Home care · Yellowstone County, MT
Home care in Yellowstone County
Of the 166,000 people in Yellowstone County, about 29,000 are 65 or older — one in six residents. Most of them intend to stay in their own homes, and most of the care that makes that possible happens quietly, in living rooms, without anyone calling it "long-term care."
Below is what we'd tell a friend in Yellowstone County: what care costs here, who provides it, what the facility alternative actually looks like, and which programs pay.
Yellowstone County, in numbers
Full Montana guide →Residents 65+
29,043
17.5% of the county.
Live with a disability
13.2%
About 21,554 people — the population most likely to need help at home.
Median household income
$78,216
20 hrs/week of care would run about 51% of it.
Certified agencies
7
Medicare-certified home health agencies serving local ZIPs; 7 rated, averaging 2.8★.
Sources: CDC/ATSDR Social Vulnerability Index 2022 (ACS 2018–2022), County Health Rankings 2024, and CMS Care Compare provider files.
What home care costs in Yellowstone County
Montana's going rate for agency home care is around $38/hr. Twenty hours a week — four hours a day, five days a week, the most common schedule families start with — comes to roughly $3,300 a month, or $39,500 a year.
Median household income in Yellowstone County is $78,216 — that schedule runs about 51% of it. Manageable for some households here, and still worth checking whether a program can carry part of it.
Who provides care in Yellowstone County
7 Medicare-certified home health agencies serve ZIP codes in Yellowstone County. 7 of them carry a CMS quality star rating, averaging 2.8 out of 5. 5 report offering home health aide services.
One distinction worth getting straight before you call anyone: those are Medicare-certified home health agencies — skilled, doctor-ordered, intermittent care, usually a nurse or therapist visiting for a few weeks after a hospital stay. That is not the same as the hourly, non-medical help most families are actually looking for: bathing, dressing, meals, driving, company. Medicare pays for the first. It does not pay for the second.
The alternative, locally
Yellowstone County has 7 certified nursing homes holding 894 certified beds, averaging 1.9 out of 5 on CMS's overall rating. About 558 people live in them on an average day.
An average of 1.9 stars is below the Montana average of 2.88, and it is worth knowing before a discharge planner hands you a list on a Friday afternoon. Look up any facility on Medicare's Care Compare by name — the overall star hides a lot, and the staffing rating is the one that best predicts what a Tuesday actually looks like.
The Montana programs that pay for care at home
- Big Sky Waiver
- Community First Choice / Personal Care Services
Montana runs 2 Medicaid pathways that pay for care at home instead of a nursing home. Each has its own income, asset, and care-need rules, and approval takes weeks to months — so the application is worth starting before the need becomes urgent.
How each Montana program works →Caregiver training in MT
91 hrs
Minimum for certified aides — above the 75-hour federal floor. MT does not license non-medical agencies, so vet carefully.
Choosing an agency in Yellowstone County
- Vet twice as hard. Montana does not license non-medical home care agencies, which means anyone can hang a shingle. Ask who runs background checks, whether caregivers are W-2 employees or contractors, whether the agency carries liability and workers' comp, and who supervises the caregiver you'd get.
- Ask what the rate covers. Around $38/hr is typical in Montana. A real agency's rate covers a trained, background-checked, insured caregiver plus supervision and backup staffing when your regular person is sick. A rate well under the local range usually means one of those is missing.
- Start the clock early. Yellowstone County is served by 7 certified agencies, so the honest answer to "when can you start?" is often two to three weeks. If you're planning around a discharge date, call before the discharge, not after.
- Ask about Medicaid now, not later. If money is going to be the constraint, ask about Big Sky Waiver at the first call. Approval takes weeks to months, and private pay is what bridges the gap — so the sooner the application starts, the smaller that bridge is.
Want to talk it through?
We provide care in the Milwaukee, WI area — but we’re glad to help any family think through the options in Yellowstone County.
Yellowstone County home care questions, answered
How much does home care cost in Yellowstone County, MT?
Agency home care in Montana runs around $38/hr for private pay. At 20 hours a week that is about $3,300 a month. For context, median household income in Yellowstone County is $78,216. Rates move with the level of care and the schedule — short daily visits cost more per hour than long shifts.
Does Medicare pay for home care in Yellowstone County?
Medicare pays for skilled home health — a nurse or therapist, doctor-ordered, for a limited stretch, usually after a hospital stay. 7 Medicare-certified agencies serve Yellowstone County. Medicare does not pay for the hourly, non-medical help most families want — bathing, dressing, meals, driving, company. For that, the money comes from private pay, long-term care insurance, VA benefits, or Montana Medicaid.
Does Medicaid pay for home care in Yellowstone County?
Yes — for people who qualify. Montana runs Medicaid programs that pay for care at home instead of a nursing home: Big Sky Waiver, Community First Choice / Personal Care Services. Income, asset, and care-need rules apply, and approval usually takes weeks to months, so apply before you need it.
How are caregivers trained and vetted in Montana?
Certified home health aides in Montana complete at least 91 hours of training — above the 75-hour federal minimum. Montana does not license non-medical home care agencies, so the vetting falls to you: ask about background checks, insurance and bonding, and who supervises the caregivers.
Is home care better than a nursing home in Yellowstone County?
It depends on the level of care needed, not on which one sounds nicer. Yellowstone County's 7 certified facilities average 1.9 out of 5 stars on CMS ratings, against a Montana average of 2.88. Round-the-clock skilled nursing is something a facility does that home care cannot. But for help with bathing, meals, medication reminders, and company, care at home usually costs less and keeps someone in their own bed — and most people, asked plainly, say that is what they want.
Does Juniper at Home provide caregivers in Yellowstone County?
Not directly — our own caregivers serve the Milwaukee area of Wisconsin. This page is a free guide for Yellowstone County families: what care really costs here, who provides it, and which programs can help pay.
Bordering counties in Montana