Memory Care in Montana

Because of the specialized staff training and resources required to provide high-quality care, memory care typically costs more than other types of residential care. On average, memory care costs 20-30% more than assisted living.

According to the Genworth 2019 Cost of Care Survey, seniors in Montana pay an average of $3,820 per month for assisted living care, which is $231 below the national median. Assuming that memory care costs 25% more than assisted living, the average cost of living in a residential memory care facility in Montana would be $4,775 per month.

Throughout the state, the average cost of assisted living varies from city to city. At $4,893 per month, Missoula’s average assisted living cost is the highest in the state. Billings’ cost is midrange at $4,350 per month, while in Great Falls the average cost is considerably lower at $3,800 per month. It’s important to keep in mind that these average costs are for assisted living, and memory care may cost between $760 and $1,500 more per month.

• Billings: $4,350
• Missoula: $4,893
• Great Falls: $3,800

Montana Medicaid Programs for Memory Care

Big Sky Waiver Program

Montana Medicaid’s Big Sky waiver program helps seniors access long-term care services in their home or an assisted living or memory care facility. Each participant is assigned a registered nurse and social worker who work together to oversee their care. Services available through the program include adult day care, private duty nursing, personal assistance, homemaker services and specialized medical services. Seniors who continue to live at home may enlist family members to provide their care under this program.

• Who Is Eligible: To qualify for the waiver, seniors should be eligible for regular Medicaid. The program is open to seniors aged 65 and older, as well as those who are under age 65 and living with physical disabilities.

• How to Apply: Seniors can apply for the Big Sky Waiver Program by calling Mountain Pacific Quality Health at 800-219-7035.

Non-Medicaid Financial Assistance Programs for Memory Care in Montana

Optional State Supplement

Seniors in Montana may be eligible for the Optional State Supplement, which is a monthly cash benefit that’s payable to aged, blind and disabled persons. The payment amount is based upon the recipient’s income and living situation. Beneficiaries can use this payment, which is meant to supplement federal Supplemental Security Income payments, to offset the cost of memory care. These two payments are issued together each month and in some cases, can be paid directly to the senior’s care facility to cover living costs and personal needs.

• Who Is Eligible: To qualify for this benefit as an individual in an assisted living or memory care facility, a person must be a recipient of the federal SSI benefit.
• How to Apply: SSI recipients should be automatically enrolled in this program if they qualify. Questions can be directed to the Social Security Administration by calling 800-772-1213.

Medicare Advantage

Medicare Advantage plans, also known as Medicare Part C, provide seniors with all the benefits of regular Medicare while covering additional expenses. All Medicare Advantage plans are administered by private insurance companies, which coordinate with Medicare to cover the benefits provided under Parts A and B while offering a variety of additional benefits, which often include dental and vision services. Because these plans are offered privately, they vary in the services covered, as well as co-pay amounts and costs. Some, such as the Humana Choice plan, may cover a portion of the cost of memory care, but it’s important to research plans to ensure they provide the coverage a senior needs before enrolling.

• Who Is Eligible: Medicare Advantage plans are only available to individuals already enrolled in Medicare Parts A and B. A senior must also live within the service area of the plan they wish to join.
• How to Apply: To apply for Medicare Advantage, seniors should directly contact the private insurance company offering the plan they wish to join. Details and insurer contact information for Medicare Advantage plans available in Montana can be accessed using the Medicare plan finder tool.

More Ways to Pay for Memory Care

In addition to the state programs mentioned above, those looking for resources to finance memory care may consider:

• Long-Term Care Insurance: Depending on the policy details, long-term care insurance may be used to pay for memory care services. It’s best to sign up for a policy early, as coverage will likely be denied if one already has long-term care needs. More information about the intricacies of long-term care insurance can be found at longtermcare.acl.gov.
• Reverse Mortgages: Reverse mortgages allow some homeowners to take out a loan as an advance from the eventual sale of their primary residence. This can be a good way to fund memory care in the short-term, but the loans will need to be paid back after the sale of the home. The most commonly used type of reverse mortgages for seniors is the Home Equity Conversion Mortgage, which is the only reverse mortgage insured by the federal government.
• Veterans Benefits: The Department of Veterans Affairs offers several programs that veterans and their spouses may use to cover health care needs such as memory care. More information about these programs can be found on the VA website.
• Life Insurance: Some life insurance policies allow policyholders to cash out their policy before a qualifying death. There may be some downsides to accessing a life insurance benefit early, so be sure to read more about the process.

Memory Care Regulation

Montana’s memory care and assisted living facilities are licensed and regulated by the Montana Department of Public Health and Human Services. It’s the responsibility of this department to ensure that all facilities comply with state laws and administrative rules by requiring a comprehensive licensing process and conducting regular inspections. In Montana, seniors with mild to moderate dementia may qualify for care in a category A or category B assisted living facility. Only category C assisted living facilities may provide memory care for individuals who are unable to make their own care decisions.

Facility Scope of Care

Services that must be provided to residents in Montana memory care facilities include:

• Personal care and assistance with daily tasks
• Assistance with medication administration by a licensed health care professional
• Regular health assessments
• At least three meals per day at regular times
• Social activities and entertainment
• Local transportation to and from health care services and social activities
• Housekeeping and laundry services by staff who are trained in proper procedures

Admissions Requirements

Category C assisted living facilities may provide full-time, residential care to seniors who require assistance with activities of daily living and need continuous help with cognitive tasks due to dementia. The following table shows the stipulations regarding who may or may not be admitted to an assisted living facility.

Care Plan Requirements

Residents must be provided with a detailed health care plan within 21 days of admission to a memory care facility. The plan must include the following:

• An evaluation of the individual’s cognitive and physical health
• An order for treatment or services, including medications and diet
• The resident’s dietary preferences
• Specific goals of treatment and measures to be used in assessing success
• Information about any additional care required by the resident

Medication Management Requirements

In Montana, the law requires memory care facilities to store all prescription drugs in locked containers in a secured room or medication cart. If residents are self-administering their medications, they must be provided with a secure storage place. Unused medications must be disposed of, safely and lawfully.

In category C assisted living facilities, direct care staff members who are administering medications must be trained and licensed to do so. When providing residents with medications, they must verify that the drugs are offered according to a practitioner’s current order and ensure that all dispensed medications are taken from labeled prescription containers.

Facility Requirements

Montana’s category C assisted living facilities must be secure and locked at all times. Additionally, if the facility offers other categories of care, they must have dining and day or activity areas for memory care residents that are separate from the remainder of the facility’s residents.

Staffing Requirements

In Montana, facility administrators are responsible for overseeing the hiring of all direct care and support staff. Administrators must work with the Montana Department of Public Health to develop safe policies and procedures for hiring, including a system for conducting background and reference checks. At all times, the facility must have a sufficient number of qualified staff on duty to meet the needs of residents.

All employees at assisted living and memory care facilities in Montana must complete orientation and on-site training. They also must be provided with an overview of policies and procedures, their job description and the services that the facility provides. All direct care staff must be trained in the abdominal thrust maneuver, basic first aid and CPR.

Medicaid Policy

Although there is no requirement in the state, most assisted living and memory care facilities in Montana accept Medicaid payments. Montana Medicaid’s Big Sky waiver program may cover the cost of memory care services; However, the program does not cover room-and-board charges.

Reporting Abuse

Seniors or their loved ones can report abuse in long-term care facilities by contacting the Long-Term Care Ombudsman at 800-332-2272 or the Department of Public Health at 844-277-9300.