Montana Home Care Medicaid

For families hoping to avoid a nursing facility altogether, Montana's Big Sky Waiver is the main path to community-based, nursing-facility-level care. Administered through the Senior and Long Term Care Division, it's a Medicaid 1915(c) Home and Community-Based Services waiver — meaning it lets people who'd otherwise need institutional care instead receive services at home or in the community.

Eligibility isn't just about income and resources. DPHHS requires a Big Sky Waiver recipient to be financially eligible for Medicaid, to meet the same minimum level-of-care standard used for nursing-facility placement, and to have an unmet need that only waiver services can address.

One important caveat: DPHHS currently reports a waiting list for the Big Sky Waiver, so families should factor timing into their planning rather than assume services can start immediately.