STATE PROFILE • Last updated: November 11, 2026
Montana Elder Care & Medicaid
Montana's senior Medicaid landscape offers the Big Sky Waiver for home and community-based care, alongside entitlement programs like Community First Choice, supporting independent living for those meeting nursing home level of care.
leaderboard
RANKED #43
GRADE F
FEATURED
Medicaid Coverage Guide for Montana
Full breakdown of Big Sky Waiver for seniors: waiver programs, nursing home eligibility, income and asset limits, spend-down rules, and how to apply.
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Program
Big Sky Waiver
Income cap
No cap
Medically-needy
Yes
Elder Care Index Report Card
5-pillar composite scoring vs other states
F
Grade
AFFORDABILITY
GRADE D · 50
QUALITY
GRADE D · 36
STAFFING
GRADE C · 33
ACCESS
GRADE F · 18
MEDICAID SUPPORT
GRADE D · 20
Composite score: 25.1 / 100 (50 = average state)
Methodology arrow_forward
Montana At a Glance
Nursing Home Facilities
61
Senior Medicaid Waivers
2
National Rank
#43 / 51
Range #42–#45 when the pillar weights shift
Senior Care Costs in Montana
local_hospital
Nursing Home
$9,336/mo
-15.4% vs national avg
- 61 nursing homes · 5,075 beds
- Avg CMS rating 3.0★ (10 rated 5★, 12 rated 1★)
- 3.97 nurse hrs/resident/day (0.94 RN)
Source: CMS Nursing Home Compare
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home_health
Home Health Aide
$28/hr
+3.7% vs national avg
- Median aide wage $15.94/hr
- ~8,010 aides employed statewide
Source: BLS OEWS
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