Does Montana Medicaid pay for assisted living?
Yes, for the care part. In Montana, Big Sky Waiver (BSW) can pay for care in assisted living. Rent and meals are generally paid by the resident. There can be a waitlist.
Montana · checked September 2026
Senior care help in Montana
How Montana helps pay for long-term care, who to call when you need help or something's wrong, and how to check a facility before you sign.
The first question
Is there public help paying for assisted living in Montana?
Yes, for the care. Big Sky Waiver (BSW) helps pay for care in assisted living. Rent and meals are usually still paid by the resident, often from Social Security. There can be a waitlist, so ask to be screened early, before savings run out.
Paying for senior care in Montana
Montana's Medicaid rules for long-term care, and the programs that pay for care outside a nursing home.
Monthly income limit
Ask the state Medicaid office
2026
Montana has no hard income cap for nursing home or waiver Medicaid. It is a medically needy (spend-down) state: the medically needy income level is $525/month for a household of 1 or 2 (DPHHS Table of Standards, current as of 01/01/2026), and income above that is spent down on medical or care costs. In a nursing home, most of the resident's income goes toward the cost of care.
Asset limit (single person)
$2,000
2026
Aged, blind and disabled limit: $2,000 individual, $3,000 couple (DPHHS Table of Standards, current as of 01/01/2026). When one spouse needs care, the at-home spouse may keep the greater of half the couple's countable resources (up to $162,660) or $32,532 (2026). A home, one vehicle and burial funds can be exempt under certain rules.
If income is over the limit
Montana doesn't use a hard cap. People over the limit can qualify by paying most of their income toward their care (a spend-down).
Look-back on gifts and transfers: 60 months.
Apply for Montana Medicaid
Montana Department of Public Health and Human Services (DPHHS)
Big Sky Waiver (BSW)
Can pay in assisted livingMontana's main Medicaid program for people who need nursing-home-level care but want to live at home or in assisted living. It can pay for care services in assisted living (called Adult Residential Living) plus in-home help, adult day health and respite, but not rent and meals. To start, call Mountain Pacific for a screening.
Waitlist: Yes. DPHHS says the Big Sky Waiver currently has a waiting list; no length is published. Get on the list early.
Community First Choice Services / Personal Care Services (CFCS/PCS)
Not for assisted livingMedicaid help with bathing, dressing, eating, medications and other daily tasks at home. You can use an agency or self-direct and hire your own caregiver, including an adult child. CFCS requires nursing-home-level need.
Waitlist: No waitlist mentioned on the DPHHS page.
State supplement to SSI
Montana pays a small state-funded addition to SSI for people living in assisted living or other designated residential care. Ask for the current amount when you apply.
PACE (all-inclusive care for 55+)
We didn't find any PACE programs operating in Montana.
Who to call in Montana
Free, and on your side. Start with the aging office if you don't know where to begin.
DPHHS Senior and Long Term Care Division, Office on Aging
Start hereThe state's aging office and its local agencies explain your options, screen for programs and help with applications.
Montana Long-Term Care Ombudsman Program (DPHHS Office on Aging)
A free, independent advocate for residents of nursing homes and assisted living. Call about any problem with care, rights, billing or a discharge.
Report abuse, neglect or exploitation
Adult protective servicesYou don't need proof to report. If someone is in immediate danger, call 911.
Montana SHIP (State Health Insurance Assistance Program), through the Area Agencies on Aging
Unbiased Medicare help from counselors who don't sell anything: plans, bills, appeals, and programs that lower costs.
How to check a Montana assisted living or nursing home
In Montana, assisted living is licensed as: Assisted Living Facility (licensed in Categories A, B and C). Read inspection reports before you sign anything.
DPHHS Office of Inspector General, Licensure Bureau
Confirm a community's license here, and ask the agency how to see its inspection reports.
File a complaint
Nursing homes
Medicare rates every nursing home on staffing, inspections and quality, with full inspection reports.
Montana veterans homes and benefits
State veterans homes are often far cheaper than private care for eligible veterans and, in many states, their spouses.
Montana Veteran Affairs Division (MVAD)
Free legal help and paperwork in Montana
DPHHS Aging and Disability Legal Assistance Program (free for 60+ and adults with disabilities)
Free legal help for older adults on issues like benefits, housing, powers of attorney and elder abuse.
Documents and forms
Montana help for caregivers and people with dementia
Can a family member be paid to provide care? Yes, in some programs.
Yes. Under self-directed Community First Choice or Personal Care Services, a Medicaid member can hire a relative such as an adult child as the paid caregiver. Spouses can be paid only in limited cases (care beyond what a spouse normally provides, up to 40 hours a week).
Respite Care for Alzheimer's Disease Caregivers
Short breaks for family members caring for someone with Alzheimer's or dementia, arranged through the Area Agencies on Aging.
TCARE (Tailored Caregiver Assessment and Referral)
A structured check-in for family caregivers that measures stress and points you to services that fit your situation.
Respite Care for Alzheimer's Disease Caregivers
State-supported respite for families caring for a person with Alzheimer's or another dementia, through the local Area Agency on Aging.
More help in Montana
Montana End-of-Life Registry
A free, secure state registry where you can store an advance directive so doctors and hospitals can find it.
Montana senior care questions
What is the Medicaid asset limit in Montana?
$2,000 for a single person (2026). Aged, blind and disabled limit: $2,000 individual, $3,000 couple (DPHHS Table of Standards, current as of 01/01/2026). When one spouse needs care, the at-home spouse may keep the greater of half the couple's countable resources (up to $162,660) or $32,532 (2026). A home, one vehicle and burial funds can be exempt under certain rules.
Who do I call with a complaint about an assisted living or nursing home in Montana?
The Montana Long-Term Care Ombudsman Program (DPHHS Office on Aging): (800) 332-2272. It's free and independent.
National help that works in Montana too
Senior living in Montana cities
Senior care guides for other states
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Researched from 36 sources, official pages first. Last checked .