Montana long-term care insurance: cost & coverage

Who regulates long-term care insurance in Montana

Long-term care insurance policies sold in Montana are regulated by the Office of the Montana State Auditor, Commissioner of Securities and Insurance (CSI). If you have a complaint about an agent, carrier, or policy, you can file it with the regulator directly.

What long-term care costs in Montana

Median assisted living cost in Montana vs. the national median:

Source: SeniorLiving.org median assisted living costs, 2026. See costs for all 50 states for the full table.

What each type of care costs in Montana

Assisted living is only one of the settings people use. Median monthly costs across the main care types in Montana:

Source: SeniorLiving.org Cost of Care Research (2026)

Montana's LTC Partnership program

Montana has an active LTC Partnership program. Montana's Partnership for Long-Term Care (established 2009) provides dollar-for-dollar Medicaid asset disregard for benefits paid under a qualified policy issued after July 1, 2009.

A Partnership-qualified policy lets you keep an extra dollar of assets, protected from Medicaid spend-down, for every dollar your policy pays out in benefits — see the note above for this state's current status. Learn more about how Partnership programs work.

How Montana treats LTC premiums at tax time

Montana no longer gives long-term care insurance premiums a deduction or a credit of their own. The 2021 restructuring (Chapter 503, Laws of 2021) repealed Montana's separate itemized-deduction statute effective with tax year 2024, so Montana taxable income now begins with your federal taxable income and uses whichever deduction — standard or itemized — you already took federally. No subtraction and no credit on the current Montana return reaches LTC premiums. One indirect route does exist: a Montana Medical Savings Account. A Montana resident can subtract up to $4,600 contributed in 2025, and long-term care expenses, long-term care insurance and long-term care annuities all count as eligible withdrawals. Married spouses can each fund their own account.

Source: Montana Department of Revenue (2025)

This is general information, not tax advice. Confirm your own situation with a tax professional licensed in Montana.

Medicaid long-term care in Montana

Montana Medicaid — the program Montana runs as Montana Healthcare Programs — is what ends up paying for most long nursing home stays here, and its asset test is strict. An unmarried Montanan entering a nursing facility may keep only $2,000 in countable resources, and a married applicant's own limit is also $2,000. Effective January 1, 2026, the spouse who stays at home keeps half the couple's combined countable resources, but never less than $32,532 and never more than $162,660. Nearly all of the resident's monthly income then goes to the facility; Montana leaves a personal needs allowance of just $50 a month. If you were 55 or older, Montana can also recover what it paid from your estate.

Source: Montana Department of Public Health and Human Services (2026)

Other Montana long-term care programs

• Big Sky Waiver. Montana's Big Sky Waiver is the state's Medicaid home and community-based waiver — a 1915(c) program run by the Senior and Long-Term Care Division at DPHHS that lets people who would otherwise be institutionalized live in their own home and community instead. To qualify you must be financially eligible for Medicaid, meet the minimum level of care required for nursing facility placement, and have an unmet need that only waiver services can resolve. Care is planned by a case management team made up of a nurse and a social worker. DPHHS says the program currently has a waiting list, so it is not something to count on being there the month you need it. Referrals go through Mountain Pacific at (800) 219-7035.
• Community First Choice Services and Personal Care Services (CFCS/PCS). Montana also runs two Medicaid in-home programs that DPHHS calls entitlement programs — Community First Choice Services and Personal Care Services — which pay an attendant to help with bathing, dressing, grooming, toileting, eating, medication assistance, walking and medical escort in your own home. You must have a health condition that limits your activities of daily living, take part in a screening, and be eligible for Medicaid; Community First Choice additionally requires a nursing home level of care. You can take the services through an agency or self-direct them and hire your own attendants. DPHHS is renaming these programs from CFC/PAS, so Montana paperwork may still carry either set of initials.
• Aging and Disability Resource Centers (ADRCs). Montana's Aging and Disability Resource Centers are the state's single point of entry for long-term care information, staffed by trained and certified information specialists working through the Area Agencies on Aging. They serve adults 60 and older and adults over 18 with disabilities, along with families and caregivers, and DPHHS is explicit that they are for private-pay Montanans too — reaching people before they become Medicaid-eligible so they can learn about low-cost options and private long-term support insurance, and prevent or delay spending down to Medicaid. Beyond information and referral they provide Options Counseling for planning long-term services and supports, and keep a current public directory of Montana providers.
• Montana State Health Insurance Assistance Program (SHIP). Before you buy anything, Montana will help you think it through at no cost. The State Health Insurance Assistance Program is administered by the Montana Office on Aging, funded by the federal Administration for Community Living, and delivered through the Area Agencies on Aging; one statewide number, 1-800-551-3191, connects you with a counselor for your county. SHIP counselors cover Medicare eligibility and enrollment, Part D comparisons, Medigap, Medicare health plans, fraud, and long-term care options — and they are not connected with any insurance company and are not licensed to sell insurance. If you cannot get out of the house, a counselor will meet you at home.
• Montana Board of Housing Reverse Annuity Mortgage (RAM) Program. Montana runs its own reverse mortgage through the Montana Board of Housing, for older homeowners who own their house outright and live on a fixed income — a way to turn home equity into monthly income and stay put rather than move into care. It is narrower than a federal reverse mortgage: every borrower must be 68 or older, the home must be a Montana single-family dwelling unencumbered by any prior mortgage, lien or pledge, mobile and manufactured homes are excluded, annual family income is capped, and you must attend a counseling session before you can apply. Loans run from $15,000 to $250,000 and are advanced monthly over a ten-year term.

How to compare quotes in Montana

• Confirm any agent or carrier you talk to is currently licensed to sell in Montana — the Office of the Montana State Auditor, Commissioner of Securities and Insurance (CSI) can confirm licensing status.
• Ask which products a carrier is actively writing in Montana today — availability changes state by state and year to year. See carriers we compare.
• If a Partnership-qualified policy matters to you, confirm with the carrier or agent whether a policy is currently certified as Partnership-qualified in Montana — see this state's Partnership status above.
• Compare traditional and hybrid options side by side — see traditional vs. hybrid coverage.
• Get quotes from more than one carrier; pricing for the same coverage can vary significantly.

Please note: Regulator names, complaint channels, and Partnership-program status can change. Confirm current details with the Office of the Montana State Auditor, Commissioner of Securities and Insurance (CSI) or a licensed agent before making any decision. LongTermCareInsurance411 is not a government agency and does not administer Montana's insurance regulations or Medicaid program.

Last updated: August 22, 2026