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Assisted Living in Montana

As one of the most tax-friendly states in the country, Montana has no state sales tax, personal income tax limits are capped at 6.75%, federal taxes can be deducted from state taxes and certain parts of Social Security and pension payments aren’t taxed at all. This tax-friendly climate combined with open spaces, abundant natural beauty, plenty of fresh air and low population density makes Montana a desirable retirement destination for those who enjoy life off the beaten track. With 19.3% of the overall population of Montana age 65 and over, those who choose to retire to the Big Sky State will be able to find plenty of friends in the same age range. 

The average cost of assisted living in Montana is $4,450 per month, although costs vary depending the town or city, the location within those communities and the amenities and services individual facilities provide. 

How Much Does Assisted Living Cost in in Montana?

According to the 2021Genworth Cost of Care Survey the average monthly cost of assisted living in Montana is $4,450, which is just slightly under the national average of $4,500. Prices drop to $3,838 next door in Idaho and even farther to $3,391 to the east in North Dakota. Residents of assisted living facilities in Wyoming pay an average of $4,169 per month, while their counterparts in Utah pay an average of $3,500. The least expensive assisted living costs in the region are found in South Dakota at $3,350.

$4450

Montana

$4500

The United States

$3838

Idaho

$3391

North Dakota

$4169

Wyoming

$3500

Utah

$3350

South Dakota

The Cost of Assisted Living in Montana’s Top Cities

Montana is a sparsely populated state that doesn’t see much variation in the assisted living costs in its major cities. Assisted living in Montana’s largest city, Billings, averages $4,564, while those in the second largest city, Missoula, pay an average of $4,650. Great Falls residents pay the Montana’s lowest costs at $4,150, while their counterparts near the Montana border in Idaho Falls, ID, pay a lower average of $3,500. Prices are a little higher over the southeast border in Rapid City, SD, at $3,914, and over the southeastern board in Casper, WY, seniors pay more than the Montana state average: $4,844.

$4564

Billings

$4650

Missoula

$4150

Great Falls

$3500

Idaho Falls, ID

$4844

Casper, WY

$3914

Rapid City, SD

The Cost of Assisted Living vs. Other Types of Care

The average cost of adult day health care in Montana $2,600 per month, which is neary $2,000 less than the average price tag of assisted living throughout the state. The average cost of a home health aide in Montana is $5,339 per month, and the average cost of homemaker services is also $5,339. Montana residents in nursing homes pay $7,574 per month for a semiprivate room. 

$4450

Assisted living

$2600

Adult day health

$5339

Home health aide

$5339

Homemaker services

$7574

Nursing home (semiprivate room)

Can You Use Medicaid to Pay for Assisted Living in Montana?

Medicaid does not directly fund assisted living in Montana but instead provides assistance in the form of a waiver to those who meet income guidelines and residency requirements. This waiver is called the Montana Big Sky Medicaid Waiver

Medicaid’s Coverage of Assisted Living in Montana

The Big Sky Waiver allows those requiring a nursing home level of care to receive a range of services designed to allow them to remain living in their own communities, including assisted living facilities. Services include assistance with the routine aspects of daily living, such as getting dressed, basic grooming and bathing or showering, homemaking and financial help paying for minor home modifications Under this program, recipients can choose their own caregivers as long as they are qualified to provide care under state regulations.

Waiver Programs for Assisted Living in Montana

Big Sky Waiver 

The Big Sky Waiver is for seniors who are either medically or financially needy. Specifically, seniors must be: 

  • Financially eligible for standard Medicaid 
  • At least 65 years of age 
  • Physically disabled per the criteria of the Social Security Administration
  • Assessed to need one or more BSW services
  • Require a nursing home level of care

There are 35 covered services, including

  • Case management
  • Non-medical transportation
  • Occupational therapy 
  • Physical therapy
  • Post-Acute Rehabilitation Services
  • Specialized Medical Equipment

Seniors can apply on the state’s website or call 800-219-7035. 

Eligibility for Medicaid in Montana

2022 Medicaid Income Limits for Seniors in Montana



Income limits* Asset limits*
Single Applicant $10,092$24,000
Two-Person Household (one person applying)$10,092$24,000 for individual applicants$137,400 for non-applicants 
Two-Person Household (both people applying) $20,184$48,000

* Per year

Applying for Medicaid in Montana

Applicants for Medicaid in Montana can apply in person, online or by phone. The most convenient way for most to apply is to visit heathcare.gov.

Applicants can also apply by phone by calling 1 800-318-2596 or in person by visiting their local Department of Health and Human Service Office. Those who are unsure of where the closest office is located can find this information on covermt.org.

Where to get help

Those who need assistance applying for Medicare in Montana can contact the Public Assistance Helpline at 888-706-1535 or visit covermt.org to find in-person help. 

Can You Use Medicare to Pay for Assisted Living in Montana?

Unfortunately, Medicare does not cover the cost of assisted living in Montana. Unlike nursing homes, assisted living facilities are not considered to be “clinical settings’ and so are not eligible for Medicare coverage. That being said, you can still use Medicare to cover the cost of approved medications, doctor visits, medical equipment, etc.

For more information about what Medicare visit medicare.gov.

Are There Other Financial Assistance Options for Assisted Living in Montana?


How to ApplyHow It Works
Aid and AttendanceApply online at va.gov.If you are a veteran and you receive a VA pension, you may also be eligible for the Aid and Attendance benefit. This benefit takes the form of a monthly cash allowance that you receive in addition to your standard pension. This benefit is used by veterans who need long-term care services, including care received at an assisted living facility.
Reverse MortgagesResearch and learn about the different types at ftc.govIf you own a home, you may be able to use a reverse mortgage to access some of the equity in your home. Like traditional loans, reverse mortgages do need to be repaid with interest, typically within 12 months, so seniors should carefully weigh this option alongside other financing methods.
Long-Term Care (LTC) InsuranceLearn about how to receive LTC insurance benefits at acl.gov.While those who currently need assisted living will typically not be eligible, if you purchased an LTC insurance policy in the past, you may be able to use it to help pay for assisted living. While most policies cover at least a portion of the cost, you still need to check the specific terms of your policy.

Free and Low-Cost Resources for Seniors in Montana

There are several free and low-cost programs for Montana seniors to receive help on variety of topics relating to healthcare, finances, legal and tax issues and veterans affairs. See below for some helpful resources. 

Resource Contact Service 
Senior and Long-Term Care Division (406) 444-4077As the Area Aging on Aging for Montana, Senior and Long-Term Care Division of the Montana Department of Public Health and Human Services provides seniors, their families and their caregivers with information, education and assistance. These services are designed to promote independence among older persons and facilitate a good quality of life. Services include finanical planning, case management, health and wellness screenings and Medicare and Medicaid counseling. 
Montana Long-Term Care Ombudsman Program(800) 551-3191The Montana Long-Term Care Ombudsman Program is designed to safeguard the legal rights of all residents of long-term care facilities, including assisted living communities. Besides investigating complaints of verbal, physical and emotional abuse, the program also provides community education and advising those in these facilities on how to set up resident councils. All services are confidential and completely free of charge. 
Montana Veterans Affairs(406) 542-2501The Montana Veterans Affairs Division helps veterans of all branches of the U.S. Armed Forces, their immediate families and survivors access service-based state and federal entitlements. Qualified veterans also receive discounts on hunting and fishing licenses and free vehicle registration and license plates. 
Aging Horizons(800) 332-2272Aging Horizons is a weekly television program produced by the Montana Department of Public Health and Human Services that provides information on various issues surrounding aging. Topics include health and wellness, Social Security, Medicaid and Medicare, assisted living, tax credits, reverse mortgages, veterans benefits and more. Aging Horizons also sends out a newsletter three or four times per year with information about aging-related events and issues in Montana. 

COVID-19 Rules for Assisted Living in Montana

The following information is based on research done on several government websites, including dphhs.mt.gov/publichealth and cdc.gov/coronavirus. 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.

Visiting Loved Ones

Can I visit my relative in person if he/she wants emotional support from me?Yes (Conditions Apply)
Can I visit my relative in person for end-of-life compassion care?Yes
Will my loved one be required to self-quarantine after I visit him or her?No
Do I need to wear PPE and/or a cloth mask if I do visit my relative in person?Yes
Are Hairdressers and other non-medical contractors still allowed in senior living facilities?Yes
Does the state recommend or require that senior living facilities assist families with setting up virtual visit alternatives? Yes
Are visitors being screened for elevated temperatures?Yes
Are visitors being asked questions about health, travel, and potential virus contact?Yes

Outings and Group Activities

Are residents allowed to leave the facility for non-medical reasons?Yes
Are residents of senior living facilities who leave and return required to self-quarantine?No (Conditions Apply)
Are senior living facilities required to cancel all group outings?No
Are residents still eating together in the dining hall?Yes (Conditions Apply)
Are facilities still allowed to host group activities within the community?Yes (Conditions Apply)

Safety Measures for Staff & Contractors

Are staff members and contractors being screened for elevated temperatures?Yes
Are staff members and contractors being tested for Coronavirus?Yes (Conditions Apply)
Are staff members and contractors being asked questions about health, travel, and potential virus contact?Yes

Safety Measures for Residents

Are staff members required to regularly screen residents for coronavirus symptoms?Yes
Are residents relied on to screen themselves and self-report potential coronavirus symptoms?No
Are staff members required to take residents’ temperatures?Yes
Are residents being tested for coronavirus?Yes (Conditions Apply)

Assisted Living Laws and Regulations in Montana

Assisted living communities and other long-term care facilities in Montana are regulated and licensed by the Montana Department of Public Health and Human Services. These facilities are required to abide by all applicable local, state and federal laws regarding staffing, medication, accomodations and anything else relevant to their operations.  

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