Paying for assisted living in Montana
Most Montana families pay for assisted living out of pocket, at least at first. Common sources include personal savings, Social Security and pension income, proceeds from selling a home, and long-term care insurance. Costs vary quite a bit across the state, so a community in Billings or Bozeman may be priced differently than one in a rural county. You can see current pricing for specific communities in the pricing tables below.
There are also two questions almost every family asks: will Medicaid help, and will Medicare help? The short answers are below.
Does Montana Medicaid (the Big Sky Waiver) cover assisted living in Montana?
Montana Medicaid can help pay for the care and services a person receives in an assisted living residence through the Big Sky Waiver (BSW), a Home and Community-Based Services waiver run by the DPHHS Senior and Long Term Care Division. It is important to understand what this does and does not do:
- The waiver may cover personal care, case management, health-related services, and similar supports in an approved assisted living setting.
- It does not pay for room and board. Residents are still responsible for their housing and meal costs.
- Because it is a waiver with limited slots, there can be a waiting list.
To qualify, a person generally must be financially eligible for Montana Medicaid and need a nursing-facility level of care. Apply for Medicaid online at apply.mt.gov or through a local Office of Public Assistance, and contact the waiver's enrollment partner to be screened for the Big Sky Waiver.
Does Medicare cover assisted living in Montana?
No. Medicare does not pay for room and board or the ongoing custodial care (help with bathing, dressing, meals, and supervision) that defines assisted living. Medicare may still cover medically necessary items a resident needs regardless of where they live, such as doctor visits, hospital stays, and short-term skilled care or rehabilitation after a qualifying hospital stay.
For free, unbiased help understanding Medicare coverage, plans, and supplements, contact Montana's State Health Insurance Assistance Program (SHIP) at 1-800-551-3191.
