Assisted Living Cost in Montana
Montana looks close to average on assisted living, then surprises in both directions: adult day care here is the most expensive in the country, while a private nursing home room costs exactly the same as the national semi-private room. The metro spread is wide too, at $2,875 a month from Missoula to Bozeman. Budget from the place figure, not the state figure, and price adult day care as its own line, not as a cheap add-on.
Sources: CareScout Cost of Care Survey 2025, released March 2026, ranked state tables and Cost of Care calculator, accessed November 2026; Montana Department of Public Health and Human Services Big Sky Waiver program information; Montana Department of Public Health and Human Services state veterans homes information.
Montana assisted living costs, against the national median
The table below is the CareScout 2025 survey for Montana, with the national median beside it. The survey collected more than 25,000 provider rates between July and November 2025 and reports medians, the middle price, not averages pulled up by luxury buildings. Assisted living figures are for a private one-bedroom apartment for 12 months of care.
| Care type | Montana median | National median |
|---|---|---|
| Assisted living, per month | $6,075 ($72,900 per year) | $6,200 ($74,400 per year) |
| Home care, non-medical caregiver, per hour | $38 ($86,944 per year at 44 hours a week) | $35 ($80,080 per year at 44 hours a week) |
| Adult day health care, per day | $266.90 ($69,395 per year at 5 days a week) | $95 ($24,700 per year at 5 days a week) |
| Nursing home, semi-private room, per month | $8,973 ($107,676 per year) | $9,581 ($114,975 per year) |
| Nursing home, private room, per month | $9,581 ($114,972 per year) | $10,798 ($129,575 per year) |
The assisted living cost Montana median runs $125 a month below the national median, which is $1,500 over a full year (74,400 minus 72,900). Home care at $38 an hour sits $3 above the $35 national rate. Adult day care at $266.90 a day sits $171.90 above the $95 national rate, and the $69,395 annual figure is the highest adult day median in the nation, nearly triple the $24,700 national median. A semi-private nursing home room at $8,973 sits $608 below the $9,581 national figure, and a private room at $9,581 sits $1,217 below the $10,798 national figure. Montana's private nursing home room costs exactly the same as the national semi-private room, at $9,581 a month. For the full national picture, read how much does assisted living cost and how much does a nursing home cost.
Assisted living cost Montana by place
Place medians come from the same CareScout survey, through its Cost of Care calculator, which reports the closest survey region for each place. All figures are 2025 monthly medians for a private one-bedroom apartment. The spread runs from $4,025 to $6,900, a gap of $2,875 a month between the lowest and highest Montana place in this table.
| Place | Assisted living median per month, 2025 | Against the Montana median |
|---|---|---|
| Bozeman | $6,900 | $825 above |
| Billings | $6,224 | $149 above |
| Great Falls | $5,295 | $780 below |
| Missoula | $4,025 | $2,050 below |
Two places in this table sit above the $6,075 state median and two sit below it, which tells you Montana's state figure is a genuine middle, not a number pulled down by one cheap region. Bozeman at $6,900 sits $825 above the state median, while Missoula at $4,025 sits $2,050 below it, the widest place gap in this batch. Do not treat the state median as the price in any of these places: use the place figure, then replace it with three written quotes in that place, with apartment size and care level stated. For how to use competing quotes, read can you negotiate assisted living costs.
What the monthly bill includes, and what it leaves out
The median buys the building and the base service: a private apartment, meals, housekeeping, supervision, and activities, with staff on site around the clock. It does not buy every charge a resident actually pays. Care is priced in levels, and the level rises as help needs grow, so the second year costs more than the first even before any annual rate increase. Medication handling, a higher care level, and a second occupant are commonly billed on top of the base rate, and many buildings charge a one-time community fee at move-in.
Montana licenses assisted living facilities through the Department of Public Health and Human Services, Quality Assurance Division, in four categories by resident need. Category A serves residents with the lowest needs, Category B serves residents who may need skilled nursing care and help with four or more daily living tasks, Category C serves residents with severe cognitive impairment, and Category D serves residents with a mental disorder, including people diverted by court order from the Montana State Hospital, and is capped at 15 residents. Ask at the tour, in writing, which category a setting is licensed for, which services the base rate covers and which are billed as extras, and what each extra costs. The tour checklist on assisted living checklist groups those questions for you.
Medicaid in Montana: Big Sky Waiver
Montana's Medicaid help for assisted living runs through the Big Sky Waiver, run by the Department of Public Health and Human Services, Senior and Long Term Care Division. A waiver is the state program that pays for care services outside a nursing home. The waiver covers Adult Residential Living, delivered as adult residential care in licensed assisted living facilities, for people who are financially eligible for Medicaid, age 65 or older or physically disabled, and meet the nursing facility level of care. Room and board is not covered by the waiver; Medicaid pays for the care services in the facility, and the resident pays room and board separately.
Apply well before care is needed: the Big Sky Waiver currently has a waiting list, and openings go to the person determined most in need, not first come first served. Referrals go through Mountain Pacific Quality Health at 800-219-7035. For the national Medicaid rules, read does medicaid pay for assisted living, and for the full payment map, read how to pay for assisted living. Medicare does not pay for assisted living room charges or custodial care; see does medicare pay for assisted living for the exact boundary.
VA resources in Montana
For a veteran parent, two Montana routes sit beside the private market. The first is VA Aid and Attendance, a monthly cash benefit added to a VA pension for a veteran or surviving spouse who needs help with daily living; the amounts and rules are on VA Aid and Attendance requirements and veterans affairs assisted living. The second is the state's own veterans homes. The Department of Public Health and Human Services operates three state veterans homes providing skilled nursing and domiciliary care: Columbia Falls, Glendive, and Butte. They are state veterans homes, not private assisted living communities, so treat them as a separate application track, not as a price comparison. For VA health care, use VA.gov to find the facility nearest your parent.
Montana against the national median, in one row
Assisted living cost Montana at $6,075 a month sits $125 below the $6,200 national median, home care at $38 an hour sits $3 above the $35 national rate, adult day care at $266.90 a day sits $171.90 above the $95 national rate, and a nursing home semi-private room at $8,973 a month sits $608 below the $9,581 national figure. Montana is a slightly cheaper state for assisted living and nursing home rooms, a slightly pricier state for home care, and by far the priciest state in the country for adult day care. At $8,973 a month, a semi-private nursing home room costs $2,898 a month more than the $6,075 assisted living median in the same state, so a parent whose needs are close to the nursing facility line should still price both settings in the same place.
Frequently asked questions
Why is Montana adult day care $266.90 a day?
Because that is what the CareScout 2025 survey measured: a $69,395 annual median, ranked first among all states, against a $24,700 national median. It is a real outlier in the release, not an error. If adult day care is part of your parent's week, budget it as its own line at the Montana rate, not at the national $95 a day, and check whether the Big Sky Waiver or another program covers it before you count on the family paying it.
Does the Big Sky Waiver have a waiting list?
Yes, currently. The Department of Public Health and Human Services states the Big Sky Waiver program has a waiting list, and openings go to the person determined most in need through a wait-list criteria tool, not first come first served. Apply well before care is needed, and ask Mountain Pacific Quality Health, the referral point, where your parent stands.
What do the Category A, B, C, and D licenses mean?
They are Montana's four assisted living license categories, set by resident need. Category A is the lowest need, Category B may include skilled nursing care and help with four or more daily living tasks, Category C is severe cognitive impairment, and Category D serves residents with a mental disorder, including court-ordered diversion from the Montana State Hospital, and is capped at 15 residents. Ask which category a setting holds, because the category sets what level of need the building may serve.
Does the $6,075 median cover two people sharing one apartment?
No. The CareScout median is for a private one-bedroom apartment occupied by one person. A second occupant adds a second-person fee set by each community, on top of the median, not inside it. Couples should budget the median plus the community's written second-person fee, plus a care level for each spouse who needs help, since care is priced per person. See average cost of assisted living for a couple for how couples totals are built.
Your next step is to take the place median for the city where your parent will actually live, get three written quotes that state apartment size, care level, and every extra fee, and check Big Sky Waiver and VA eligibility before you sign. Start with assisted living checklist and assisted living costs.