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Family Caregiver Pay Map · Montana · Verified October 19, 2026

Montana: Who Can Be a Paid Family Caregiver Under Medicaid

Montana pays relatives and friends as personal assistants under Community First Choice and the Big Sky Waiver, agency-based or self-directed with a provider agency as employer of record; since 2025 a spouse or the parent of a minor can be paid for extraordinary care or where no other providers are available, and the Big Sky Waiver keeps a wait list.

Spouse
In defined cases
Adult child / other relatives
Yes
Friends / neighbors
Yes
Parent of a minor child
In defined cases

Who can be paid: Adult children, siblings, other relatives, friends and neighbors as agency-based or self-directed attendants; a spouse or the parent of a minor child under the state's legally responsible person rules; not the member's representative.

The Home Care Agency is a free enrollment matching service — not a home care agency, not a Medicaid plan, and not a government agency. This research is educational. Eligibility, authorized hours and payment are always determined by the state program and, where applicable, the managed care plan.

The programs behind the answer

Community First Choice / state-plan Personal Assistance Services, agency-based or self-directed

Administered by Montana DPHHS Senior and Long Term Care Division.

  • Who employs the caregiver: Agency or self-directed
  • Waitlist: No waitlist
  • Type: State plan entitlement (serves everyone who qualifies)
  • Self-directed members manage their attendants while an approved provider agency is employer of record; legally responsible persons payable for extraordinary care since Jan 2025

Big Sky Waiver

Administered by Montana DPHHS Senior and Long Term Care Division.

  • Who employs the caregiver: Agency or self-directed
  • Waitlist: Waitlist
  • Slot-limited; legally responsible individuals may be paid personal care workers through an agency or the member

How to apply in Montana

We do not yet have partner agencies in Montana. Start with the program's administering agency — Montana DPHHS Senior and Long Term Care Division — using the official sources below; the state determines eligibility and enrolls participants.

Official sources

Facts on this page were last reviewed October 19, 2026 against the sources above. Program rules change; confirm with the program before making decisions. Method: how the Pay Map is verified.

Questions

Questions About Paid Family Caregiving in Montana

Can a spouse be paid to care for their husband or wife in Montana?
In defined cases. Montana allows a spouse to be the paid caregiver only under conditions written into its rules; see the summary and sources on this page.
Who can be the paid caregiver in Montana?
Adult children, siblings, other relatives, friends and neighbors as agency-based or self-directed attendants; a spouse or the parent of a minor child under the state's legally responsible person rules; not the member's representative.
Is there a waitlist for Medicaid home care in Montana?
Community First Choice / state-plan Personal Assistance Services, agency-based or self-directed: no waitlist (Self-directed members manage their attendants while an approved provider agency is employer of record; legally responsible persons payable for extraordinary care since Jan 2025). Big Sky Waiver: waitlist (Slot-limited; legally responsible individuals may be paid personal care workers through an agency or the member).
Who decides eligibility?
The state program, never The Home Care Agency. The Home Care Agency is a free enrollment matching service — not a home care agency, not a Medicaid plan, and not a government agency. This research is educational. Eligibility, authorized hours and payment are always determined by the state program and, where applicable, the managed care plan.