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Assisted Living Montana
Known for its wide-open spaces and rugged natural beauty, Montana is one of the most popular states to live in for the nation’s retirees. It boasts the sixth-highest senior population in the country, with more than 19% of residents aged 65 and up. Montana’s many small cities and towns offer seniors a strong sense of community paired with the laid-back pace of country living.
Montana was ranked 26th in the nation in the 2024 Senior Living Report, scoring high marks in categories such as Health Care and Community Involvement. Seniors throughout the state have access to top-rated hospitals such as Providence St. Patrick and Benefis Health System. The state scored lowest in the Affordability category, but Montana’s assisted living prices are slightly cheaper than the national average, and a lack of sales tax can help seniors keep more money in their pocket.
This guide covers the cost of assisted living in Montana compared to nearby states, plus average prices for other types of care. It also gives an overview of financial assistance options, helpful resources and regulations for care facilities throughout the state.
The Cost of Assisted Living in Montana
When trying to decide how to pay for assisted living, one of the first questions that comes up is "How much does it cost?" With the impact of inflation, it's more important than ever to have up-to-date information when making a financial plan for senior living. To help shed light on real senior living prices, Caring.com has compiled proprietary cost data from its network of over 75,000 senior living providers to offer insight into the average cost of assisted living in Montana and its 6 cities.
According to the Genworth 2021 Cost of Care Survey, assisted living in Montana costs an average of $4,450 per month, which is $50 less than the national average of $4,500. It’s one of the priciest states for care compared to surrounding states, though. On average, seniors pay $3,838 in Idaho, $4,169 in Wyoming, $3,350 in South Dakota and $3,391 in North Dakota.
The Cost of Assisted Living in Montana's Top Cities
Assisted living prices in Montana fluctuate based on city of residence. In Bozeman, seniors pay about $5,968 per month, while those in Missoula can access care for $4,575. Prices are higher in Billings, where care costs average $6,615, but significantly lower in Great Falls, offering assisted living for $2,800.
Montana
$5,257
Bozeman
$5,968
Missoula
$4,575
Billings
$6,615
Great Falls
$2,800
Inflation's Impact on the Cost of Assisted Living in Montana
Due to inflation, assisted living costs in Montana continue to rise. Prices rose from $5,038 to $5,257, an increase of 4.3%, between 2022 and 2023, and are projected to rise another 6.5% in 2024 to $5,599. This is lower than the United States overall increase of 9.6%, bringing costs to $4,459 in 2023. Many surrounding states are also feeling inflation's effects. For example, North Dakota experienced an increase of nearly 14%, while Wyoming saw a jump of 26.8%. Although costs increased in Idaho by 13.6%, they decreased in South Dakota by 1.6%.
| Location | 2022 Cost (Historical) | 2023 Cost (Current) | 2024 Cost (Estimated) |
|---|---|---|---|
| Montana | $5,038 | $5,257 | $5,599 |
| U.S. Average | $4,070 | $4,459 | $4,802 |
| North Dakota | $3,047 | $3,472 | $3,653 |
| Wyoming | $3,944 | $5,000 | $5,325 |
| Idaho | $3,864 | $4,388 | $5,122 |
| South Dakota | $4,514 | $4,443 | $4,732 |
The Costs of Other Types of Senior Living
Prices also vary depending on care type due to the level of care, amenities and services offered. While seniors pay about $5,257 for assisted living, memory care has a higher monthly rate of $5,822, while independent living is more affordable at $2,714.
Assisted Living
$5,257
Memory Care
$5,822
Independent Living
$2,714
Does Medicaid Cover Assisted Living in Montana?
While Medicaid doesn’t directly cover the cost of assisted living in Montana, certain seniors may be eligible for the Big Sky Home and Community Based Services Waiver Program. The Big Sky Waiver is a Medicaid-based program that covers the cost of care in approved assisted living facilities throughout the state. It’s open to people who meet income and asset eligibility requirements, which can make assisted living accessible for retirees of limited financial means.
What Assisted Living Services Are Covered by Medicaid in Montana?
Montana’s Senior & Long-Term Care Division (SLTC) and Department of Public Health & Human Services (DPHHS) cover a number of assisted living services for qualifying residents. Services are limited to those approved by the resident’s care plan, and can include:
- Personal assistance with activities of daily living
- Medication assistance and administration
- Other health and nursing services
Assisted Living Waiver Programs in Montana
Big Sky Home and Community Based Waiver Program
The Big Sky Waiver Program allows eligible seniors, who would otherwise require institutionalization, to receive care in their home or an approved assisted living facility. Services are provided by a case management team consisting of social workers, nurses and other medical professionals. Montana’s case management teams can only serve a certain number of people each year, so program applicants may be placed on a waiting list before they can receive assistance. Services that may be provided by the Big Sky Waiver include:
- Adult day health care
- Adult residential living
- Case management
- Chemical dependency counseling
- Dietitian and nutrition counseling
- Personal assistance
- Private duty nursing
- Personal emergency response system
- Physical, speech and occupational therapies
- Transportation
- Specialized medical equipment and supplies
To qualify for the Big Sky Waiver, seniors must meet the minimum level of care requirements for nursing home placement and be eligible for Medicaid in Montana. Seniors can determine their eligibility and start the application process by contacting Mountain Pacific Quality Health at (800) 219-7035.
How To Know If You’re Eligible for Medicaid in Montana
Eligibility for Medicaid is determined by the Montana Department of Public Health & Human Services. In Montana, any aged, blind or disabled individual who qualifies for Supplemental Security Income (SSI) is automatically eligible for Medicaid. In general, seniors may be eligible for Medicaid if they are:
- 65 years older and up
- In need of medical care
- Blind or disabled
- Low-income
As of 2023, single applicants must have a pre-tax income of $10,968 per year or less ($941 per month) and assets valued at $2,000 or less.
| Household Size | Number of Applicants | Income Limits Per Year* | Asset Limits: Applicant(s) | Asset Limits: Non-Applicants |
|---|---|---|---|---|
| One Person | 1 | $10,968 | $2,000 | |
| Two People | 1 | $10,968** | $2,000 | $148,620 |
| Two People | 2 | $21,936*** | $4,000**** |
*Depending on the facility setting, a recipient may not be able to keep income up to this level.
**Income limit is for applicant only.
***Income is limited to $914 per month per spouse.
****Assets are limited to $2,000 per spouse
In addition to these income and asset limits, seniors must meet additional requirements to receive services under the Big Sky Medicaid Waiver Program. They are required to undergo a medical assessment that demonstrates a level of impairment that would otherwise require placement in a nursing home facility. Applicants can demonstrate this need if they require help with:
- Medication administration
- Personal care
- Instrumental activities of daily living, such as eating, grooming, toileting and dressing
How to Apply for Medicaid in Montana
Seniors can apply for Medicaid through HealthCare.gov. To apply by phone, call (800) 318-2596.
Information You Will Need
The following information is required to apply for Medicaid in Montana:
- Name, birth date, address and contact information for everyone in the applicant’s household
- Information about current health care coverage for household members, including Medicare, coverage through an employer or through a spouse’s employer
- Income information for everyone in the household
- Information about SSI/SSA payments
- Social Security Number and/or immigration documents, for applicants only
How To Get Help Applying for Medicaid
Montana’s seniors can get free Medicaid counseling and other types of assistance through one of several resources and programs. These resources help Montanans learn about benefits, find the right plan and appeal Medicaid applications that have been denied.
| Program | Contact | Services provided |
|---|---|---|
| Information, Assistance and Referral (I & A/R) | (800) 551-3191 | Managed by the Montana Office of Aging, this statewide program provides free assistance to help seniors understand Medicaid benefits, eligibility requirements and what they'll need to apply. It also maintains a directory of current Medicaid providers throughout the state. |
| Long-Term Care Ombudsman Program | (800) 332-2272 | Montana's long-term care ombudsman advocates for seniors when Medicaid refuses to cover necessary prescription drugs and other medical services they need. In the event of a denial, the ombudsman can work with Medicaid on a senior's behalf. |
| Cover Montana | (844) 682-6837 | Cover Montana provides Medicaid education services and can help seniors apply online or over the phone. On the Cover Montana website, residents can enter their zip code to find in-person assistance near them. |
Does Medicare Cover Assisted Living in Montana?
The short answer is that no, Medicare does not cover the cost of assisted living in Montana. Assisted living facilities are considered to be a “residential setting” and not a “clinical setting,” (think nursing homes). While Medicare doesn’t cover the cost of care received in an assisted living community, it does 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 senior living in a nursing home, and for Medicare-related resources, see our guide to Nursing Homes in Montana.
Paying for Assisted Living Facilities in Montana
The Montana Department of Health and Human Services offers the Big Sky Waiver program to low income individuals. This program offsets costs for assisted residential care, case management and a variety of personal care services.
To be eligible, applicants must:
- Be a Montanan
- Be Medicaid eligible
- Have needs that require a nursing-home level of care
To learn more about eligibility requirements, call Mountain Pacific Quality Health Foundation at 1-800-219-7035. There is often a waiting list for this program.
Other Financial Assistance Options for Assisted Living 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 Assisted Living affordable.
| 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 Assisted Living. |
| 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 Assisted Living. 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 Assisted Living. 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 Assisted Living will not typically be eligible to sign up for a LTC insurance policy. |
Free and Low-Cost Resources for Seniors in Montana
There are many resources in Montana that assist seniors in their retirement. Caring.com has compiled information on local organizations, programs and agencies and categorized them into care types for easy reference.
Area Agency on Aging
Retirees can find support and advice on various senior-related issues from their local Area Agency on Aging. The agency provides advice on topics such as financial assistance programs, in-home care and long-term care planning. It also connects seniors and caregivers with community-based resources.
| Program Name | Phone Number | Description |
|---|---|---|
| Montana Area Agencies on Aging | In Montana, seniors have access to 10 Area Agencies on Aging across the state, which provide a variety of supportive services. These agencies offer seniors education regarding Medicare benefits, insurance fraud, elder abuse and many other advocacy concerns. They can also point seniors toward local assistive services, including transportation to medical appointments, exercise classes, nutrition and meal delivery programs, community centers and local care options. Additionally, seniors can discover their local Ombudsman program through AAAs. |
Cash Assistance Programs
Cash assistance programs in Montana provide financial support to help low-income retirees remain in their own homes for as long as possible. Seniors and caregivers can apply for tax rebates and reductions, discounts on vital services and help covering the cost of heating and cooling their home.
| Program Name | Phone Number | Description |
|---|---|---|
| Montana Lifeline Program | 800-234-9473 | The LifeLine Program offers a discount on landline or mobile telephone service, ensuring that participants can stay in contact with loved ones. |
Food Assistance Programs
Local organizations help ensure elderly citizens have a balanced diet and receive essential vitamins and minerals to remain healthy. Through nutrition programs, congregate meals, home-delivered meals and food pantries, these programs help Montana seniors afford the nutritious food they need.
| Program Name | Phone Number | Description |
|---|---|---|
| Montana Meals on Wheels | Montana Meals on Wheels is a food assistance program open to statewide seniors ages 60 and over, along with those who are unable to shop for and prepare meals due to limited mobility. These nutritious meals fulfill seniors' dietary needs and are available on a sliding-fee scale based on income, ranging from no cost to full cost. Congregate meals are served at local senior centers, while home-delivered meals provide seniors with daily socialization and safety checks to help monitor well-being. | |
| Montana Senior Farmers Market Nutrition Program (SFMNP) | 406-926-1625 | In Missoula, MT, the Community Food and Agriculture Coalition partners with the Montana Department of Public Health and Human Services to distribute coupons to low-income seniors aged 60 and older. Seniors are free to redeem these vouchers at over 30 farmer's markets and farm stands throughout the state for fresh fruits, vegetables and honey. Starting May 1st, seniors who meet USDA income limits can sign up for this program, which runs from June 1st to October 31st. |
| Montana Supplemental Nutrition Assistance Program (SNAP) | 888-706-1535 | The Montana Supplemental Nutrition Assistance Program is a food-assistance program for Montana residents who meet the eligibility requirements, which is based on the number of residents per household compared to their respective gross and net monthly income. Qualified recipients can access benefits via their Montana Access Card, a debit card linked to the Electronic Benefit Transfer (EBT) system. In addition to using the card to buy food at certain stores, residents can use it at farmers' markets. |
Free Used Medical Equipment
Due to the high cost of purchasing new medical equipment, several organizations in Montana collect lightly used medical devices such as wheelchairs, ramps and walkers and distribute them to local seniors and residents in need.
| Program Name | Phone Number | Description |
|---|---|---|
| Montana MonTECH | 406-243-5511 | MonTECH is a statewide assistive technology program that allows people to borrow a wide range of devices, such as wheelchairs, tablets, lifts, walkers and feeding devices, for a set period of time. The organization also maintains community exchange listings. |
Health Insurance & Prescription Drug Coverage for Seniors
Montana seniors who meet certain income criteria can apply to local resources to help them pay for prescription drugs. Eligible residents can also receive assistance through health insurance and other programs to access free or discounted medical services.
| Program Name | Phone Number | Description |
|---|---|---|
| Montana Big Sky Rx Program | 866-369-1233 | Administered by the State of Montana, the Big Sky Rx Program helps Medicare beneficiaries pay for prescription medication insurance premiums. |
| Montana Rx Card | As the state's prescription assistance program, the free Montana Rx Card is available to all Montana residents. It provides discounts on prescription drugs when obtained from participating pharmacies. |
Home Repair and Modifications
Seniors and those with disabilities can access a variety of local resources to help them pay for home repairs and modifications. Programs in Montana have different eligibility criteria and often assist retirees by providing grants or loans.
| Program Name | Phone Number | Description |
|---|---|---|
| Montana Section 504 Home Repair Program | The Section 504 Home Repair Program provides loans and grants to low-income homeowners. Seniors may receive a grant of up to $10,000 to remove health and safety hazards from their residence. Home repair and modernization loans up to $40,000 are available to seniors who can repay them. |
Medicaid Resources
Navigating the Medicaid system is often difficult and confusing. Several Montana resources help older adults by providing advice on Medicaid options, waiver programs and eligibility criteria to help seniors receive the right health care benefits.
| Program Name | Phone Number | Description |
|---|---|---|
| Montana Big Sky Waiver Program | The Montana Big Sky Waiver Program is a home- and community-based services Medicaid waiver that provides tailored support services to enable eligible seniors to remain at home or in an assisted living community. The program seeks to prevent or delay admission to a nursing home or other institutional setting. Services may include nursing care, rehabilitation therapies, environmental modifications, attendant care, help with personal care, daily activities and domestic chores, respite care and transportation. |
Social Security Offices
Social Security offices in Montana help seniors and disabled people access the benefits they're entitled to. Older adults can contact their local office for information about receiving retirement benefits, disability allowance and Supplemental Security Income.
| Program Name | Phone Number | Description |
|---|---|---|
| Montana Social Security | Social Security is a source of income available to retirees and people who can no longer work because of a disability. The money for Social Security comes from a payroll tax levied on employers, employees and self-employed individuals. When you retire, you'll receive monthly payments based on how much you earned when you were working. |
Tax Assistance
Seniors can apply for tax assistance from several Montana resources. Elderly residents and those with disabilities could be eligible for tax exemptions on medical expenses, reductions on property tax and other tax assistance programs.
| Program Name | Phone Number | Description |
|---|---|---|
| Montana Elderly Homeowner/Renter Credit Program | Seniors aged 62 and older who own or rent a home in Montana may be eligible for property tax relief. Refunds of up to $1,150 may be credited to a senior's Individual Income Tax. |
Utility & Energy Bill Assistance
Low-income seniors who are struggling to meet the costs of maintaining their homes can find support from organizations that offer assistance with utility and energy bills. Montana retirees could also qualify for emergency funding programs if they're in danger of losing utility services due to unpaid invoices.
| Program Name | Phone Number | Description |
|---|---|---|
| Montana Energy Share | 888-779-7589 | The nonprofit Energy Share of Montana provides emergency assistance to Montana residents facing hardship and who are at risk of losing heating or lighting in their home. All cases are considered on an individual basis. |
| Montana Low Income Home Energy Assistance Program (LIHEAP) | 833-317-1080 | Montana's Low Income Energy Assistance Program can help seniors afford their heating bills during the cold winter months. In addition to paying a portion of energy bills, the program assists seniors in need of emergency furnace replacement. The LIHEAP is open to renters and homeowners, although some income limits apply. Seniors who are already participating in certain other federal programs, including the Supplemental Nutrition Assistance Program and SSI, generally qualify automatically for Montana's LIHEAP. |
Veteran's Services
Montana retirees who have served in the U.S. military can find support from local veteran services. These offices and organizations help vets access the benefits they're eligible for and provide advice and information on a variety of issues.
| Program Name | Phone Number | Description |
|---|---|---|
| Montana VA Benefits and Health Care | Montana VA Benefits and Health Care offers comprehensive VA benefit, compensation and pension assistance via five Vet Centers. Advisors can help seniors file claims and appeal adverse decisions. Those with a service-related injury can obtain free medical care from a network of outpatient and community-outpatient clinics in addition to Fort Harrison VA Medical Center. The state has two cemeteries for veterans: Fort Missoula Post Cemetery and Yellowstone National Cemetery. |
Assisted Living Laws and Regulations in Montana
In Montana, assisted facilities must comply with rules and regulations set by the Department of Public Health and Human Services. These regulations ensure quality of care by setting minimum standards for staffing, caregiver training and medical services.
| Topic | Rule |
|---|---|
| Assisted Living Service Plan Requirements | ALFs give pre-admission assessments to determine care needs for each resident and create individual care plans within 60 days of admission. Category A communities may reevaluate this plan in 60 days. Residents at Category B or C communities are assessed by a healthcare professional within 21 days. Residents in Category C facilities who wander or show significant changes are evaluated for needs or interventions. Plans are reviewed annually, or if needs change significantly. |
| Assisted Living Admissions Requirements | ALF residents must be capable of some independent activity. Residents of Category A communities must be able to make decisions while not requiring skilled nursing or help with four or more daily activities. Category B communities offer such services but not to residents who are dangerous, require restraints, or wander. Category C communities assist residents who cannot make decisions or wander with all activities. Doctor’s orders are needed for Category B or C communities. |
| Assisted Living Scope of Care | Facilities are required to provide or make provisions for assistance with ADLs, help with mobility, transportation, personal care services, 24-hour supervision by staff, assistance with self-administration of medication and help with arranging medical appointments as well as recreational activities. Depending on the facility's license, it may also provide medication administration and skilled nursing. |
| Assisted Living Medicaid Policy | Montana's Big Sky Medicaid Waiver Program covers the cost of assisted living community services for older adults who would otherwise need to reside in a nursing home for assistance with the activities of daily living. The waiver allows seniors to choose their care providers, although their chosen care provider must be approved by the state, and the waiver must be used at a Montana state licensed assisted living facility. |
| Assisted Living Facility Requirements | Up to four residents may reside in a bedroom in facilities licensed prior to 2004. Facilities licensed later, or that serve residents with severe cognitive impairment, can have up to two residents per room. There must be one bathing facility for every 12 residents and one toilet room for every four residents which can be used without passing through another resident’s room or a communal area. Kitchens must be removable or disconnected if their use by residents is restricted. |
| Medication Management Requirements | Residents of Category A facilities must self-administer medications, while residents of Category B facilities can receive assistance. B facility residents who need assistance and all C facility residents must have medications administered by a licensed healthcare professional. Direct care staff can give some aid, such as opening container lids. Medication organizers can be filled up to four weeks in advance and injectable medications can be prepared up to a week in advance. |
| Staffing Requirements | ALFs must employ an administrator who makes sure regulations are followed and that residents are supervised 24-hours. The administrator also ensures there is staff to meet the health, safety and well-being needs of residents at all times. Acting administrators must be present when the administrator is off-duty. Category B facilities must employ or contract with a registered nurse to supervise or provide nursing services and Category C facilities must have 24-hour awake staff. |
| Staff Training Requirements | New staff must receive training and orientation for their responsibilities and duties, which includes an overview of services provided at the facility, the facility's procedures and policies, residents’ rights, and elder abuse identification and prevention. Annually, staff must undergo at least 16 hours of continuing education relevant to their duties and responsibilities. Direct care staff must be trained in the abdominal thrust maneuver and basic first-aid procedures. |
| Background Checks for Assisted Living | Administrators must develop procedures for screening and assessing staff. This process should help the community identify prospective hires that may pose a threat to the health, safety or welfare of residents. A facility must check if certified nursing assistants have adverse findings in the Nurse Aide Registry, including reports of neglect, abuse, resident mistreatment or theft of resident property and keep records on file. |
| Requirements for Reporting Abuse | All staff members of assisted living facilities, regardless of the capacity in which they serve, are considered mandated reporters who are required to report suspected or observed neglect, abuse and exploitation. Reports must be made to the Department of Health and Human Services’ Adult Protective Services hotline at (844) 277-9300. Reports can also be submitted online. |
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