating and communicating.