This page provides a plain-English summary of key elder care and estate planning information specific to Montana residents. It covers Montana Medicaid limits, estate tax rules, advance directive information, and links to important Montana agencies and resources.
Information on this page is updated periodically but laws and limits change frequently. Always verify current figures with the relevant agency or a licensed attorney.
Montana Medicaid — 2026 Eligibility Limits for Long Term Care
Montana’s Medicaid program is administered by the Montana Department of Public Health and Human Services — DPHHS. Montana expanded Medicaid in 2015 through the HELP Program — Health and Economic Livelihood Partnership — providing coverage to adults up to 138 percent of the federal poverty level. Montana’s vast rural geography creates unique challenges for long term care access with many areas having limited nursing facility options and a strong cultural preference for aging in place at home.
Income limit — Montana nursing home Medicaid uses Share of Cost — no income cap Montana is one of the few states that does not impose a hard monthly income cap for nursing home Medicaid eligibility. Instead Montana uses a Share of Cost model — meaning nearly all of a resident’s income must be contributed toward nursing home care costs after allowances for a personal needs allowance Medicare premiums and any spousal income allowance. Having higher income does not disqualify a person from Montana nursing home Medicaid but does mean contributing more toward care costs.
Big Sky Waiver income limit — lower threshold Montana’s HCBS program — the Big Sky Waiver — uses a significantly lower income limit based on the Federal Benefit Rate. The income limit for the Big Sky Waiver is $994 per month for a single applicant in 2026. Applicants with income above $994 can use a spend-down pathway — applying excess income toward qualifying medical expenses to reduce countable income to the $994 threshold.
Asset limit — single applicant A single applicant must have $2,000 or less in countable assets. Exempt assets include the primary residence with equity up to $752,000 if the applicant intends to return home, one vehicle, personal belongings and household furnishings, and irrevocable funeral trusts. Note that IRAs and 401(k)s are counted as countable assets in Montana.
Home and community based care — Big Sky Waiver Montana’s primary HCBS program for seniors is the Big Sky Waiver which provides home and community based services for Montana residents who need nursing facility level care but want to remain at home. The asset limit is $2,000 for a single applicant and the income limit is $994 per month — using the Federal Benefit Rate rather than the higher 300 percent FBR standard used by most states. Services include personal care homemaker services adult day services respite care assistive technology and home modifications.
Montana also offers a Community First Choice Services — CFCS — program and a Personal Care Services — PCS — program that provide in-home personal care assistance. These programs do not require nursing facility level of care making them more accessible for some applicants. Neither CFCS nor PCS triggers the 60-month look-back period.
Rural access considerations Montana’s rural character means that nursing home and HCBS options may be limited in many areas of the state. The Big Sky Waiver and home-based programs are especially important in rural Montana where the nearest nursing facility may be hours away. Families in rural areas should apply for HCBS programs early and explore all available options.
Married couples — one spouse applying When only one spouse applies for Montana Medicaid the community spouse — the spouse who remains at home — may retain 50 percent of the couple’s combined countable assets up to a maximum of $162,660. If 50 percent of the couple’s assets is less than $32,532 the community spouse may retain up to $32,532. The applicant spouse retains $2,000.
Monthly Maintenance Needs Allowance The minimum Monthly Maintenance Needs Allowance for the community spouse is $2,644 per month in 2026. The maximum is $4,066.50 per month for community spouses with high housing costs.
Personal needs allowance Montana nursing home Medicaid recipients are allowed to keep $50 per month as a personal needs allowance. The remainder of income is applied toward the cost of care.
Look-back period and divestment penalty Montana has a 60-month — five year — look-back period for nursing home Medicaid and Big Sky Waiver applications. The look-back period does not apply to CFCS or PCS programs. Asset transfers made within 60 months of applying that were for less than fair market value may result in a penalty period of ineligibility. The 2026 divestment penalty divisor in Montana is approximately $9,190 per month — equivalent to approximately $306 per day.
Estate recovery Montana requires Medicaid estate recovery. After a Montana Medicaid recipient dies the state seeks reimbursement from the estate for long term care costs paid. Planning with an elder law attorney can help protect assets from estate recovery.
How to apply for Montana Medicaid Applications can be submitted online through the Montana Medicaid portal at apply.mt.gov, by phone at 1-888-706-1535, or in person at your local Montana DPHHS county office.
Montana Medicaid administering agency Montana Department of Public Health and Human Services — dphhs.mt.gov
Montana Estate Tax — 2026
No Montana state estate tax Montana does not impose a state estate tax. Montana’s state estate tax was eliminated for deaths occurring after January 1 2005. No Montana estate tax applies to any estate regardless of size.
No Montana inheritance tax Montana does not impose an inheritance tax. Montana’s inheritance tax was repealed effective for deaths on or after January 1 2001. Beneficiaries who receive assets from a Montana decedent owe no Montana inheritance tax regardless of the size of the inheritance or their relationship to the deceased.
Federal estate tax Montana residents may be subject to the federal estate tax. The federal estate tax exemption is $15,000,000 per person in 2026 following enactment of the One Big Beautiful Bill Act. The exemption is portable between spouses meaning a married couple can protect up to $30,000,000 from federal estate tax with proper planning. The top federal estate tax rate is 40 percent on amounts above the exemption.
No Montana gift tax Montana does not impose a state gift tax. Federal gift tax rules apply — the annual gift tax exclusion is $19,000 per recipient in 2026.
No Montana sales tax Montana has no state or local sales tax — one of only five states without a sales tax. This provides meaningful ongoing savings for Montana residents on everyday purchases and makes Montana particularly attractive for large purchases such as vehicles and equipment.
Montana income tax — reducing rates Montana has a progressive income tax with two brackets — 4.7 percent and 5.65 percent in 2026 — down from higher rates in recent years as Montana has been reducing its income tax. Social Security benefits are partially taxed in Montana. Pension income and IRA and 401(k) distributions are fully taxable in Montana.
Montana property taxes — new 2026 tiered structure Montana implemented a new tiered property tax structure in 2026 for primary residences and long-term rentals. The rate is 0.76 percent on assessed value up to the statewide median of approximately $378,000 — 0.90 percent from $378,001 to $756,000 — 1.10 percent from $756,001 to $1,511,999 — and 1.90 percent on values above $1,512,000. Second homes short-term rentals and vacant lots are taxed at a flat 1.90 percent. Primary residence owners who received the 2025 property tax rebate and continue to occupy the home for at least seven months in 2026 automatically qualify for the reduced tiered rates.
Step-up in basis Inherited assets in Montana receive a stepped-up tax basis to fair market value at the date of the original owner’s death. This can significantly reduce capital gains taxes when beneficiaries later sell inherited property including Montana farmland and ranchland which has appreciated significantly in recent years.
Montana Advance Directives
Montana law recognizes the following advance directive documents:
Montana Durable Power of Attorney for Health Care Names a healthcare agent to make medical decisions on your behalf when you are unable to do so. Must be signed and witnessed by two adults or notarized.
Montana Declaration — Living Will Documents your wishes regarding life-sustaining treatment when you have a terminal condition or are in a persistent vegetative state. Must be signed and witnessed by two adults.
Montana POLST — Physician Orders for Life-Sustaining Treatment Montana uses a POLST form for seriously ill patients that documents specific medical orders regarding CPR hospitalization and artificial nutrition. Must be signed by a physician or nurse practitioner.
Montana Do Not Resuscitate Order A physician order directing emergency personnel not to perform CPR. Montana has standardized out-of-hospital DNR protocols.
Montana Advance Directive Registry Montana does not maintain a statewide advance directive registry. Copies of your advance directive should be given to your healthcare agent physician and any hospital or care facility where you receive care.
Free Montana advance directive forms Free Montana-specific advance directive forms are available at caringinfo.org and from the Montana Medical Association at montanadoctors.org.
Montana Key Agencies and Resources
Montana Department of Public Health and Human Services — DPHHS Administers Montana Medicaid including long term care programs. Website: dphhs.mt.gov Apply Montana Portal: apply.mt.gov Phone: 1-888-706-1535
Montana Senior and Long Term Care Division — SLTC Coordinates programs and services for older Montanans including home care nutrition programs caregiver support and the Montana SHIP program for free Medicare counseling. Website: dphhs.mt.gov/sltc Phone: 1-800-332-2272 Montana SHIP — free Medicare counseling: 1-800-332-2272
Montana Area Agencies on Aging Montana is served by Area Agencies on Aging that coordinate local services for older adults and caregivers across the state’s vast rural geography. Eldercare Locator: 1-800-677-1116 or eldercare.acl.gov
Montana Long Term Care Ombudsman Program Advocates for the rights of residents of nursing homes and assisted living facilities. Investigates complaints and helps resolve problems free of charge. Website: dphhs.mt.gov/sltc/ombudsman Phone: 1-800-332-2272
State Bar of Montana Lawyer Referral Service Connects Montanans with attorneys including those who specialize in elder law and estate planning. Website: montanabar.org Phone: 1-406-442-7660
Montana Legal Services Association Provides free civil legal services to low income Montanans including seniors on issues related to Medicaid benefits housing and elder law. Website: montanalegal.org Phone: 1-800-666-6899
Montana Veterans Resources
Montana Department of Military Affairs — Veterans Affairs Division Provides services and benefits to Montana veterans and their families including free VA claims assistance and connections to Montana veterans resources. Website: montanadma.org/veterans-affairs Phone: 1-406-324-3740
Montana Veterans Homes Montana operates veterans homes providing long term care to eligible veterans and their spouses. Facilities are located in Columbia Falls and Glendive. Website: montanadma.org/veterans-homes
Montana Senior Property Tax Benefits
Property Tax Assistance Program Montana homeowners who occupy their home as a primary residence and meet income requirements may have the assessed valuation of their property reduced by 30 percent 50 percent or 80 percent of the first $418,000 of market value. Income and asset limits apply. Apply through the Montana Department of Revenue.
Elderly Homeowner and Renter Credit Montana residents aged 62 and older who have lived in the state for at least nine months and meet income requirements — household income below $45,000 — may qualify for a refundable property tax credit of up to $1,150. The credit is calculated based on household income rent paid and property taxes paid. Claim using Schedule IV with your Montana income tax return.
New 2026 Tiered Property Tax Structure Montana’s new tiered property tax structure for 2026 provides reduced rates for primary residences particularly for more modestly valued homes. Qualifying primary residence owners pay 0.76 percent on assessed value up to the statewide median of approximately $378,000 — providing meaningful property tax relief compared to the flat rate previously applied.
Disabled Veteran Property Tax Exemption Montana veterans who are totally and permanently disabled due to a service-connected disability may qualify for a property tax exemption on their primary residence. Contact your county assessor for details.
Finding Elder Law and Estate Planning Attorneys in Montana
The following resources can help you find a qualified elder law or estate planning attorney in Montana:
- National Academy of Elder Law Attorneys — NAELA — naela.org — searchable directory by location
- State Bar of Montana Lawyer Referral Service — montanabar.org — 1-406-442-7660
- Montana Chapter of NAELA — Montana has an active NAELA chapter with members throughout the state
- Montana Legal Services Association — montanalegal.org — free legal assistance for income-qualifying seniors — 1-800-666-6899
The information on this page is for general informational purposes only and does not constitute legal or financial advice. Montana Medicaid rules and other figures change frequently. Always verify current information with the relevant agency or a licensed attorney. Laws vary and individual circumstances differ significantly.
Last updated: May 2026