---
title: "Montana Medicaid Long-Term Care | Funding LTC Marketplace"
url: https://fundingltcmarketplace.com/states/montana/medicaid-long-term-care/
description: "How Montana DPHHS, local OPA offices, and the Senior and Long Term Care Division administer nursing-facility and community Medicaid pathways."
last_updated: 2026-10-20
author: George A. Mellendorf, CLTC, LTCP (Central States Insurance Services, Inc.)
publisher: Funding LTC Marketplace
note: Educational content; not legal, tax or financial advice. Markdown copy of the HTML page at the URL above.
---
Montana · Medicaid Program

# Montana Medicaid Long-Term Care

Last updated 2026-10-20

Montana Medicaid can pick up the cost of nursing-facility care and home- and community-based long-term services once a person clears the program's financial and nonfinancial requirements. The Department of Public Health and Human Services runs the state program, its Senior and Long Term Care Division and Community Services Bureau oversee community-based services, and your local County Office of Public Assistance handles the actual eligibility determination.

The nursing-facility rule is refreshingly simple in one respect: an otherwise-eligible resident (or spouse) is treated as income-eligible whenever the monthly nursing-home bill equals or exceeds their monthly income. Once that threshold is met and eligibility is locked in — whether categorically or medically needy — a separate 'Step II' calculation figures out how much of the resident's income actually goes toward the cost of care.

This is a meaningfully different structure from a flat national income cap. Montana's medically needy policy lets a person qualify by applying incurred medical expenses toward a spend-down obligation, by simply paying a cash amount to the Department, or by blending both approaches — whichever fits the family's situation better.

## Sources and official resources

- [Montana DPHHS: How Can Medicaid Help with Nursing Home Bills?](https://dphhs.mt.gov/assets/sltc/ADRC/MedicaidHelpBrochure.pdf)
- [CMS: 2026 SSI and Spousal Impoverishment Standards](https://www.medicaid.gov/federal-policy-guidance/downloads/cib04272026.pdf)

Rules and figures change. Confirm current details with the agency before you act.

[← Back to the full Montana guide](https://fundingltcmarketplace.com/states/montana/)