Montana Medicaid waiver guide
Learn how Montana Medicaid waiver services work, which state agency to start with, how the application process usually begins, and where to search for home and community-based services.
Last reviewed July 2026. See something out of date? Use the “Suggest an edit” button to let us know.
Montana's main waiver for people with intellectual and developmental disabilities is the 0208 Comprehensive Waiver, run by the Developmental Disabilities Program (DDP) within the Department of Public Health and Human Services. A regional specialist determines eligibility, and since July 2015 you are placed on the 0208 waitlist automatically once eligibility is established. The wait is long — DDP has described a current average of about seven years — which makes one detail unusually valuable: you can keep your place on the 0208 waitlist while receiving services through the Big Sky Waiver.
Search by state, city, or ZIP code to compare provider profiles, services, contact details, and verified status.
People with intellectual and developmental disabilities originating before age 18
People who are aged, blind, or have physical disabilities — at all stages of life
Eligibility for the 0208 waiver means the person was born with a condition, or experienced an illness or injury before age 18, resulting in significant and permanent delays in development. Income is not a factor in the DDP eligibility determination itself. Documentation typically includes a current psychological evaluation showing an IQ of approximately 70 or below, medical evidence of intellectual disability, cerebral palsy, epilepsy, autism, or a related neurological condition, and an adaptive behavior assessment such as the Vineland.
The person must have been born with a condition, or experienced an illness or injury before age 18, that results in significant and permanent delays in development.
A current psychological evaluation with an IQ of approximately 70 or below, medical evidence of intellectual disability, cerebral palsy, epilepsy, autism, or a related neurological condition, and an adaptive behavior assessment such as the Vineland.
The DDP eligibility determination itself does not consider income. Medicaid financial rules still apply to fund waiver services, so ask how the two fit together in your situation rather than assuming income disqualifies you at the first step.
A DDP regional specialist makes the eligibility determination. That finding is what places you on the 0208 waitlist.
Since July 2015, DDP automatically places people on the 0208 waiver waitlist once formal eligibility has been determined — you do not have to separately ask. Selection off the list generally follows length of time waiting. The wait is substantial: DDP has described a current average of about seven years.
Montana routes everything through DDP. A regional specialist reviews your documentation and determines eligibility for services.
Open linkDDP looks for a current psychological evaluation with an IQ around 70 or below, medical evidence of a qualifying condition, and an adaptive behavior assessment such as the Vineland. A stale or incomplete evaluation is the usual cause of delay.
Since July 2015, formal eligibility determination results in automatic waitlist placement. Confirm the date your eligibility was determined, since selection generally follows length of time waiting.
This is the most useful move available in Montana. You cannot be on the Big Sky waitlist if you are already served by another waiver — but you can stay on the 0208 waitlist while receiving Big Sky services, and move onto 0208 when your turn comes. Seven years of waiting does not have to mean seven years without support.
Open linkOver a multi-year wait, addresses and phone numbers change. Make sure DDP can reach you when your name comes up.
Exact covered services depend on the waiver, assessed need, Medicaid rules, funding, and state program requirements. Confirm services, availability, and payment acceptance with the state, support coordinator, and provider.
Many 0208 waiver services can be delivered either through traditional providers or through self-direction, where participants manage their own support services and staff. Ask your case manager which services are available under each model before choosing.
Approved waiver services are paid by Montana Medicaid. Once enrolled, there is generally little or no direct cost for covered services.
DDP's eligibility determination does not consider income. Medicaid financial rules apply to funding services, so the practical question is how those interact — worth asking rather than self-disqualifying at the first step.
In residential settings the waiver pays for services, not room and board, which is generally covered by the person's own income such as SSI.
Montana provides early intervention for infants and toddlers with delays, separately from the 0208 waiver.
With an average wait around seven years and selection largely by time waiting, an early eligibility determination is worth far more than an early application to anything else. Do not wait for adult services to feel urgent.
The condition must have originated before age 18. Make sure the psychological evaluation, medical evidence, and adaptive assessment establishing that exist before the birthday.
If the person also qualifies as aged, blind, or having a physical disability, Big Sky Waiver services can be received without giving up the 0208 place. This is the single most useful thing to explore during a long wait.
If eligibility or a waiver service is denied, reduced, or ended, you have the right to appeal and to request a fair hearing within the deadline printed on your notice. Disability Rights Montana is the state's protection and advocacy system and provides legally based advocacy, available weekdays 8am–4pm.
Protection & Advocacy system for Montana
1-800-245-4743Visit siteEligibility determination, regional specialists, and the 0208 waitlist
Visit siteWhat the waiver covers and how services are delivered
Visit siteThe waiver you may be able to use while waiting for 0208
Visit siteFree legally based advocacy — 406-449-2344 voice/TDD
1-800-245-4743Visit siteLocal help & referrals — dial 211
Visit siteDDP has described a current average wait of about seven years. Selection generally follows how long you have been on the list, so the date your eligibility was determined matters a great deal. Ask your regional specialist for the current estimate.
No. Since July 2015, DDP automatically places people on the 0208 waitlist once formal eligibility has been determined. What you should confirm is the date of that determination, since it sets your position.
Possibly, and this is the most valuable thing to know in Montana. You cannot join the Big Sky waitlist if another waiver already serves you — but you can remain on the 0208 waitlist while receiving Big Sky Waiver services, then move to 0208 when your turn arrives. Ask DDP whether Big Sky eligibility applies.
A current psychological evaluation with an IQ of roughly 70 or below, medical evidence of intellectual disability, cerebral palsy, epilepsy, autism, or a related neurological condition, and an adaptive behavior assessment such as the Vineland. An out-of-date evaluation is a common cause of delay.
Not the DDP eligibility determination itself — income is not a factor there. Medicaid financial rules still govern paying for waiver services, so ask DDP how the two fit together rather than assuming income rules you out at the start.
Eligibility for the 0208 waiver means the person was born with a condition, or experienced an illness or injury before age 18, resulting in significant and permanent delays in development. Income is not a factor in the DDP eligibility determination itself. Documentation typically includes a current psychological evaluation showing an IQ of approximately 70 or below, medical evidence of intellectual disability, cerebral palsy, epilepsy, autism, or a related neurological condition, and an adaptive behavior assessment such as the Vineland.
contact the developmental disabilities program, assemble the evaluation package, you're placed on the 0208 waitlist automatically, ask about the big sky waiver while you wait, then enroll and choose providers. Start with Montana Developmental Disabilities Program.
Covered services vary by waiver and assessed need, and commonly include in-home supports, respite, supported employment, day services, behavior support, residential supports. Confirm specifics with the state and provider.
Since July 2015, DDP automatically places people on the 0208 waiver waitlist once formal eligibility has been determined — you do not have to separately ask. Selection off the list generally follows length of time waiting. The wait is substantial: DDP has described a current average of about seven years.
Approved waiver services are generally covered by Medicaid at little or no direct cost once enrolled, though some enrollees may owe a monthly patient responsibility based on income.
Eligibility, regional offices, and how to begin.
MontanaThe full service list, eligibility documentation, and self-direction options.
MontanaThe waiver for people who are aged, blind, or have physical disabilities — usable while waiting for 0208.
MontanaFree protection and advocacy services, including appeals help.
MontanaFind waiver providers and services in Montana on Waiverly.
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