Cost of Senior Care in Montana (2026)

The cost of senior care in Montana follows the national pattern, with one local twist: assisted living and nursing-home care run below the national line, while in-home care runs above it. On the most recent national benchmark, the CareScout 2025 Cost of Care Survey released in March 2026, assisted living has a national median of about $6,200 a month and a semi-private nursing-home room about $9,581 a month.1 Which setting a family chooses can swing the yearly bill by tens of thousands of dollars.

This guide lays out what senior care costs on the current survey, how Montana compares, what pushes the price up or down, and how families actually pay, from private funds to Medicaid for those who qualify.

In This Guide

• Key Takeaways
• The Cost of Senior Care by Setting
• What Drives the Cost of Senior Care
• How Montana Families Pay for Senior Care
• How to Plan and Budget for Senior Care
• Frequently Asked Questions

The Cost of Senior Care by Setting in Montana

The figures below come from the CareScout Cost of Care Survey, the 2025 edition released March 2026, which is the most recent national benchmark. CareScout, formerly Genworth, has run this survey for more than two decades; the numbers are medians from an industry survey, not government rates and not maximums, so the cost at any one provider can land higher or lower depending on location, room type, and how much care a person needs.1

One thing to know before reading any cost page: every senior-care survey publishes a different number. CareScout, SeniorLiving.org, and A Place for Mom each run their own survey on their own schedule, so the "national median for assisted living" can differ by hundreds of dollars a month depending on whose data you read. This guide uses the CareScout figures because that survey is the longest-running and most widely cited benchmark, and it states the year plainly so you can compare like with like.

Nationally, the semi-private nursing-home figure works out to about $315 a day and the private room to about $355 a day; the national in-home figure assumes about $35 an hour at 44 hours a week, which is closer to daily help than around-the-clock supervision.1 Round-the-clock home care costs far more, because the hours multiply quickly, which is why heavy daily needs often tip the math toward a facility even where staying home is the preference.

In CareScout's own ranked state tables, Montana runs below the national line for residential care and above it for care at home: assisted living about $72,900 a year, a semi-private nursing-home room $295 a day, a private room $315 a day, and a non-medical caregiver about $38 an hour, roughly $86,944 a year. Adult day health care runs the other way: at about $267 a day, Montana is the most expensive of the states CareScout reports for that service.1 Costs still vary by region and level of care, and the CareScout interactive cost-of-care tool lets you look up a specific area.

A note on the 2025 in-home category: CareScout used to publish two separate in-home lines, a homemaker (household tasks like cooking and cleaning, no hands-on care) and a home health aide (personal care like bathing and dressing). The 2025 survey combined them into a single "non-medical caregiver" service.1 If you are comparing this year's home-care number to one you saw last year, that is why the categories look different.

What Drives the Cost of Senior Care in Montana

The single biggest driver of cost is the level of care a person needs. A nursing home provides 24-hour licensed nursing care, with a staff of nurses and aides on every shift plus the building, equipment, and oversight that skilled care requires, which is why the semi-private national median, about $9,581 a month, sits well above assisted living's roughly $6,200.1 Assisted living is built for people who need help with daily tasks but not constant skilled nursing, so it carries a lighter staffing load and a lower bill.

In-home care is the setting that surprises people most, and it surprises Montana families especially. A non-medical caregiver runs about $35 an hour nationally, or roughly $80,080 a year at 44 hours a week, and in Montana the median is higher, about $38 an hour, or roughly $86,944 a year.1 Because in-home help is billed by the hour, the bill climbs fast as the hours grow: daily help for a few hours is affordable, but continuous home care rarely is, and it can approach the cost of a facility.

Within any single setting, the advertised rate is rarely the whole bill. A facility usually quotes a base rate for room and routine services, then adds charges as care needs grow: help with more activities of daily living (ADLs), medication management, memory care, or a higher staffing tier. A resident who enters needing little help and later needs much more can see the monthly cost climb well past the opening figure. When you compare quotes, ask what the base rate includes and what triggers an add-on, because two facilities with similar headline prices can bill very differently once care needs rise.

How Montana Families Pay for Senior Care

Almost no one pays for years of senior care out of a single source. Most families start with private funds and shift to other payers as the bills mount. Here is how the main options work in Montana.

Private pay is savings, income, the proceeds of a home sale, and long-term care insurance if a person bought it. It is the most flexible option, since it covers any setting, but it is also the one that runs out, and at a national median of about $114,975 a year for a semi-private nursing-home room or roughly $80,080 for full-time non-medical home care, it can run out faster than families expect.1 Long-term care insurance, where it exists, can offset a share of the cost, though policies vary widely in what they pay and for how long.

Montana Medicaid pays for long-term care, including nursing-facility care and home- and community-based services, for people who meet both a level-of-care test and the financial rules.2 Montana sets eligibility differently from most states, and the difference matters for planning. KFF's 2026 survey reports Montana as the only state that does not offer the optional long-term-care eligibility pathway, so it does not use the special income limit of 300 percent of the SSI federal benefit rate, $2,982 a month in 2026, that most states have adopted. Instead Montana follows a medically needy, spend-down approach: its medically needy income level is $525 a month, and an applicant whose income sits above the standard can still qualify by meeting the spend-down with incurred medical expenses, a cash payment to the department, or both. A nursing-home resident on Medicaid applies their income, less allowable deductions, to the cost of care and keeps a personal needs allowance of $50 a month.2 The countable-resource limit is $2,000 for an individual and $3,000 for a couple, and the home and its surrounding property are excluded. When one spouse needs care, the at-home spouse keeps a community spouse resource allowance (CSRA) equal to the greatest of half the couple's combined countable resources (capped at $162,660), the $32,532 minimum, or an amount a hearings officer or a court sets, so a hearing or court order can leave the at-home spouse more than $162,660.2

If a nursing home is not the right fit, Montana funds home and community-based care mainly through the Montana Big Sky Waiver, administered by the Montana Department of Public Health and Human Services (DPHHS), which supports people who would otherwise need nursing-facility care in their own homes and communities. To qualify for the Big Sky Waiver, an applicant must be financially eligible for Medicaid and meet the minimum level of care required for nursing-facility placement.2 Two more rules shape long-term-care planning: Montana applies a 60-month look-back to asset transfers, counted back from the date an applicant requests Medicaid coverage, unless the transfer is one the rules exempt, and federal law requires the state to recover Medicaid payments after death from, among others, people who were 55 or older when they received Medicaid-paid services.2

One gap trips up many families: Medicaid does not pay the room-and-board cost of assisted living. Montana's Medicaid long-term-care coverage centers on nursing-facility care and its home and community-based services; it does not cover the rent-and-meals portion of an assisted-living bill the way it covers a nursing-facility stay.3 A family choosing assisted living should plan to cover room and board privately, even where a waiver or personal-care benefit helps pay for the care services themselves.

A note on Medicare, because the assumption is common: Medicare covers only short-term skilled rehabilitation after a hospital stay, not the long-term custodial care, the ongoing help with daily living, that most families are budgeting for. That long-term care is what private pay and Medicaid cover.

How to Plan and Budget for Senior Care

Start by matching the setting to the actual need, not the other way around. A candid assessment of how much help a person truly needs is worth more than a default assumption. Many people who need help with daily tasks but not skilled nursing are well served by assisted living or a few hours a day of in-home care, while someone needing continuous care may find a nursing home costs no more than full-time help at home, especially in a rural area where in-home rates run high.

Then build a realistic timeline. Estimate the monthly cost of the right setting, list the resources available to pay for it, and work out how long private funds will last before Medicaid would come into play. If Medicaid is likely to be part of the plan, the look-back and estate-recovery rules reward starting early and getting advice, because last-minute moves to qualify often trigger penalties. Two Brevy guides go deeper here: Medicaid Planning Strategies walks through how to position assets and income within the rules, and Medicaid Personal Needs Allowance, Explained covers the small monthly amount a resident keeps.

Finally, budget for the add-ons, not just the base rate. Care needs tend to rise over time, so the figure you start with is rarely the figure you finish with. A plan that assumes some increase is more likely to hold up than one built on today's lowest quote. For Montana-specific help, the Montana DPHHS Senior and Long Term Care division can point you to local resources; you can reach the Community Services Bureau, which administers the Big Sky Waiver, through dphhs.mt.gov/sltc/csb.

Learn More

Find personalized help building a realistic senior-care budget for Montana at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.