Washington Medicaid long-term care
The eligibility rules and the actual application path in Washington. We link to the state agency at every step and we do not submit anything for you.
Who to apply with
Income and asset rules
Monthly income limit (applicant, SSI-based)
$2,982 USD/month (individual, gross income cap)
Washington's Medicaid Special Income Level (SIL) is 300% of the SSI federal benefit rate and is described in the state's own chart as the 'maximum gross income level for institutional Medicaid', effective Jan 1 2026. It is a per-person cap, so there is no separate couple figure. Washington also publishes a Medically Needy income level ($994 for one person, Jan 1 2026) used by people who do not meet institutional status requirements.
Countable asset limit (applicant)
$2,000 USD (individual) · couple $3,000
Countable resource standard for SSI-related long-term care under WAC 182-513-1350: $2,000 for a single person or an institutionalized spouse, $3,000 for a legally married couple. The rule was last effective Feb 25 2023 and the dollar standard is still current in the state's July 1 2026 standards chart.
Community spouse income allowance
$4,066.5 USD/month (2026)
Community spouse maintenance needs allowance maximum, effective Jan 1 2026, from the same official chart.
Community spouse resource allowance
$162,660 USD (maximum, 2026)
Federal spousal resource maximum effective Jan 1 2026, as published in Washington's own LTSS standards chart. The same chart also lists a 'State Spousal Resources' figure of $72,529 (effective Jul 1 2025, updated in odd years).
Washington does not use an income cap the way some states do. People whose gross income is above the SIL may still qualify for certain HCS waiver services under the nursing-facility-rate rule (WAC 182-515-1508), and the state also runs a Medically Needy program with its own income level ($994 for one person, Jan 1 2026). Confirm the pathway that applies with HCA/ALTSA before filing.
Home and community based services
- HCS Home and Community Based Services (HCBS) waivers — Home and Community Services
Adults who need a nursing-facility level of care and meet the financial rules; the waiver pays for care at home instead of in a facility.
- Medicaid Alternative Care (MAC)
Older adults who need long-term care and do not qualify under another categorically needy pathway (WAC 182-513-1605).
- Tailored Supports for Older Adults (TSOA)
Older adults at risk of needing Medicaid-funded long-term care; the state publishes a TSOA income standard of $3,976/month and resource standards of $84,354 ($156,883 with a community spouse), effective Jan 1 2026. Income eligibility is tested against 400% of the SSI federal benefit rate (WAC 182-513-1635).
- DDA HCBS waivers — Developmental Disabilities Administration
People with an intellectual or developmental disability who meet institutional level of care.
A waiver usually requires meeting both the financial rules and a functional (level-of-care) test. Waiting lists vary by waiver and by year.
How the application works
- 1. Apply through Washington Connection or HCA
Long-term care applications start with the state: Washington Connection (DSHS) or the HCA long-term care application page. No agency or consultant has to file for you. · official page
- 2. Functional assessment (CARE assessment)
ALTSA staff complete a functional assessment to establish whether the person needs a nursing-facility level of care, which the waiver programs require. · official page
- 3. Financial review (income, resources, spousal protections)
Income is compared with the Medicaid Special Income Level ($2,982/month, Jan 1 2026) and countable resources with the LTC resource standard ($2,000 single / $3,000 couple). · official page
- 4. Program assignment and case management
Depending on the outcome, the person is assigned to an HCS waiver, MAC, TSOA or DDA pathway, with an ALTSA case manager. · official page
- 5. Services start, with a personal needs allowance
The state publishes the personal needs allowance amounts (for example $108.74 for most medical institutions and $2,982 for DDA/HCS waiver clients at home, Jan 1 2026). · official page
Before you file
Related
We are an independent informational and tools site. We are not a government agency, not a healthcare provider, and not a licensed referral agency under California CCR Title 22 or Florida Stat. 429.195. We do not place people into facilities and we do not charge families. Nothing here is legal, medical or financial advice — always confirm current rules with the state agency or a licensed professional.