Washington Medicaid for Senior Care
Complete guide to Medicaid eligibility, coverage, and application process for nursing homes, assisted living, and home care in Washington.
7.6 million Medicaid long-term care recipients nationwide
Washington State Health Care Authority (HCA)
Processing Time
30-45 days for standard Apple Health (Medicaid); Community First Choice services typically available within 30 days of approval. Washington has relatively efficient processing.
Washington Medicaid Eligibility Requirements (2026)
To qualify for Medicaid long-term care in Washington, applicants must meet both financial eligibility criteria (income and assets) and medical criteria (level of care needs). Washington follows federal Medicaid guidelines with some state-specific variations.
Income Limits
Individual Applicant
$2,982/month
Married Couple (One Applying)
$5,964/month
Income includes Social Security, pensions, annuities, interest, dividends, and rental income.
Asset Limits
Individual Applicant
$2,000
Community Spouse (At-Home Spouse)
$3,000
Primary residence, one vehicle, personal belongings, and prepaid burial arrangements are exempt from asset limits.
5-Year Look-Back Period
Washington Medicaid reviews all financial transactions for the 60 months prior to application. Asset transfers or gifts during this period can result in a penalty period of Medicaid ineligibility. The penalty is calculated by dividing the transferred amount by $10,567/month average (semi-private), $11,600/month (private) (the average monthly nursing home cost in Washington).
Medical Eligibility
Applicants must demonstrate need for nursing facility level of care through a state assessment. This typically requires assistance with 2-3 Activities of Daily Living (bathing, dressing, toileting, transferring, eating) or cognitive impairment requiring supervision.
Assessments are performed by state-designated evaluators (nurses or social workers) and typically take 45-90 minutes. The assessment can occur at home, in a hospital, or at the care facility.
What Medicaid Covers in Washington
Nursing Home Care
Medicaid pays 100% of nursing home costs in Washington once eligibility is established. The average monthly cost is $10,567/month average (semi-private), $11,600/month (private). Recipients contribute most of their monthly income toward care costs, keeping only $50-75 for personal needs.
Coverage includes room, board, 24-hour nursing care, meals, medications, therapy services, and all medical care provided at the facility.
Assisted Living Coverage
Community First Choice and Medicaid Personal Care: Washington covers personal care services for individuals living in licensed assisted living facilities through Community First Choice and standard Medicaid personal care benefits. Medicaid pays for care services, medication administration, and care coordination. Room and board costs are not covered—residents typically pay $1,500-3,000/month from their income or private resources for housing.
Note: This program covers personal care services but does not cover room and board costs. Residents need approximately $1,500-$2,500/month from Social Security or other income to cover housing expenses.
Home and Community-Based Services (HCBS) Waivers
Washington offers 3 HCBS waiver programs that provide in-home care and community services as an alternative to nursing facility placement.
Community First Choice (CFC)
Washington's state plan option (not technically a waiver) providing personal care services to individuals meeting institutional level of care. Over 45,000 participants statewide. Includes services like personal care, respite, environmental modifications, assistive technology.
Program Details →New Freedom Waiver
Serves individuals age 18+ transitioning from nursing facilities to community settings. Provides enhanced services during transition including moving assistance, housing setup, and community integration support.
Program Details →Roads to Community Living (RCL)
Supports individuals transitioning from institutional care with one-time services like deposits, essential furnishings, moving costs, and accessibility adaptations.
Program Details →How to Apply for Medicaid in Washington
Washington Medicaid applications typically take 30-45 days for standard Apple Health (Medicaid); Community First Choice services typically available within 30 days of approval. Washington has relatively efficient processing.. Starting the process early and submitting complete documentation helps avoid delays.
Application Methods
You can apply for Medicaid in Washington through:
- Online at WashingtonConnection.org (state benefits portal)
- Phone: 1-855-923-4633 (Washington Healthplanfinder) or 1-800-562-3022 (HCA Customer Service)
- Download application and mail to: Washington Healthplanfinder, P.O. Box 946, Olympia, WA 98507
- In-person at Department of Social and Health Services (DSHS) office
Step 1: Gather Required Documents
Before starting your application, collect:
- •Birth certificate and Social Security card
- •Proof of citizenship (passport, naturalization)
- •5 years of bank statements
- •Investment and retirement account statements
- •Property deeds and mortgage statements
- •Life insurance policies
- •Social Security award letter
- •Pension benefit statements
- •Medicare card
- •Doctor's statement of care needs
Step 2: Submit Your Application
Complete and submit your application through one of the methods listed above. If applying online or by mail, keep copies of all submitted documents.
Step 3: Medical Assessment
A state assessor will evaluate level of care needs. This assessment typically takes 45-90 minutes and covers functional abilities, medical needs, cognitive status, and safety concerns.
Step 4: Financial Review
Medicaid staff review all financial documents and investigate any transfers or gifts made in the past 60 months. They may request additional documentation during this process.
Step 5: Receive Determination
You'll receive written notification of approval or denial. Approved applications include the effective date of coverage (often retroactive up to 3 months), patient responsibility amount, and covered services.
Get Free Application Help
Free Medicaid application assistance is available in Washington from:
- •Area Agency on Aging: Call 1-800-677-1116 (Eldercare Locator) to find your local office
- •SHIP counselors: Free Medicare/Medicaid counseling
- •Nursing facility social workers: In-facility application support
- •Elder law attorneys: Paid help for complex financial situations ($2,000-$5,000)
Washington-Specific Programs and Resources
Medicare Savings Programs (QMB/SLMB/QI)
QMB pays Medicare premiums, deductibles, and coinsurance. SLMB pays Part B premiums. QI pays Part B premiums (limited funding).
Learn MorePACE (Program of All-Inclusive Care for the Elderly)
Available in select Washington counties (primarily Puget Sound region). Comprehensive medical and social services for frail elderly age 55+.
Learn MoreFamily Caregiver Support Program
Provides respite care, training, counseling, and support groups for family caregivers of seniors.
Learn MoreNeed Help with Washington Medicaid?
Contact Washington State Health Care Authority (HCA) for specific questions about eligibility, application status, or covered services.