I. What You Should Expect to Pay for Home Care in Montana

According to the 2021 Genworth Cost of Care Survey, the average cost for home care in Montana is $5,339 per month, and prices for home health care are the same. Home health care provides medical services, such as skilled nursing, therapies and disability or illness management. Home care service assists with household upkeep but doesn’t include medical services.

The Cost of Home Care and Home Health Care in Nearby States

Montana’s monthly home care cost of $5,339 is higher than the monthly national average of $4,957 but cheaper than its surrounding states. Idaho’s prices are slightly higher at $5,434 per month, and Wyoming’s monthly costs rise somewhat to $5,529. North Dakota seniors pay $5,689 per month. South Dakota is the region’s most expensive state, with monthly prices averaging $5,911.

Montana’s home health care costs $5,339 per month, making it the cheapest option yet again. Home health care expenses in Idaho, Wyoming, North Dakota and South Dakota are the exact price as their home care costs. Montana’s price is only a little higher than the national average of $5,148.

Home Care Home Health Care
Montana $5,339 $5,339
National $4,957 $5,148
Idaho $5,434 $5,434
Wyoming $5,529 $5,529
North Dakota $5,689 $5,689
South Dakota
$5,911 $5,911

The Cost of Home Care vs. Other Types of Care

There are a few other kinds of care to consider depending on your needs. Nursing home care is ideal for people who require a high level of supervision and clinical services due to physical or cognitive impairment. It’s the most specialized type of care and is priced accordingly at $7,574 for a semiprivate room. Assisted living, which costs $4,450, can be an appealing option if you don’t want to maintain a household or prefer to live in a community setting. For $2,600, you can get adult day care, which provides services during normal business hours only.

II. Can Medicaid Help You Pay for Home Care in Montana?

In Montana, Medicaid pays for home care through two home- and community-based service options: the Big Sky Waiver and the Community First/Personal Assistance Services Program.

Home Care Waiver Programs in Montana

Big Sky Waiver

The Big Sky Waiver enables seniors to remain in their homes and communities instead of an institution through many social services and supports. Seniors can get personal care, housekeeping, transportation to doctor’s appointments and environmental adaptations to make their homes safer to navigate. The waiver also includes clinical services such as therapies, private-duty nursing, mental health consultations and specialized medical equipment and supplies. The program can only serve a limited number of people per year. If it reaches this cap, you may be placed on a waiting list to get services.

To qualify for the Big Sky Waiver, you must:

  • Be financially eligible for Medicaid
  • Meet the minimum level of care requirements for nursing facility placement
  • Have an unmet need that the Big Sky Waiver can only meet

To make a self-referral for the Big Sky Waiver, call Mountain-Pacific Quality Health at (800) 219-7035. If accepted, you will be assigned a case management team consisting of a social worker and nurse. Your team will assess your needs and work with you to develop a comprehensive care plan.

Community First/Personal Assistance Services (CFA/PAS) Program

The CFA/PAS Program provides long-term supportive care in a home setting. The program tailors care to each senior’s specific living situation, personal needs and family caregiver availability. It covers nonclinical help with daily living activities, including grooming, dressing, bathing, toileting and eating meals. The program also assists with light housekeeping, laundry, shopping and yard hazard removal. Non-medical transportation, major cleaning, home modifications and home repairs are not covered.

CFA/PAS has two options to receive services: Self-direct and Agency-based. The Self-direct option allows you to choose your own providers and manage your own care. Under the Agency-based option, a case management team will organize and direct services on your behalf.

To be eligible, you will need to:

  • Qualify for Medicaid
  • Undergo a medical screening process
  • Have a health condition that requires help with activities of daily living

For more information about program eligibility and membership, contact the program manager at (406) 444-4564.

How to Know if You're Eligible for Medicaid in Montana

To qualify for Medicaid, you must meet certain income and asset limits, such as investments, bank accounts and property you own (excluding your primary residence). In Montana, your yearly income can’t exceed $10,092 ($841/month) for a single person and $15,132 ($1,261/month) for a married couple. The asset limit is $2,000 for one person and $3,000 for a two-person household.

2022 Medicaid Income Limits for Seniors in Montana
Income Limits* Asset Limits
Single Person $10,092 $2,000
Two-Person Household $15,132 $3,000

*Per year

You must also meet several requirements, including;

  • Montana residency
  • U.S. citizenship, U.S. national, legal alien or permanent residency
  • Being 65+ and/or blind or disabled

How to Apply for Medicaid in Montana

To apply for Medicaid, visit HealthCare.gov and create an account. You can then access Montana’s Medicaid Marketplace and fill out an application. Alternatively, call (800) 318-2596 to apply by phone.

What Information You Will Need

The Medicaid application will ask you to provide several pieces of information to verify your eligibility. These include:

  • Name, birth date and contact information for every household member
  • Proof of all income, including income from an employer, SSI payments and Social Security benefits
  • Social Security numbers and/or immigration documents (only for those applying for coverage)
  • Current health insurance, including Medicare or coverage through your spouse’s employer

How to Get Help Applying for Medicaid

If you need assistance with understanding Medicaid benefits or filling out your application, there are several ways to get help.

Contact Area Served Services Provided
Cover Montana (844) 682-6837 Entire State The Cover Montana website has information about Medicaid enrollment, an eligibility calculator, Marketplace insurance options and an explanation of benefits you could receive. It also provides a directory of statewide enrollment assistance partners if you prefer in-person help.
Montana Public Assistance Helpline (888) 706-1535 Entire State Call this number to get answers about the Medicaid enrollment process, find out your application’s status, manage your case or change your information after applying.
Montana Legal Services Association (800) 666-6899 Entire State This organization provides information about Medicaid and other public benefits. If you are denied Medicaid and want to appeal, a volunteer attorney may be able to help for free.

III. Can You Use Medicare to Pay for Home Care in Montana?

Medicare doesn’t pay for non-medical home care, but it can cover the cost of the medical version of home care, called “Home Healthcare” in some situations. In order to be eligible, you need to be homebound and have a referral from your doctor for the specific type of medical care that is needed. There are also other restrictions that apply.

Below is an overview of some of the services typically covered by Medicare for those who are eligible:

  • Physical Therapy: Physical therapy is used to help patients recover from injuries (broken bones, knee injuries, etc.), and to treat ongoing conditions such as arthritis. Additionally, physical therapy is often provided in the home to help seniors recover from surgeries and procedures, such as a knee or hip replacement.
  • Nursing Care: Licensed nurses can provide a number of medical services (such as wound care, changing feeding tubes, etc.) for those who need medical care, but don’t need to stay in a hospital full-time.
  • Occupational Therapy: Occupational therapy is designed to help seniors regain or maintain the ability to accomplish normal, daily tasks, such as bathing, dressing, eating, etc., and providers can travel to your home if needed.
  • Speech Therapy: Seniors can lose the ability to adequately communicate for many reasons, and speech therapists are there to help seniors regain the ability to communicate using a variety of means. Additionally, speech therapists help to keep seniors independent by modifying diets and teaching special techniques to swallow safely.

As mentioned above, home care is distinctly different from home healthcare, but there is some overlap – so while Medicare doesn’t cover non-medical home care, there are personal care services that may be covered in special circumstances – such as an occupational therapist helping with eating or dressing.

Read our guide to Medicare and Home Care Coverage for more information.

IV. Other Financial Assistance Options for Home Care in Montana

While the above programs can be a great way to make home care affordable for many people, they are not the right solution for everyone. Thankfully, there are other ways to make home care more affordable for you and your family. For more information about your other options, read our section on Other Ways to Pay for this guide.

V. Free Resources for Aging in Place in Montana

Throughout Montana, you’ll find a variety of organizations and government agencies offering resources to help you safely age in place. These free services aim to help Montana seniors live in their own homes for as long as possible.

Contact Area Served Services Provided
Area Agencies on Aging (AAA) (800) 551-3191 Entire State Montana has 10 AAAs serving seniors in every county statewide. Its advisory counselors provide information about home care, healthy living, local social services and financial help for low-income households. Services offered vary by AAA office but may include grocery/medication delivery, caregiver respite, telephone wellness checks and support groups for people with disabilities.
Energy, Water and Weatherization Assistance Programs (833) 317-1080 Entire State The Montana Department of Health and Human Services (DPHHS) offers three financial relief programs to lower utility bills for financially eligible households: LIHEAP, LIHWAP and Weatherization Assistance. LIHEAP pays for a portion of winter heating bills and emergency furnace repair. LIHWAP partially covers water bills to prevent shutoff due to nonpayment. Weatherization Assistance provides energy-efficient home modifications that can lower your electric bills. You can apply for all three programs at once via your local DPHHS office.
Montana Veteran Affairs Division (406) 324-3742 Entire State The Montana Veteran Affairs Division has nine regional offices serving former military members throughout the state. These offices provide information about tax breaks, VA health care, employment assistance and monetary benefits veterans may have earned. If you think you might be eligible for benefits, such as service-related disability compensation, contact your local office to find out how to apply.
Nutrition Services (800) 551-3191 Entire State The Montana Aging Network provides several nutrition programs for older adults. Residents can enjoy a low-cost or free meal at one of about 170 congregate sites, most of which are senior centers. If you’re unable to leave your home or cook for yourself, you might be eligible for home-delivered food through Meals on Wheels or a similar service. Consult your AAA office for meal options near you.
Montana Elderly Homeowner/Renter Credit Program (406) 444-6900 Entire State This program gives homeowners and renters a refundable tax credit of up to $1,150. The credit amount is based on your mortgage/rent payment, income and property tax. To qualify, you must be 62 or older, have lived in Montana for at least nine months and have a household income of less than $45,000.
LIFTT Independent Living (406) 259-5181 Entire State LIFTT provides information about home modifications, such as wheelchair ramps, widened doors, handrails and shower grab bars to help make your home safer and easier to navigate. The organization may refer you to programs to build these modifications at low or no cost to you.
MonTECH (406) 243-4539 Entire State Through the University of Montana, the MonTECH program loans assistive technology equipment, such as prosthetics, power lifts and computer screen readers, to seniors and others with disabilities. It also offers one-on-one training to help seniors learn how to use their assistive devices. You can borrow equipment for up to 180 days. The program will ship equipment to you if possible, but if the item is too heavy, you may need to pick it up yourself from the MonTECH office in Missoula.

VI. Vaccination Requirements & COVID-19 Rules for Home Care Aides in Montana

According to a January 2022 memo by the Centers for Medicare & Medicaid Services (CMS), all Montana home care workers employed by Medicare- and/or Medicaid-certified providers must comply with the federal mandate to be vaccinated against SARS-CoV-2. Non-certified providers are not legally required to comply with the order but may choose to enforce their own vaccination requirements for employees who have direct contact with patients. The rule protects the elderly by helping to prevent the spread of COVID-19.

Although this rule is current as of April 2022, rules and regulations can often change. Contact your home care provider if you have concerns about the vaccination status of staff who may enter your home. You can also contact your local AAA for the most current information on vaccination rules.

VII. Rules and Regulations for Home Care Providers in Montana

The DPHHS is responsible for the licensing and regulation of home care agencies in Montana. The state regulates care plan requirements, medication administration, staff screening, training and other rules providers must follow.

What Types of Care Can Be Provided? In Montana, home care workers may provide nonclinical services, including help with eating meals, bathing, dressing, grooming, toileting and mobility. Home health care staff can offer skilled nursing and therapeutic services, such as physical, speech and occupational therapy. They can also administer medical supplies and equipment as deemed necessary by the patient’s physician.
Are Care Plans Required? Montana does not outline care plan requirements for people who receive regular home care. For those patients, providers must develop a plan before the first home visit by personnel. The plan must outline treatments and expected outcomes, medications and services. A physician should review this plan every 60 days.
Can Home Care Providers Assist with Medication Management? Regular home care providers can’t administer medications but may assist patients with self-administration of medications as prescribed by their physician. Assistance includes reminding clients to take medicine, guiding the client’s hand to self-administer medication and helping them swallow fluid to take oral medications.
Are There Special Requirements for Screening Home Care Aides? All Montana home care workers must pass a criminal background check that screens for exploitation, abuse, theft and violent crime. Home health care workers must be registered with the state and have no adverse findings on the Nurse Aide Registry.
Are Home Care Aides Required to Undergo Special Training? Home care aides must undergo adequate training in their duties to satisfy each client’s care plan requirements. Staff providing health services must complete a nurse aide program approved by the Montana DPHSS.
Does Medicaid Cover Home Care in Montana? In Montana, Medicaid covers home care under the Big Sky Waiver and the Community First/Personal Assistance Services Program.
How Do I Report Abuse of Myself or a Loved One? To report abuse, call Adult Protective Services at (844) 277-9300. You can also submit a report online.

VIII. How to Find a Home Care Provider in Montana

Whether you are looking for yourself or a loved one, finding a quality home care provider can be a stressful process. To help you overcome this challenge, we’ve created a helpful checklist below that can help guide you through the process of both determining your needs, and finding a home care agency that will be the best fit for you and your family.

Download PDF Here

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