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.

The Cost of Nursing Home Care in Montana

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.

$7665

Montana

$7756

The United States

$8669

Idaho

$8258

Wyoming

$12167

North Dakota

$7011

South Dakota

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.

$9429

Missoula

$9125

Great Falls

$7756

Billings

$8456

Casper, WY

$9064

Idaho Falls, ID

$10646

Bismarck, ND

$7452

Rapid City, SD

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.

$5138

In-Home Care

$5138

Home Health Care

$2115

Adult Day Care

$4213

Assisted Living Facility

$7665

Nursing Home Care

Does Medicaid Cover Nursing Home Care in Montana?

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. 

Medicaid Eligibility in Montana

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 Medicaid Income Limits for Seniors in Montana

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:  

  • Be a resident of Montana
  • Be a U.S. citizen or documented resident
  • Be aged 65 or older 

How To Apply for Medicaid in Montana

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:

  • Social Security number
  • Proof of Montana residency
  • Proof of age, such as a birth certificate
  • Financial information, such as bank account and investment statements 
  • Insurance information, including policy numbers and benefit amounts
  • Property deeds
  • Financial information for other household members

Additional Medicaid Support & Resources in Montana

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

(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. 

(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. 

(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. 

Does Medicare Cover Nursing Home Care in Montana?

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:

  • Meals
  • A semiprivate room
  • Medications
  • Skilled nursing
  • Physical therapy
  • Occupational therapy
  • Speech therapy
  • Audiologist care
  • Medical supplies
  • Medical social services
  • Nutritional counseling
  • Ambulance transportation

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.

Medicare Support & Resources in Montana

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. 

Resource
Contact
Service

(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. 

(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.

(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. 

Other Financial Assistance Options for Nursing Home Care in Montana

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.

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.

Free and Low-Cost Resources for Seniors in Montana

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

(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. 

(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. 

(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.

(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.

COVID-19 Rules for Nursing Homes in Montana

The following information is based on research done on several government websites, including dphhs.mt.gov/publichealth. These rules apply to Independent Living Communities 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)

Nursing Home Laws and Regulations in Montana

Nursing Home Laws and Regulations in Montana
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.