Can a spouse be paid?
SometimesSometimes — it depends on the program and the care needed.
The fine print: limited — yes under Big Sky Waiver self-directed option; prohibited under CFCS/PCS (spouses and parents of minors excluded there)
Montana
Montana has real Medicaid programs that pay family members to care for a loved one at home. Here's what they pay, who can be paid, and how to start.
Rates vary — check with the program.
Your exact pay is set by the program and your care plan. We'll tell you your real number before you enroll.
Source: Montana Medicaid program data · Updated September 2026
Some programs here have no waitlist. Others can have one.
BSW: yes, limited slots (~2,800/yr, waitlist forms when full); CFCS/PCS: entitlement, no waitlist
Sometimes — it depends on the program and the care needed.
The fine print: limited — yes under Big Sky Waiver self-directed option; prohibited under CFCS/PCS (spouses and parents of minors excluded there)
Not for young children right now — but parents of adult children can often be paid.
The fine print: no under CFCS/PCS (explicitly prohibited); Big Sky Waiver serves adults — parent-of-minor not addressed
Run by: Montana DPHHS, Senior & Long Term Care Division (406-444-4077)
A program that can pay a family member for care at home.
2-min check →A program that can pay a family member for care at home.
2-min check →Our quick check tells you which programs fit your family before you talk to anyone.
Apply for Montana Medicaid at apply.mt.gov or a local Office of Public Assistance (helpline 888-706-1535); Mountain Pacific Quality Health does the functional assessment (800-219-7035).
Forms, phone calls, the enrollment visit — we walk you through it all, free.
Yes. These are real Medicaid programs run by the state. In Montana, they are overseen by the Montana DPHHS. We help you enroll — applying costs you nothing.
Care at home costs Medicaid far less than a nursing home. So states pay family members to give that care at home. It's good for your loved one, and it's the law working the way it should.
Sometimes — it depends on the program and the care needed. The fine print: limited — yes under Big Sky Waiver self-directed option; prohibited under CFCS/PCS (spouses and parents of minors excluded there)
Not for young children right now — but parents of adult children can often be paid. The fine print: no under CFCS/PCS (explicitly prohibited); Big Sky Waiver serves adults — parent-of-minor not addressed
Montana doesn't publish one flat rate — rates vary and the program sets your exact pay. We'll tell you your real number before you enroll.
Some programs here have no waitlist. Others can have one. Details: BSW: yes, limited slots (~2,800/yr, waitlist forms when full); CFCS/PCS: entitlement, no waitlist
It depends on the program. In Montana: hybrid — member hires/fires the caregiver but a financial management services / provider agency handles payroll, taxes, background checks; agency-based model also available
Sources: medicaidplanningassistance.org · medicaidplanningassistance.org · dphhs.mt.gov · Updated September 2026. Program rules change — always confirm with the program.
The programs are the same across Montana. Pick your county to see how they work where you live.
Answer 5 easy questions. See your programs and pay before you share any contact info.