Montana had 1,0068,778 residents in 2019, and according to the U.S. Census Bureau, 18.7% of those residents were 65 or older. The Montana Department of Commerce expects the number of seniors in Montana to grow by 104.8% between 2000 and 2030, which will increase the demand for senior care and related services. Seniors have plenty of reasons to retire in Montana, from the 6.9% cap on state income tax to a landscape dotted with mountains and lakes.

Although Montana has a higher cost of living than many states, the average costs of senior care are lower than the national average. Montana seniors can expect to pay an average of $3,820 per month for assisted living while the national average is $4,051 per month, for example. This guide provides an overview of the costs of senior care in Montana and how those costs compare to those of nearby states, as well as state and local resources that may be able to help Montana seniors cover the costs of Senior living.

Montana senior living facilities are permitted to hire volunteers, but volunteers shouldn’t be counted when determining whether a facility has a sufficient number of qualified staff on hand to meet the needs of residents.

The Cost of Senior Living in Montana

Note: There currently isn’t authoritative data on the average cost of Independent Living Facilities nationwide, so instead, we use the cost of Assisted Living to estimate it. Since the cost of Independent Living is typically 30-40% lower than the cost of Assisted Living, the numbers below were calculated by subtracting 35% from the cost of Assisted Living.

Note: Memory care is typically provided in communities licensed as assisted living facilities, and in general, costs 20-30% more than standard assisted living services. No authoritative cost data is available for this type of care, so we estimated memory care rates by adding 25% to assisted living fees in the Genworth 2021 Cost of Care Survey.

Based on data from the Genworth 2021 Cost of Care Survey, costs of long-term care in Montana are generally on par, or a little lower, than national averages. Depending on their health conditions, needs, finances and preferences, older adults have several care options to consider in Montana.

Seniors who need skilled nursing services and a high level of care may be best suited for residential nursing home care. Active seniors with no medical or personal care needs may enjoy the low-maintenance lifestyle and social opportunities of independent living communities. For those who require daily assistance with everyday activities, assisted living provides the necessary level of support. Memory care, which is usually offered within assisted living communities, provides enhanced specialized care for older adults with dementia. 

Providing the highest level of care, nursing homes are the costliest care option in Montana, with median monthly fees of $7,574. Seniors who require cognitive support can expect to pay around $5,563 per month, while assisted living runs around $4,450. At a monthly cost of $2,893, independent living provides the most affordable choice.     

The Cost of Assisted Living in Montana

Average rates for assisted living in Montana are $4,450 per month. This is similar to the U.S. average of $4,500. Across the southern border in Wyoming, seniors typically pay around $4,169 for assisted living. To the west, average monthly rates in Idaho are $3,838. At around $3,391 per month, North Dakota offers competitive pricing for the same type of care. 

The Cost of Nursing Home Care in Montana

Montana nursing facilities charge around $7,574 per month for a semiprivate room, which is $334 lower than the national average of $7,908. The state’s most affordable neighbor for nursing home care is Wyoming, where the average monthly fee is $6,996. At around $8,517 per month, seniors in Idaho pay more for nursing facility care. Average rates soar to $11,978 in North Dakota, resulting in residents paying more than $4,400 extra than those in Montana.        

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

Long-term care can be costly. Luckily, Montana offers assistance programs that may help seniors meet their care costs. Many older adults use Medicaid to cover care costs beyond their budgets. Operated jointly between federal and state governments, the program provides health insurance coverage for eligible individuals.

For seniors who reside in nursing homes, Medicaid funds care and services directly under the regular state Medicaid program. 

Medicaid doesn’t directly cover the costs for seniors who live in assisted living or memory care facilities. Instead, seniors may find community services available through the Montana Big Sky Waiver Program. 

In common with most states, Montana Medicaid doesn’t cover independent living. This type of care is for seniors who have no medical or personal care needs, so coverage isn’t available either through the traditional Medicaid program or waivers.   

	Medicaid Coverage Level	Type of Medicaid Coverage	Entitlement?*
Assisted Living	Partial	Medicaid Waivers	No
Independent Living	None	N/A	N/A
Memory Care	Partial	Medicaid Waivers	No
Nursing Home Care	Full	Medicaid	Yes

*Note: Entitlement programs mean that everyone who qualifies will receive coverage and be accepted into the programs. If the program is not “entitlement,” then participant caps could be in place, and there may be a waiting list.

Medicaid’s Coverage of Assisted Living & Memory Care in Montana 

For eligible seniors, Montana’s Medicaid program pays for assisted living and memory care services via the Montana Big Sky Waiver Program. 

Montana Big Sky Waiver Program 

The Montana Big Sky Waiver Program provides customized support services to help seniors who would otherwise require institutional care to remain in the community. The program does not cover meals or accommodation costs. Facilities create personalized service plans for residents, identifying individual care needs and listing necessary services. Such services may include: 

• Adult residential living
• Rehabilitative therapies
• Nursing care
• Dietetic support
• Specialized medical supplies and equipment
• Transportation
• Personal assistance
• Attendant care
• Accessibility adaptations 

To qualify for this waiver, individuals must be 65 or older, disabled or blind and fulfill income and asset criteria. They must also require nursing home level care, which means they cannot live independently because of medical, mobility, cognitive, functional or other care-necessitating issues. 

For program referrals, individuals should call Mountain Pacific Quality Health at (800) 219-7035.         

Medicaid’s Coverage of Nursing Home Care in Montana

Statistically, 60% of Montana’s nursing home residents receive Medicaid funding. Assistance covers 24-hour monitoring, skilled nursing services, medication management, help with daily and personal care activities, rehabilitative therapies and specialized medical equipment and supplies. Medicaid also pays toward the costs of bed and board. Seniors may need a medical assessment to qualify for nursing home services. 

Beneficiaries must spend all of their available income on care costs, except for a monthly personal needs allowance of $50, Medicare premiums and, where applicable, a spousal income allowance. Medicaid funds additional amounts to cover the full care costs.     

Eligibility for Medicaid in Montana 

 In Montana, income and asset limits apply for Medicaid eligibility. While nursing home Medicaid and the Montana Big Sky Waiver Program share the same asset caps, income requirements are different for each program. 

Older adults applying for Medicaid to cover nursing home care have no maximum income limit. However, their income must be lower than the costs of nursing home care. 

For single applicants claiming the Montana Big Sky Waiver Program, their maximum permitted yearly income is $10,092. This doubles to $20,184 per annum for joint-applicant couples. For couples where only one spouse submits a Medicaid claim, the applicant’s income is capped at $10,092. 

For regular Medicaid and waivers, the asset limit for single claimants is $2,000. Dual-applicants cannot own more than $4,000 in assets. For couples where only one spouse applies for Medicaid, the applicant’s asset cap is $2,000 and the community spouse has an enhanced limit of $137,400.         

2022 Montana Medicaid Income Limits  

	Income Limits*	Asset Limits
Single Person	Nursing home: No set limit Waiver: $10,092	$2,000
Two-Person Household (Only one applicant)	Nursing home: No set limit Waiver: $10,092 for applicant	$2,000 for applicant $137,400 for non-applicant
Two-Person Household (Two applicants)	Nursing home: No set limit Waiver: $20,184	$4,000

*per year 

Eligibility also depends on additional requirements: 

• Applicants must be U.S. citizens, nationals or legal aliens
• Claimants must be permanent residents of Montana
• Seniors must satisfy functional requirements of needing nursing home level of care

Applying for Medicaid in Montana

Individuals can call the Cover Montana Helpline at (844) 682-6837  or the Health Insurance Marketplace hotline at (800) 318-2596 to apply for Montana Medicaid. Those who prefer to apply online can do so at the nationwide HealthCare.gov website.   

Before You Apply 

Preparing necessary documents in advance can make the application process easier and enhance the applicant’s chance of a swift decision. Relevant information includes: 

• Proof of identification
• Proof of Montana residency
• Proof of citizenship status
• Social Security number
• Details of all income and assets
• Details of insurance policies, including health coverage
• Current bank statements 

 How To Get Help      

Montana elders can obtain advice and help related to Medicaid from several sources. The following resources can check eligibility, help claimants understand coverage, assist with completing applications and file appeals against unfavorable decisions.    

	Contact	What You Should Know
Cover Montana	(844) 682-6837	Older adults can apply for Medicaid over the phone, and helpline advisers can provide in-depth information about the program. They can also help applicants find local enrollment assistants at community health centers for in-person guidance.
Health Insurance Marketplace	(800) 318-2596	The Health Insurance Marketplace website has pertinent information for those researching Medicaid as well as an eligibility checking tool. Advisers can provide information and enroll people by phone.
American Council on Aging	Online form	The American Council on Aging provides state-specific up-to-date information on its website, including eligibility requirements and Medicaid planning strategies. Older adults can obtain a free eligibility assessment by completing an online form. The Council can also provide details of cost-effective local Medicaid planners.

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

Unfortunately, Medicare does not cover the cost of assisted living, independent living, or memory care. Unlike nursing homes, these care types are not considered to be “clinical settings” and so are not eligible for Medicare coverage. That being said, those who live in these communities can still use Medicare to cover the cost of approved medications, doctor visits, medical equipment, etc.

When it comes to nursing home care, it gets much more complicated. Medicare does provide limited coverage for a qualified stay in a nursing home,but there are strict rules and requirements of which you should be aware. This benefit is available to seniors who have been hospitalized for at least three days, excluding the date of discharge.

Once you’ve met the hospitalization requirement, Medicare will pay for up to 100 days in a skilled nursing facility (per benefit period). While the first 20 days are covered in full, there is a daily coinsurance rate that must be paid starting on day 21. After day 100, seniors are responsible for the entire cost.

	Medicare Coverage	Medicare Coverage Duration	Coinsurance Requirement?
Assisted Living	None	N/A	N/A
Independent Living	None	N/A	N/A
Memory Care	None	N/A	N/A
Nursing Home Care	Limited	100 Days Per Benefit Period	Yes – After 20 Days

What Nursing Home Care Services Does Medicare Cover?

Medicare covers a number of specific services, including:

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

What Nursing Home Care Services Aren’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.

Several services help Montana seniors navigate Medicare plans and application processes. The following resources can help individuals compare health insurance plans, sign up for coverage, appeal adverse decisions, report fraud and save money on fees.    

Resource	Contact	What You Should Know
Montana State Health Insurance Program	(800) 551-3191	Helping people make informed decisions regarding health benefits, the Montana Health Insurance Program (SHIP) offers free Medicare and health insurance counseling to seniors. Services are confidential and unbiased and counselors help people understand eligibility, costs and coverage terms for regular Medicare, Medigap, prescription drug plans and private insurance policies. They also help seniors apply for plans. Individuals may meet with advisors in person, or home visits are available for housebound seniors or those who don’t have transportation.
Information and Assistance/Referral Services	(800) 551-3191	Operated by the Montana Office of Aging Bureau in partnership with Area Agencies on Aging, the Information and Assistance/Referral Services program helps seniors with a range of aging-related issues. In addition to insurance counseling and assistance, information covers topics such as social services, transportation, support groups, respite and meal services. Seniors can contact a trained adviser through the toll-free number.
Social Security Administration	(800) 772-1213	Individuals can visit their local Montana Social Security office for general information about Medicare and assistance enrolling for coverage. Advisers can also complete eligibility checks. Alternatively, seniors can obtain assistance via the online contact form or toll-free helpline.

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

Depending on your unique situation, there may be other financial assistance options to partially or fully cover the cost of senior living in Montana. Below, we cover some of the common ways that seniors can make senior living options such as assisted living or memory care more affordable.

	How to Get Started	What You Should Know
Aid and Attendance	Apply 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 Mortgages	Research and learn about the different types at ftc.gov.	If 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) Insurance	Learn 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 Senior Living Resources for Seniors in Montana

Varied services and programs help Montana’s aging population maintain a good quality of life, regardless of individual care needs and income levels.  

	Contact	What You Should Know
Area Agencies on Aging	(800) 551-3191	Montana has 10 Area Agencies on Aging that administer diverse programs for the elderly. Seniors can call the toll-free helpline during regular business hours for information or visit one of the statewide senior centers. All the centers promote socialization and engagement through activities and events and advise on a range of topics, including nutrition and well-being, health insurance and benefits, long-term care options and transportation services.
Aging and Disability Resource Centers	(406) 444-4077	Supporting people aged 60 and above and individuals with disabilities, Montana’s Aging and Disability Resource Centers (ADRCs) provide people with the necessary information to decide their own care options. As well as providing comprehensive information on matters such as financial assistance, housing options and long-term support, advisers can make referrals to help seniors obtain appropriate services.
Legal Services Developer Program	(800) 332-2272	Housed within the Montana Office on Aging, the Legal Services Developer Program helps seniors understand legal forms and documents and refers older adults to free local legal providers. Telephone assistance is available between 8 a.m. and 5 p.m. on weekdays. People aged 60 and above can also attend scheduled document clinics for free assistance with drafting, completing and notarizing estate planning papers such as wills and powers of attorney.
Alzheimer’s Association – Montana Chapter	(800) 272-3900	The Montana Chapter of the national Alzheimer’s Association educates individuals and the public about issues surrounding Alzheimer’s disease and other forms of dementia. It operates local support groups for seniors and family members and hosts events to promote socialization for those in the early stages of the disease.
Montana Senior Medicare Patrol	(800) 551-3191	Operated through local Area Agencies on Aging, the Montana Senior Medicare Patrol (SMP) program trains senior volunteers to advise their peers on Medicare fraud, scams and mistakes. Older adults may contact the program for advice relating to their health care bills and to report suspected abuse within the system or if they are interested in becoming a volunteer.
AARP Montana	(866) 295-7278	AARP Montana maintains an informative website and active social media presence to provide current aging-related information to people aged 50 and above. The organization also facilitates local events and virtual workshops, including social activities, safe driving courses, educational courses, legal guidance, fitness classes and benefits advice. Members can take advantage of discounts for travel, leisure, shopping and technology.
Golden College Program	(406) 243-6266	Active adults aged 65 or older who enjoy learning can obtain a tuition fee waiver for undergraduate courses at the University of Montana. The diverse course list includes languages, sciences and the arts.

COVID-19 Rules and Restrictions for Montana Senior Living Facilities

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)

Senior Living Laws and Regulations in Montana

Note: All these rules typically apply to non-clinical senior living facilities, such as independent living, assisted living, and memory care facilities. Nursing homes and other senior living facilities with a clinical setting may have additional or slightly different requirements and regulations.

The Montana Department of Public Health protects seniors by overseeing senior living facilities throughout the state. Every senior living facility must obtain a license from DPH and remain in compliance with all relevant regulations. If DPH conducts an inspection and determines a senior living facility is not in compliance, it has the authority to take administrative action.

Scope of Care

At a minimum, a Montana senior living facility must provide recreational activities, 24-hour supervision, personal services, assistance with self-administration of medication, assistance with arranging medical appointments and assistance with activities of daily living that do not require the presence of a licensed health care professional. Senior living facilities may also offer medication management, but they’re not required to do so.

Staffing Requirements

The Department of Public Health has not established a minimum staffing ratio for Montana senior living facilities. However, state regulations indicate that a facility must have a sufficient number of qualified staff members on duty during each shift to meet the scheduled and unanticipated needs of residents. A facility must have enough staff members on hand to respond to emergencies, maintain order, ensure the facility is clean, prepare meals, assist with medications, provide housekeeping services and ensure residents receive an adequate level of supervision.

Montana senior living facilities are permitted to hire volunteers, but volunteers shouldn’t be counted when determining whether a facility has a sufficient number of qualified staff on hand to meet the needs of residents.

Reporting Abuse, Neglect and Exploitation

Montana has mandatory reporting requirements for employees of senior living facilities, nursing homes and other long-term care facilities. If a staff member suspects that a resident has been abused, neglected or exploited, a report must be made to the Montana Long-Term Care Ombudsman at 1-800-332-2272.

Each report must include the name and address of the resident, the name and address (if known) of the person who allegedly committed the abuse, a description of the incident, the name and address of the person making the report and any information about prior acts of abuse or neglect committed by the same person. Anyone who’s required to submit a report and fails to do so could face up to six months in jail or a $500 fine.

Frequently Asked Questions

How much does assisted living cost in Montana?

Montana seniors can expect to pay an average of $3,820 per month for assisted living, which is lower than the national average. Residents of Missoula and Billings should expect to pay more than seniors living in Great Falls or Helena.

Are there financial assistance programs available for assisted living in Montana?

Yes. Montana’s Medicaid program offers a waiver known as the Big Sky Home and Community-Based Services Program. The waiver is available to Montana residents who qualify for Medicaid and require a nursing facility level of care.

What are activities of daily living?

Activities of daily living are routine activities related to personal hygiene, bodily functions and nourishment. Some of the most important ADLs include eating, bathing and using the toilet. Performing these activities is an important part of remaining independent.

What is the difference between assisted living and independent living?

One of the main differences between assisted living and independent living is the level of support provided to residents. Independent living facilities are designed to help active seniors maintain their privacy and independence. These facilities don’t provide personal care or medical services. Assisted living facilities provide extra support for seniors who need help with medication management or some of the activities of daily living. Residents of assisted living facilities have more contact with staff members than the residents of independent living communities do.

Who should consider assisted living?

Assisted living is a good option for seniors who can’t stay in their homes but don’t need the skilled nursing care provided in a nursing home. Not only do seniors in assisted living facilities receive help with tasks, such as meal planning and medication management, but they also have many opportunities to form new friendships. Seniors who need more help than their children or spouses can provide may also be good candidates for assisted living.

Learn More About Senior Living in Montana

For more information about specific types of senior living in Montana read our Guide to Assisted Living and Independent Living.

The Top Cities for Senior Living in Montana

Learn more about the cost of senior living in the top Montana cities. Additionally, find reviews and information about assisted living facilities and other senior living communities across the state.