State Medicaid Waiver Directory
Find your state's Katie Beckett waiver, TEFRA pathway, HCBS programs, and Medicaid eligibility rules for children and adults with disabilities. Each guide covers waitlists, application steps, income limits, and parent caregiver pay options.
For informational purposes only — not legal, medical, or financial advice. Medicaid rules, eligibility, and waitlists change frequently. Always verify with your state's official Medicaid agency before making decisions. Cross-check with Medicaid.gov's official waiver page.
Montana
Program Overview
Overview
Montana has a Developmental Disabilities Waiver and a Big Sky Waiver for elderly and individuals with physical disabilities. Montana Medicaid administers these programs.
Katie Beckett or similar pathway
Montana has not adopted the Katie Beckett/TEFRA option, and there is no comparable waiver — middle-income families above standard Medicaid income limits generally cannot qualify through a child-only income route. Instead, children access services through the Developmental Disabilities (Comprehensive) Waiver and the Big Sky Waiver, both 1915(c) waivers whose eligibility is based on the child's own income rather than parental income. The Pediatric Complex Care Assistant Program also pays parents of children enrolled in Medicaid for certain care tasks. Contact Montana DPHHS about these programs.
Child-relevant waivers
The Developmental Disabilities (DD) Waiver is the most relevant for children with intellectual and developmental disabilities. Montana also has the Big Sky Waiver, which is the primary HCBS program for adults who are elderly or have physical disabilities and need nursing-facility level of care but choose to live in the community. The Big Sky Waiver covers personal care, home health aide, adult day services, and other community supports.
Eligibility
Who qualifies
DD Waiver serves individuals with developmental disabilities who meet ICF/ID level of care and financial eligibility.
Financial and income rules
Montana Medicaid financial eligibility applies. Waiver-specific rules also apply.
Level of care
ICF/ID level of care is required for the DD Waiver.
Age rules
DD Waiver serves individuals of various ages including children.
Getting Started
How to apply
Contact Montana Department of Public Health and Human Services for DD Waiver intake.
Documents needed
Disability documentation, level-of-care assessment, and financial information are typically required.
Waitlist information
Montana's DD Waiver may have limited enrollment. Confirm current waitlist status with DPHHS.
Practical next step
Contact Montana DPHHS and ask about DD Waiver intake, eligibility, and service availability in your area. For non-Medicaid supports, contact Montana VR or Disability Rights Montana.
Services & Support
Services available
DD Waiver can cover residential services, day services, supported employment, and in-home supports.
Parent caregiver pay
Montana's Pediatric Complex Care Assistant Program allows parents and guardians to be paid to provide tube feedings, trach care, medications, and personal care for children enrolled in Medicaid. The DD Waiver allows parents and guardians of minors to be paid for care, and the Big Sky Waiver allows legally responsible individuals to provide personal assistance, specially trained attendant, and homemaker services.
Equipment exchange & assistive technology
Montana Assistive Technology Program / MonTECH (dphhs.mt.gov/detd/vocrehab/VRBSAssistiveTechnology) — free device demonstrations, short-term loans, and reuse programs. Serves all Montanans with disabilities statewide.
Mental health and Medicaid coverage
Montana Medicaid covers outpatient mental health services, psychiatric evaluations, therapy, medication management, and crisis services. The Behavioral Health and Developmental Disabilities (BHDD) Division within DPHHS oversees public behavioral health. Community mental health centers are the primary access points. Given Montana's rural geography, telehealth mental health services are widely used. Children can access mental health services through the EPSDT benefit. Montana has expanded mobile crisis services and peer support programs.
Additional notes
Montana's rural geography means that in-person service options can be limited depending on where a family lives. Asking about telehealth and remote service delivery options is important, especially for behavioral health and specialty care.
State-Specific Resources
Montana Vocational Rehabilitation & Blind Services — Employment Services
Montana VR (dphhs.mt.gov/detd/vocrehab) provides career counseling, job training, assistive technology, job placement, and vocational rehabilitation services for Montanans with disabilities. Services include support for transition-age youth (ages 14+). Blind Services provides specialized vocational rehabilitation for individuals who are blind or have significant vision loss. Services are free statewide.
MonTECH — Assistive Technology Program
MonTECH (dphhs.mt.gov/detd/vocrehab/VRBSAssistiveTechnology) serves Montanans with any type of disability (developmental, physical, learning, or age-related). Services include device demonstrations, short-term equipment loans for trial, device reuse programs, and information on AT funding. Available statewide.
Montana Council on Developmental Disabilities (MCDD) — Advocacy & Resources
MCDD administers federal funds to support advocacy, research, and training for people with developmental disabilities and their families. The Council provides resources, information, and advocacy support statewide.
Disability Rights Montana (DRMT) — Legal Advocacy & P&A
DRMT (disabilityrightsmt.org) is the state's Protection and Advocacy agency, providing free legal services, advocacy, and assistance to people with disabilities on education rights, employment issues, assistive technology access, and abuse/neglect.
Ability Montana — Independent Living & Advocacy
Ability Montana (abilitymt.org) promotes independence and advocates for people with disabilities. Services include advocacy, community education, and connection to resources for living independently in the community.
Montana Paid Family & Medical Leave (FAMLI) — Paid Leave
Montana's Family and Medical Leave Insurance (FAMLI) Act, effective 2027, will provide up to 12 weeks of paid leave annually to care for a seriously ill family member, address personal medical needs, or bond with a new child. Currently, Montana relies on unpaid FMLA leave.
Sources
Community Tips & Experience
Comments reflect the personal experiences and opinions of individual community members only. They do not represent the views, positions, or endorsements of National Disability Resource Project or any of its staff, volunteers, or affiliated members. Always verify information with official agencies and qualified professionals before making decisions.
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Cole. Brown
4/15/2026Very generally speaking the waiver program in Montana has a long waitlist and is hard to get on. As far as I can tell *in the experiences with my family*, they are a lot stricter about small things and more difficult to get any sort of disability support than most states.
Cole. Brown
4/15/2026Very generally speaking the waiver program in Montana has a long waitlist and is hard to get on. As far as I can tell *in the experiences with my family*, they are a lot stricter about small things and more difficult to get any sort of disability support than most states.
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