Medicaid Nursing Home Eligibility in Montana
2026 income limits, asset limits, and look-back rules
In Montana, a single applicant can hold up to $2,000 in countable assets to qualify for Medicaid nursing home coverage. Monthly income must be at or below $2,829 (or channeled through a Qualified Income Trust if above that limit).
Quick Asset Eligibility Check for Montana
Countable assets include: cash, checking/savings, stocks, bonds, second homes, and most investments. Exempt: primary home (if returning), one vehicle, personal belongings, prepaid burial.
Income Rules in Montana Income Cap State
Income cap state. Miller trust required above $2,829/mo.
What is a Miller Trust (Qualified Income Trust)?
A Miller Trust is a legal arrangement used in income cap states. Each month, income above $2,829 is deposited into the trust account. The trustee sends it to the nursing facility as the patient pay amount. This makes you technically compliant with the income limit while still contributing your income toward care costs. You need an elder law attorney to set one up — typically $500–$1,500.
Asset Limits in Montana
| Single applicant — countable assets | $2,000 |
| Community spouse resource allowance — minimum | $29,724 |
| Community spouse resource allowance — maximum | $148,620 |
| Look-back period | 5 years (60 months) |
| Primary home (if planning to return) | Exempt |
| One vehicle | Exempt |
| Personal belongings and household items | Exempt |
| Prepaid burial (irrevocable) | Exempt |
Community spouse resource allowance figures are 2025 federal minimums/maximums — Montana may set its own within this range. Source: CMS.gov, 2025 spousal protection amounts.
How to Apply for Medicaid Nursing Home Coverage in Montana
Applications go through Montana Medicaid Long-Term Care.
Gather 5 years of financial records
Bank statements, brokerage accounts, deeds, and documentation of any asset transfers from the past 60 months. Missing records are the most common cause of delays.
Consult an elder law attorney
Medicaid planning before application can legally protect assets for a spouse or heirs. Strategies include spousal asset transfers, annuities, and irrevocable trusts. An elder law attorney costs $2,000–$5,000 but can protect far more.
Submit the application
Apply in person, by mail, or online through Montana's Medicaid portal. Include the nursing facility's medical assessment confirming the level of care required. Processing takes 45–90 days.
Set up a Miller Trust if needed
Montana is an income cap state. If monthly income exceeds $2,829, you must establish a Qualified Income Trust (Miller Trust) before or at the time of application.