If your income is over the limit or a parent just entered a nursing home, here is how to apply for Montana Medicaid: online, by phone, by mail, or in person. File at apply.mt.gov, call the Public Assistance Helpline, or go to a local Office of Public Assistance. Federal rule requires the state to take a mailed application too. Montana uses spend-down, not a Miller Trust, so income above the limit does not bar you.

In This Guide

How to Apply for Montana Medicaid

The Montana Department of Public Health and Human Services (DPHHS) administers the state's Medicaid program, including its long-term-care coverage, through four application channels: online, by phone, in person, and by mail., All four feed the same eligibility determination, which checks your income against the medically needy spend-down rules and your countable assets against the $2,000 limit for a single applicant. Gathering your documents before you start is the single most effective way to avoid delays. Work through the steps below.

1
Step 1

Gather your documents first

Before you begin, collect identity and citizenship proof, income statements, and bank and asset records for everyone applying (see the documents section below). Missing paperwork is the most common reason an application stalls, so having it ready keeps the fastest channel fast.

2
Step 2

Choose a channel and submit your application

Apply online at apply.mt.gov, by phone through the Montana Public Assistance Helpline at 1-888-706-1535, or in person at a local Office of Public Assistance (OPA). Online is available around the clock and lets you save progress, upload documents, and track status; phone and in-person suit applicants with complex finances, a recent asset transfer, or a spend-down situation to explain, since staff can walk you through the forms. You can also apply by mail, a channel federal rule requires the state to accept and the one that matters when you can neither get online nor travel to an office; ask the helpline or a local OPA for the paper form and the address to send it to. If you are deaf, hard of hearing, or speech-impaired, use Montana Relay at 711 before dialing.

3
Step 3

Complete the financial review and any long-term-care assessment

DPHHS reviews your income, assets, and, for long-term care, your spend-down expenses. Nursing-facility and waiver applicants also receive a clinical level-of-care assessment that runs separately from the financial review.

4
Step 4

Respond promptly to any request for more information

If DPHHS needs additional documentation, answer quickly. Delays in providing what the agency asks for extend your processing time and are the leading cause of denials.

How Montana's Spend-Down Works (No Miller Trust Needed)

Montana is a medically needy state. That is a meaningful difference from income-cap states like Texas or South Dakota.

In an income-cap state, an applicant whose gross monthly income exceeds the cap is ineligible for long-term-care Medicaid unless they establish a Miller Trust (Qualified Income Trust) to redirect the excess. Montana does not require this. Instead, it sets an Aged, Blind and Disabled medically needy income level (MNIL) of $525/month for an individual ($525 for a couple), and lets applicants over that standard "spend down" excess income on incurred medical and care costs to qualify.

Spend-down works like a deductible: the gap between your countable monthly income and the $525 standard is the amount you must show in qualifying medical expenses before Medicaid pays. DPHHS reviews those expenses as part of the eligibility determination. Effective January 1, 2026, an additional $391 medically needy income deduction applies when DPHHS calculates the spend-down amount, though that deduction does not apply to institutional (nursing-facility) eligibility.

Qualifying spend-down expenses include nursing home or assisted living bills, prescription drug costs not covered by another payer, Medicare premiums and cost-sharing, physician and specialist visits, and medical equipment and supplies. Keep receipts and billing statements; DPHHS asks for documentation. If you work with an elder law attorney, ask them to confirm your monthly spend-down amount before you apply so the calculation is right the first time.

Before You Apply for Montana Medicaid: Asset Check

DPHHS reviews your countable assets before approving long-term-care Medicaid. The single-applicant resource limit is $2,000 ($3,000 for a couple; the resource standard for an institutionalized individual is also $2,000).

Exempt assets, which do not count, include the primary home up to the federal home-equity limit, one vehicle, household goods and personal property, and a prepaid burial plan. Countable assets, which do count, include checking and savings accounts, certificates of deposit, stocks and bonds, non-retirement investment accounts, the cash value of life insurance above any exempt threshold, and most retirement accounts depending on payout status.

For 2026, the Medicaid home-equity limit for long-term-care eligibility is $752,000 unless the state elects a higher amount, up to $1,130,000, and both figures are indexed annually. Beginning January 1, 2028, a 2025 federal law (the One Big Beautiful Bill Act, Public Law 119-21) will cap that figure at $1,000,000 for any home not on a lot zoned for agricultural use, so the limit will stop rising with inflation once it reaches that ceiling. A primary residence with equity above the applicable limit can disqualify an applicant from nursing-facility coverage, with statutory exceptions when a spouse or dependent lives in the home.

If your countable assets exceed $2,000, you spend them down before qualifying. Work with an elder law attorney to avoid transfers that could trigger the 60-month look-back penalty.

The 60-month look-back. Montana reviews the prior 60 months of financial transactions for any gifts or below-market transfers. Transfers made for less than fair market value during the look-back trigger a penalty period during which Medicaid will not pay for nursing-facility services. The length of the penalty depends on the amount transferred divided by the average monthly private-pay cost of nursing care in Montana.

For married couples, spousal protections apply. The community spouse (the spouse not entering the nursing facility) may keep up to $162,660 in countable assets (minimum $32,532) under the Community Spouse Resource Allowance, and may receive a Minimum Monthly Maintenance Needs Allowance in the federal range of $2,705.00 to $4,066.50 per month from the institutionalized spouse's income.

What Documents You'll Need

Gather these before you start. Incomplete applications slow processing.

Identity and citizenship:

  • Social Security card or statement
  • Birth certificate, U.S. passport, or other citizenship documentation
  • Montana driver's license or state ID

Income:

  • Social Security award letter or SSA-1099
  • Pension and retirement benefit statements
  • Any other monthly income documentation

Assets and financial accounts:

  • Bank statements for all accounts (at minimum the past 3 months; for nursing home applications, prepare up to 60 months)
  • Statements for retirement accounts, certificates of deposit, stocks, and bonds
  • Life insurance policy documentation (face value and cash surrender value)
  • Prepaid burial or funeral contract documentation

Property:

  • Property deed and recent tax assessment
  • Vehicle registration or title

Medical expenses (for the spend-down calculation):

  • Medical bills from recent months
  • Medicare premium and supplement statements
  • Pharmacy receipts

For nursing home or home- and community-based services (HCBS) waiver applications, prepare five years of bank statements. DPHHS reviews the full 60-month look-back for these applications.

How Long It Takes and What Happens After You Apply

Federal law caps how long the state may take. Under 42 CFR 435.912, a DPHHS eligibility determination may not exceed 45 days for most applicants or 90 days for people who apply for Medicaid on the basis of disability. Montana follows this federal timeliness standard. Which limit applies turns on the basis the application was filed under, not on whether a disability determination happens to arise, so an older adult applying for long-term-care coverage on the basis of age is on the 45-day standard even when medical records are part of the file. The 45-day and 90-day figures are outer limits on the agency measured from the date of application, not a guarantee that a decision arrives by then; long-term-care determinations often run toward the longer end because the financial review and any clinical assessment take time. The most common cause of delay is missing documents, so respond to any DPHHS request quickly.

After DPHHS receives a complete application, one of three things happens:

  • If approved, you receive a Medicaid card and an eligibility notice. Coverage can be backdated: federal law requires retroactive eligibility for covered services furnished in or after the third month before the month you apply, if you would have been eligible then. (For applications filed on or after January 1, 2027, a federal law change shortens that window to two months before the application month for most enrollees, and one month for the Medicaid expansion adult group.)
  • If DPHHS requests more documents, respond by the deadline in the notice. Missing that deadline is one of the most common reasons applications are denied or delayed.
  • If denied, you have the right to appeal (see below).

Check your status online at apply.mt.gov if you applied online, or call the Public Assistance Helpline at 1-888-706-1535 for an update.

Applying as a Nursing Facility Resident

If a family member recently entered a nursing facility and Medicaid is not yet approved, applying now limits out-of-pocket exposure, because retroactive coverage can reach back up to three months. You can still apply after a relative has moved in; facility social workers often assist with applications and coordinate with DPHHS on your behalf.

Once Medicaid is approved, the resident keeps a Personal Needs Allowance of $50/month from their income; the rest goes toward the cost of care, with Medicaid covering the difference. If a community spouse is living at home, DPHHS calculates how much of the institutionalized spouse's income the community spouse may keep (the Minimum Monthly Maintenance Needs Allowance). Any amount above that contribution goes toward the cost of the facility.

Can Someone Else Apply on Your Behalf?

Yes. A family member, friend, or legal representative can apply for you.

  • A close family member with knowledge of the applicant's finances can typically sign the application directly.
  • Someone outside the family who is not a legal representative needs a signed authorization form from the applicant.
  • A person with legal authority (power of attorney, legal guardian, or court-appointed conservator) can sign and act as the applicant's representative by providing documentation of that authority.

Once authorized, a representative can submit the application, provide documents, communicate with DPHHS, and receive notices on the applicant's behalf.

If You're Denied: How to Appeal

Montana applicants who are denied have the right to a fair hearing. Under federal rule 42 CFR 431.221(d), a state Medicaid agency must give a reasonable time to request one, and that window may not exceed 90 days from the date the denial notice is mailed. Ninety days is the outer limit a state may allow, not a guarantee: Montana's own deadline may be shorter, and a shorter deadline is fully enforceable. Your denial notice states the reason for the denial and the deadline to appeal, so read it carefully and treat the date printed there as the one that binds you.

To request a hearing, you can:

During the hearing, an independent hearing officer reviews the case. You can present documents and explain your situation. Having an elder law attorney or a legal aid representative present is often helpful for complex cases. Free legal help is listed in the resources below.

Where to Get Help

Use these Montana and federal resources to start your application, check your status, ask questions, or get free legal help with a denial.

Montana Department of Public Health and Human Services (DPHHS) Administers Montana Medicaid; the Public Assistance Helpline takes applications and answers status questions. 1-888-706-1535 dphhs.mt.gov/MontanaHealthcarePrograms
apply.mt.gov Montana's online portal to submit and track a Medicaid application and upload documents. apply.mt.gov
Montana Legal Services Association (MLSA) Free legal assistance to low-income Montanans, including help appealing a Medicaid denial. 1-800-666-6899 www.montanalegalservices.org
Medicaid.gov Federal overview of Medicaid eligibility, benefits, and enrollee rights. www.medicaid.gov
Social Security Administration Verifies Social Security numbers and provides the award letters used as proof of income. 1-800-772-1213https://www.medicare.gov/basics/get-started-with-medicare/sign-up/how-do-i-sign-up-for-medicare www.ssa.gov

Frequently Asked Questions

Does Montana require a Miller Trust to apply for long-term care Medicaid?

No. Montana is a medically needy state. Applicants with income above the medically needy income level of $525/month qualify by spending down excess income on incurred medical and care expenses. A Miller Trust (Qualified Income Trust) is not required and is not part of Montana's Medicaid program.

What is the income limit to apply for Montana Medicaid long-term care?

Montana does not use a fixed income cap for long-term-care Medicaid. It sets an Aged, Blind and Disabled medically needy income level of $525/month for an individual, and applicants above that standard qualify by documenting and deducting qualifying medical expenses (spend-down). There is no single income ceiling that bars you from applying.

How far back does Montana look at my financial history?

Montana applies a 60-month (5-year) look-back to any transfers of assets made for less than fair market value. Gifts, below-market sales, and transfers to trusts within that window can trigger a penalty period. The look-back applies to nursing-facility and HCBS waiver applications.

Can my spouse keep the house if I go into a nursing home?

Generally, yes. The primary home is an exempt asset while the community spouse lives there, subject to the federal home-equity limit, which for 2026 starts at $752,000 and is indexed annually. That annual indexing will not run forever: beginning January 1, 2028, federal law will hold the limit at no more than $1,000,000 unless the home sits on a lot zoned for agricultural use. After the death of the Medicaid recipient, Montana may pursue estate recovery on the value of the home. Talk to an elder law attorney about steps that can minimize or defer recovery.

How long will it take to get a decision on my application?

Federal rule 42 CFR 435.912 caps DPHHS at 45 days for most applicants and 90 days for people who apply for Medicaid on the basis of disability. Which cap applies depends on the basis you applied under, not on whether a disability determination arises, so an aged-basis long-term-care application sits on the 45-day standard. Those are limits on the agency rather than a guaranteed decision date. Delays most often result from missing documents. Submit a complete package and respond to any DPHHS requests promptly. If you applied at apply.mt.gov, check your status there; otherwise call 1-888-706-1535.

What if my income changes after I'm approved?

Report income changes to DPHHS promptly. Montana requires Medicaid recipients to report changes in income, assets, or household composition. Changes can affect your spend-down amount or your overall eligibility, and failing to report them can result in an overpayment and a repayment obligation.

Learn More

MedicaidHow to Apply for Medicaid by State: Steps, Documents, and Where to ApplyApplying for Medicaid follows the same federal steps everywhere; the agency and portal are your state's. What to gather, how long it takes, and where to apply. MedicaidMontana Medicaid Eligibility and Income LimitsMontana Medicaid income limits 2026: adults under 65 qualify to 138% FPL with no asset test; seniors and long-term care get a spend-down and a $2,000 limit. MedicaidMontana Medicare Cost-Sharing Help for SeniorsMontana Medicare Savings Programs 2026: QMB, SLMB, and QI income limits, what each pays, Part D Extra Help, and how to apply through Montana DPHHS. MedicaidMedicaid Planning StrategiesSee which assets you keep, how the 5-year look-back works, and the legal moves that qualify you for Medicaid long-term care without losing the house. MedicaidMedicaid Estate Recovery ExplainedMedicaid estate recovery explained: federal law, 51-state matrix, categorical protections, hardship waivers, and 2025-2026 reform updates. Verify before acting.

Find personalized help applying for Montana Medicaid 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.

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Brevy Care Team

Expert eldercare guidance from Brevy's team of healthcare professionals and researchers.