Elder Care Index

What It Costs Across Montana

Finding the right care for your loved one involves understanding the financial landscape, which varies across Montana. While the statewide median for assisted living is around $4,450 per month, recent averages from 2024 suggest costs closer to $4,908 per month or even $5,000 per month. Expect significant differences depending on the region. Major cities like Billings often see higher prices, averaging around $6,204 to $6,615 per month. Bozeman is also on the higher end, with costs around $5,968 per month. In contrast, Missoula is closer to the state average at about $4,575 per month, and more rural areas or cities like Great Falls can offer more affordable options, with costs as low as $2,800 to $3,200 per month. These price differences are typically due to factors like the facility's location, the specific level of care needed, room size, and the range of services and amenities provided.

Will Medicaid Help Pay?

Yes, Medicaid can help cover some costs through Montana's Big Sky Waiver program, also known as the Elderly/Physically Disabled Waiver. This waiver aims to help seniors and individuals with physical disabilities receive care in their homes or an approved assisted living facility, preventing or delaying nursing home placement. The Big Sky Waiver covers a variety of services, including personal care assistance, homemaker services, adult day care, respite care, and specialized medical equipment. However, it's crucial to understand that the waiver does not directly pay for the room and board expenses within an assisted living facility. To be eligible, your loved one must be a Montana resident, typically 65 or older (or physically disabled), and meet a nursing facility level of care. Financial eligibility also applies, with 2026 income limits for a single applicant at $994 per month and an asset limit of $2,000. Be aware that the Big Sky Waiver is not an entitlement, meaning there are limited slots, and a waitlist can occur, sometimes lasting for months or even years.

How to Find a Good Facility

Montana has over 200 licensed assisted living facilities statewide. When searching, prioritize facilities that align with your parent's safety, well-being, and preferences, considering proximity to family and healthcare services. Montana's assisted living facilities are categorized (A, B, C, and D) based on the level of care they provide, from basic assistance to specialized care for those with cognitive impairments. The primary oversight agency in Montana is the Department of Public Health and Human Services (DPHHS), specifically its Quality Assurance Division and Licensure Bureau. They inspect facilities every one to three years, with facilities in good standing inspected less frequently. Unfortunately, Montana offers limited public access to inspection records online; you'll need to formally request copies of inspection reports or complaints by writing to the Licensure Bureau, Quality Assurance Division, DPHHS, 2401 Colonial Drive, Helena, MT 59620, or call 406-444-0596 to file a complaint. For an independent perspective, you can also contact the State Long-Term Care Ombudsman.

Last updated: March 2026. Sources: Genworth 2024, state licensing agency.