Montana Medicaid for Senior Care
Complete guide to Medicaid eligibility, coverage, and application process for nursing homes, assisted living, and home care in Montana.
7.6 million Medicaid long-term care recipients nationwide
Montana Department of Public Health and Human Services (DPHHS)
Processing Time
30-45 days standard Medicaid; Big Sky Waiver applications take 60-90 days and may face waiting list delays depending on capacity
Montana Medicaid Eligibility Requirements (2026)
To qualify for Medicaid long-term care in Montana, applicants must meet both financial eligibility criteria (income and assets) and medical criteria (level of care needs). Montana follows federal Medicaid guidelines with some state-specific variations.
Income Limits
Individual Applicant
$2,982/month
Married Couple (One Applying)
$5,964/month
Income includes Social Security, pensions, annuities, interest, dividends, and rental income.
Asset Limits
Individual Applicant
$4,000
Community Spouse (At-Home Spouse)
$6,000
Primary residence, one vehicle, personal belongings, and prepaid burial arrangements are exempt from asset limits.
5-Year Look-Back Period
Montana Medicaid reviews all financial transactions for the 60 months prior to application. Asset transfers or gifts during this period can result in a penalty period of Medicaid ineligibility. The penalty is calculated by dividing the transferred amount by $8,456/month average (semi-private), $9,277/month (private) (the average monthly nursing home cost in Montana).
Medical Eligibility
Applicants must demonstrate need for nursing facility level of care through a state assessment. This typically requires assistance with 2-3 Activities of Daily Living (bathing, dressing, toileting, transferring, eating) or cognitive impairment requiring supervision.
Assessments are performed by state-designated evaluators (nurses or social workers) and typically take 45-90 minutes. The assessment can occur at home, in a hospital, or at the care facility.
What Medicaid Covers in Montana
Nursing Home Care
Medicaid pays 100% of nursing home costs in Montana once eligibility is established. The average monthly cost is $8,456/month average (semi-private), $9,277/month (private). Recipients contribute most of their monthly income toward care costs, keeping only $50-75 for personal needs.
Coverage includes room, board, 24-hour nursing care, meals, medications, therapy services, and all medical care provided at the facility.
Assisted Living Coverage
Big Sky HCBS Waiver - Assisted Living Services: Montana's Big Sky Waiver explicitly includes "assisted living services" as a covered benefit. Participants can live in licensed assisted living facilities and receive Medicaid-covered services including personal care, medication management, and care coordination. However, room and board costs are not covered by Medicaid—residents must pay housing costs privately.
Note: This program covers personal care services but does not cover room and board costs. Residents need approximately $1,500-$2,500/month from Social Security or other income to cover housing expenses.
Home and Community-Based Services (HCBS) Waivers
Montana offers 2 HCBS waiver programs that provide in-home care and community services as an alternative to nursing facility placement.
Big Sky HCBS Waiver (0208)
Montana's primary waiver serving individuals age 18+ who are elderly or have physical disabilities and meet nursing facility level of care. Covers adult day care, assisted living services, attendant care, case management, chore services, homemaker services, home-delivered meals, personal care, respite care, residential and day habilitation, supported employment, adult residential care, and goods/services not otherwise covered. Approximately 3,200 participants statewide.
Program Details →0209 Waiver (Severely Disabled)
Serves individuals with severe disabilities requiring extensive support. Similar services to Big Sky Waiver but with more intensive service coordination and support.
Program Details →How to Apply for Medicaid in Montana
Montana Medicaid applications typically take 30-45 days standard Medicaid; Big Sky Waiver applications take 60-90 days and may face waiting list delays depending on capacity. Starting the process early and submitting complete documentation helps avoid delays.
Application Methods
You can apply for Medicaid in Montana through:
- Online at apply.mt.gov
- Phone: 1-800-362-8312 (DPHHS HelpLine) or 1-888-706-1535 (MT Health Link application line)
- Download application at dphhs.mt.gov and mail to: DPHHS, P.O. Box 4210, Helena, MT 59604
- In-person at local DPHHS office
Step 1: Gather Required Documents
Before starting your application, collect:
- •Birth certificate and Social Security card
- •Proof of citizenship (passport, naturalization)
- •5 years of bank statements
- •Investment and retirement account statements
- •Property deeds and mortgage statements
- •Life insurance policies
- •Social Security award letter
- •Pension benefit statements
- •Medicare card
- •Doctor's statement of care needs
Step 2: Submit Your Application
Complete and submit your application through one of the methods listed above. If applying online or by mail, keep copies of all submitted documents.
Step 3: Medical Assessment
A state assessor will evaluate level of care needs. This assessment typically takes 45-90 minutes and covers functional abilities, medical needs, cognitive status, and safety concerns.
Step 4: Financial Review
Medicaid staff review all financial documents and investigate any transfers or gifts made in the past 60 months. They may request additional documentation during this process.
Step 5: Receive Determination
You'll receive written notification of approval or denial. Approved applications include the effective date of coverage (often retroactive up to 3 months), patient responsibility amount, and covered services.
Get Free Application Help
Free Medicaid application assistance is available in Montana from:
- •Area Agency on Aging: Call 1-800-677-1116 (Eldercare Locator) to find your local office
- •SHIP counselors: Free Medicare/Medicaid counseling
- •Nursing facility social workers: In-facility application support
- •Elder law attorneys: Paid help for complex financial situations ($2,000-$5,000)
Montana-Specific Programs and Resources
Medicare Savings Programs (QMB/SLMB/QI)
QMB covers Medicare premiums, deductibles, and cost-sharing. SLMB covers Medicare Part B premiums. QI covers Part B premiums with limited funding availability.
Learn MorePassport to Health
Montana's health insurance program for uninsured children up to age 19. Includes dental and vision coverage.
Learn MoreHelp Me Grow Montana
Connects families to community resources and services, including early intervention and developmental services.
Learn MoreNeed Help with Montana Medicaid?
Contact Montana Department of Public Health and Human Services (DPHHS) for specific questions about eligibility, application status, or covered services.