Based on population data, Montana is home to the sixth-oldest state population in the nation. It’s home to 228,718 seniors citizens who represent about 20% of the state’s 1,068,778 residents. An aging population means there’s increasing demand for skilled nursing facilities, home health providers and other forms of long-term care. Montana currently has 70 licensed nursing homes that accommodate more than 3,776 residents at any given time.
Skilled nursing facilities provide intermediate to advanced medical care to individuals who are recovering from surgeries or medical events or are coping with multiple medical conditions. In Montana, these facilities typically charge $7,665 for a semiprivate room and $8,273 for a private room, which is slightly less than the national average.
This guide explores the cost of nursing homes in Montana as well as possible alternatives. It also takes a look at Medicaid long-term care benefits, financial assistance programs, nonprofit resources and state regulations that govern skilled nursing facilities. These materials are designed to help you make an informed decision regarding your current or future needs.
According to Genworth Financial’s Cost of Care Survey for 2020, a semiprivate room in a Montana nursing home costs $7,665 per month, which is $91 less than the U.S. median of $7,756. Montana performs favorably when compared to most neighboring states, excluding South Dakota where average rates are about $650 lower. Seniors in Wyoming pay almost $600 more per month of care, and rates are approximately $1,000 higher in Idaho, coming in at $8,669. With an average cost of $12,167 per month, nursing homes in North Dakota are 58% more expensive, which equates to a monthly price difference of $4,502.
Nursing homes in Montana’s largest cities typically charge anywhere from $7,756 to $9,429 per month. Rates are on par with the U.S. average in Billings at $7,756. Great Falls is moderately more expensive at $9,125, which is almost 20% more than the state median, and at $9,429, rates in Missoula exceed the state median by $1,764, or 23%. Rapid City, South Dakota, is one of the most affordable metropolitan areas in the Northern Plains at $7,452. Nursing home rates in other major cities, including Casper, Idaho Falls and Bismarck, exceed the state median by $791 to $2,981.
Missoula
$9429
Great Falls
$9125
Billings
$7756
Casper, WY
$8456
Idaho Falls, ID
$9064
Bismarck, ND
$10646
Rapid City, SD
$7452
With an average monthly cost of $7,665, skilled nursing is the most expensive form of long-term care in Montana by a significant margin. In-home care provided by homemakers or home health aides costs $5,138, or $2,527 less per month. Assisted living is more affordable still at $4,213, which represents an estimated monthly savings of $3,452. Adult day care costs about half as much as assisted living at $2,115. However, the services that these community-based facilities provide are minimal, especially when compared to nursing homes.
In-Home Care
$5138
Home Health Care
$5138
Adult Day Care
$2115
Assisted Living Facility
$4213
Nursing Home Care
$7665
In Montana, people aged 65 and older make up 19.3% of the population, and on average, about 7,800 of these seniors are enrolled in Medicaid every month. Many of these older adults are on Medicaid because they require care in a nursing home. Using both state and federal funding, Montana Medicaid covers the cost of room and board in these facilities, including a private room when deemed medically necessary. Medicaid covers many care services within these communities, including activities programs, local transportation, light housekeeping and social programs. Medicaid can also cover the cost of skilled nursing services in community settings. Seniors account for 5% of total Medicaid enrollment in the state.
There are 71 licensed nursing facilities in Montana with a total bed capacity of 6,274. The state determines the number of beds, including swing beds, needed every year in its Long-Term Care Facilities Plan. The trend in Montana is moving away from nursing facilities and into aging in place, and Medicaid helps pay for this transition through the Big Sky Waiver. In addition to skilled nursing, the waiver covers a wide range of supportive services, therapies, modifications and case management services.
Seniors in Montana who require a nursing home level of care and earn less than what that care costs are eligible for Medicaid coverage. There are also financial limits on the assets you can hold, excluding your home and vehicle. A single applicant can’t have more than $2,000 in assets, and a couple can’t have more than $4,000. When only one person in a married couple is applying, the asset limit is $137,400.
2022 Basic Medicaid Income Limits for Seniors in Montana
| Annual income limits | Asset limits | |
|---|---|---|
| Single Applicant | Less than nursing home costs | $2,000 |
| Two-Person Household(Only One Person Applying) | Less than nursing home costs | $2,000 for applicant $137,400 for non-applicant |
| Two-Person Household (Both People Applying) | Less than nursing home costs | $4,000 |
In addition to the financial requirements, the Medicaid applicant must need the level of care offered by licensed nursing facilities in the state. This is determined by a care assessment performed by Mountain Pacific Quality Health (MPQH). Your loved one must also:
You can apply for Montana Medicaid by visiting https://apply.mt.gov. You’re required to create an account. If you prefer to apply over the phone, you may call (888) 706-1535. You can also visit your local benefits field office and speak with a Medicaid representative in person.
Information You Will Need
Before you begin the Medicaid application process, make sure you have the following information available:
Montana seniors who need help applying for Medicaid or with their existing benefits can contact the following organizations for assistance. These resources are funded by the state and federal government, and they’re free at the point of service.
| Resource | Contact | Service |
|---|---|---|
| Montana ADRC | (800) 551-3191 | The Aging and Disability Resources Center in Montana can help you find local Medicaid providers and other Medicaid resources in your community, including licensed nursing homes, in-home care providers and other forms of long-term care. The ADRC offers direct assistance with long-term planning through its Montana Options Counseling service. It also offers vouchers to family caregivers who could benefit from the Montana Lifespan Respite Coalition. |
| Benefits.gov | (800) 362-8312 | Benefits.gov is a federal resource that provides basic information about Medicaid in each state, including Montana. You can learn more about eligibility requirements, what's covered and what other benefits may be available to your family. You can get assistance for your loved one online or over the phone. The hotline is free of charge. |
| Field Offices of Public Assistance | (888) 706-1535 | Montana DPHSS operates 19 Field Offices for Public Assistance throughout the state. These offices can help your loved one apply for Medicaid or a Medicaid waiver as well as other benefit programs offered by the state, including food stamps and cash assistance. You can call your local office for assistance or visit in person with an eligible family member if able. |
Medicare provides limited coverage for short-term stays in a skilled nursing facility following a hospital stay, but seniors must meet a number of specific requirements. This benefit is available to beneficiaries who have been hospitalized for at least three days, excluding the date of discharge, so it’s most valuable for those who are recovering from an injury, illness or surgery.
Once seniors meet the hospitalization requirement, Medicare will pay for up to 100 days of skilled nursing per benefit period. The first 20 days are covered in full. Starting on day 21, beneficiaries must pay a daily coinsurance rate. After day 100, seniors are responsible for the entire cost.
What Does Medicare Cover?
Medicare covers a number of specific services, including:
What Isn’t Covered by Medicare?
Medicare does not cover long-term custodial care that addresses seniors’ day-to-day needs. This includes help with daily activities, such as bathing, dressing and using medical equipment.
For more information about Medicare and when it covers Nursing Home Care, read our Guide to Nursing Homes.
The following resources can help you resolve many issues related to Medicare, including problems you may have with a provider or answers to questions about coverage options. The services listed are provided free of charge.
| Program | Contact | Service |
|---|---|---|
| Kepro | (888) 319-8452 | Montana is included in Region 1 of the Beneficiary and Family Centered Care-Quality Improvement Organization BFCC-QIO (KEPRO). It can help your Medicare beneficiary appeal the termination of care or file a complaint about a Medicare provider. It also offers a variety of informational resources that can help you make smart decisions about long-term care for your family. |
| State Health Insurance Assistance Program (SHIIP) | (800) 551-3191 | You can contact SHIIP for free health benefits counseling and advocacy whether you're a Medicare beneficiary or a family member of a beneficiary. Counselors provide unbiased assistance aimed to help you get the most out of your Medicare benefits, including access to long-term care options. SHIIP counselors are highly trained and knowledgeable professionals who know how to be objective. |
| Medicare.gov | (800) 633-4227 | Visit Medicare.gov to learn all about what benefits your loved one has access to and whether there are supplemental options that meet their needs. You can get a lot of information by browsing the site or calling their helpline. There are also live chat representatives available 24/7 to answer any questions you might have about the Medicare system and how it relates to nursing homes and long-term care. |
While Medicaid and Medicare are two of the most common programs used to pay for Nursing Home Care, there are other financial assistance options available, depending on your unique situation.
| Name | 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 skilled nursing 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 nursing 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 skilled nursing 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 skilled nursing care will not typically be eligible to sign up for a LTC insurance policy. |
Seniors who need help beyond the scope of Medicare and Medicaid may find some of the following free and low-cost resources helpful. Many of these organizations rely on volunteers and funding from the government.
| Resource | Contact | Service |
|---|---|---|
| Adult Resource Alliance | (406) 259-9666 | Adults Resource Alliance (ARA) may be able to help seniors at risk of nursing home placement find the services they need to remain at home or in a community setting. Its Meals on Wheels program delivers food to seniors aged 60 and older who can't obtain their own meals, and the transportation service brings seniors to and from medical appointments and other important activities. These services are available to people in the Billings, Lockwood, Laurel and Worden areas. |
| Disability Rights Montana | (800) 245-4743 | Disability Rights Montana advocates for the interests of Montana residents who have disabilities, including those who need to stay in a nursing facility or are at risk for nursing home placement. Its services include the Client Assistance Program, Protection & Advocacy to Receive Assistive Technology, Protection & Advocacy for Beneficiaries of Social Security and Protection & Advocacy for Individual Rights. |
| Montana Area Agencies on Aging | (800) 551-3191 | The Area Agencies on Aging for Montana are divided into 10 regions. Each regional office is responsible for delivering service beneficial to seniors in nursing homes and other settings. One of these is the Long-Term Care Ombudsman program, which addresses reports of abuse in nursing homes and advocates for the rights and interests of seniors in long-term care. Contact your local AAA to see if you can access home-delivered meals, respite skilled nursing, legal aid, transportation and other available services. |
| Montana Veteran Affairs Division (MVAD) | (406) 324-3742 | This state-operated program helps veterans obtain their federal VA benefits so they can pay for nursing care and other needs, such as the Aid & Attendance benefit mentioned above. Veterans and eligible beneficiaries can get help over the phone or visit MVAD office locations in Belgrade, Billings, Butte, Great Falls, Havre, Helena, Kalispell, Miles City and Missoula. |
| Topic | Rule |
|---|---|
| Licensing | Long-term care facilities that provide intermediate or skilled nursing are licensed by the Montana Department of Public Health and Human Services, Quality Assurance Division, Licensure Bureau. |
| Staffing | Skilled nursing facilities must meet strict minimum staffing standards for RN, LPN or CNA care based on the number of licensed beds. Minimum requirements may vary for day, evening and night shifts. |
| Staff Training | Nursing homes in Montana may employ qualified nurses and certified nursing assistants who have completed at least 75 hours of training with at least 16 hours of clinical experience. These standards are consistent with federal minimums established by Medicare. |
| Admission Restrictions | Health care facilities that provide skilled nursing must have written policies and procedures for resident admission. Before admitting a resident, the facility must perform a comprehensive needs assessment to determine whether the applicant can be accepted through one of the three admission categories or through an exemption. Prospective residents have a right to appeal a denial by paying a $100 fee for an independent needs assessment. |
| Care Planning | Health care facilities must prepare an individualized service plan for each resident. The initial plan must be reviewed within 60 days of admission or more often if required by the resident's admission category. The plan of care must describe all of the services that the resident will receive as well as the name and type of provider, treatment goals and other pertinent details. |
| Dietary and Nutrition Services | Skilled nursing facilities must follow strict standards for planning, preparing and serving resident meals. Facilities must provide at least three properly timed meals that are nourishing and well-balanced and accommodate residents' dietary needs or preferences. Facilities must employ a full-time dietitian or a similarly qualified professional to prepare menus according to nationally recognized nutritional standards. |
| Specialized Rehabilitative Services | Nursing homes may provide physical therapy and other forms of restorative or rehabilitative care as directed by a physician. |
| Medication and Pharmaceutical Services | Skilled nursing facilities must provide all routine and emergency medications as required by residents. Prescriptions can be filled by an in-house pharmacy or by a contracted provider. The facility must maintain comprehensive medication records for each client, and a qualified pharmacist must review each resident's medication regimen at least four times per year. |
| Activities | Facilities must maintain at least one centrally located common area designed for recreational activities and socialization. |
| Infection Control | When providing personal care, nursing homes must take steps to minimize accidents, injuries and infections. Health care facilities must have written policies and procedures to prevent the transmission of communicable diseases. These policies must include protocols for hand washing, hazardous waste disposal, employee screening and caring for residents who have or are suspected of having communicable diseases. |
| Medicaid Coverage | Montana Medicaid offers long-term care benefits to individuals who require nursing home care and use all of their income, excluding a personal needs allowance, to pay for these services. |
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