Montana Big Sky Waiver Program

The Big Sky Waiver (BSW) Program allows people who would otherwise be institutionalized to live in their own home and community. The services are made available through the Senior and Long-Term Care Division (SLTCD) with the Department of Public Health & Human Services (DPHHS).

 

To qualify for BSW, a recipient must be financially eligible for Medicaid and meet the minimum level of care requirements for nursing facility placement. Individuals must have an unmet need that can only be resolved through the BSW Program services to qualify for the program.

Currently, the BSW Program has a waiting list..

How to Apply

To make a referral to BSW, contact the Mountain Pacific (800) 497-8322 or (406) 443-4020.

Eligibility specialists at your county Office of Public Assistance (OPA) office can help you determine Medicaid eligibility.

 

Home and Community-Based Services (HCBS) in Montana are provided through the state’s BSW, which operates under Section 1915(c) of the Social Security Act. This waiver gives Montana the flexibility to deliver long-term care supports in homes and community settings rather than institutions.

Montana Medicaid 1915(c) Home and Community Based Services Waiver

BSW offers a range of services designed to support individuals in their homes and communities. Services are coordinated by Case Management Teams (CMT), which include both a nurse and social worker. Together, they help identify each person’s medical and psycho-social needs and develop a plan of care based on individual preferences.

Examples of services that may be available through the BSW include:

  • Adult Residential Living
  • Adult Day Health
  • Case Management
  • Chemical Dependency Counseling
  • Dietician
  • Environmental Adaptations
  • Habilitation Services
  • Homemaker Services
  • Nutrition
  • Personal Assistance
  • PERS
  • Private Duty Nursing
  • Psychosocial Consultation
  • Respiratory Therapy
  • Respite Care
  • Special Child Care
  • Transportation
  • Therapies (OT, PT, Speech)
  • Specially Trained Attendant
  • Specialized Medical Equipment and Supplies
  • Services for Individuals with Traumatic Brain Injury

You can use Medicare’s Care Compare tool to search and compare Medicare‑certified providers — including nursing homes, home health agencies, hospice providers, hospitals, and more — by location, services, quality ratings, and contact details. This helps identify nearby options and review quality measures before reaching out to a facility.

Note: Assisted living may not appear in Medicare’s tool the same way as nursing homes. If you don’t find an assisted living residence there, contact facilities directly to confirm availability, services, and pricing.

  • Find a provider in your area: Link coming soon.
  • Licensing and regulatory information: Office of Inspector General (oversight, inspections, complaint processes)

 

Contact for More Info

Senior and Long-Term Care Division
(406) 444-4077