The home exclusion has a 2026 equity boundary
DPHHS’s current policy excludes the home and surrounding property in stated circumstances and allows a home to remain a principal residence during a temporary absence when the client, spouse, power of attorney, guardian, or authorized representative expresses an intent to return. It says only one principal residence is excluded and warns that a home outside Montana is counted even if the person expresses intent to return (DPHHS CMA 402-1 home policy).
For nursing-home and waiver benefits, however, DPHHS says coverage cannot be paid when home equity exceeds $752,000 effective January 1, 2026. That cap does not apply when a community spouse or a minor or disabled child lawfully resides in the home (DPHHS CMA 402-1 2026 home-equity rule).
Montana uses medically needy income rules, not a hard LTC income cap
For 2026, DPHHS lists $30 as the categorically needy income standard for an individual living in an institution and $525 as the medically needy income level. Its nursing-home policy says otherwise eligible residents are income eligible when the monthly facility cost equals or exceeds monthly income, with a later Step II calculation of the resident’s cost-of-care responsibility (DPHHS ABD 008 2026 standards; DPHHS ABD 013 nursing-home income policy).
DPHHS’s general medically needy policy says clients may establish coverage through incurred medical expenses, a cash spend-down payment, or a combination. The 2026 policy adds a $391 ABD medically needy deduction when calculating a spend-down, but expressly says that deduction does not apply to institutional eligibility or the Step II cost-of-care budget (DPHHS CMA 002 medically needy standards).
Spousal protections require a resource assessment
For a married applicant entering an institution or waiver coverage, Montana’s 2026 community-spouse resource maintenance allowance is the greater of one-half of the couple’s countable resources, capped at $162,660, or $32,532; a hearing officer or court order can establish a different amount. The assessment uses resources the couple owned individually or jointly at the relevant entry or waiver date (DPHHS CMA 001 2026 community-spouse standards; DPHHS CMA 803-1 resource assessment policy).
DPHHS says resources comprising the allowance must generally be legally transferred to the community spouse within 90 days after Medicaid approval. The policy also states that both spouses receive notice and can appeal the resource-maintenance allowance determination (DPHHS CMA 803-1).
2026 figures: $2,000 institutionalized individual resources; $3,000 ordinary ABD couple resources; $32,532-$162,660 community-spouse resources; and a $752,000 home-equity cap, subject to the published exceptions (
DPHHS CMA 001;
DPHHS CMA 402-1).
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