Programs that pay for or cover the cost of care itself, from Medicaid services and the COPES waiver to the VA pension.
The biggest and most widely used first. We take no referral fees, so this is what is worth your time, not what pays us.
Dollar figures are ranges, not promises, and each program sets its own rules. Confirm eligibility with the program before acting.
This site is free to use and takes no referral fees. Your support helps cover the cost of running it, so it stays online and independent for every Washington family.
Support this projectThe Community Options Program Entry System (COPES) is Washington's main Medicaid waiver for adults who need nursing-home level care. It is run jointly by the Health Care Authority and the Home and Community Living Administration. A January 1, 2025 update made three changes. First, it lets people with 6 years of social-service work experience (equal to a Social Service Specialist 2) qualify to work as evaluators or assessors. Second, it changed how Adult Day Care is counted. Personal-care hours are no longer cut by 30 minutes for each hour of Adult Day Care. Instead, Adult Day Care is now counted in the CARE assessment as informal support. Third, it added a new kind of provider, a Death Doula, under the Client Support Training and Wellness Education service.
SHIBA is Washington's State Health Insurance Assistance Program, known nationally as SHIP. Trained volunteers give free, unbiased, and private one-on-one help with Medicare. They can explain Parts A, B, C, and D, compare Medicare Advantage and Medigap (Medicare Supplement) plans, help you through Open Enrollment, help you choose a prescription drug plan, and help you apply for Medicare Savings Programs and Extra Help (also called the Low-Income Subsidy). SHIBA does not sell insurance.
Medicare is the federal health insurance program. Original Medicare is Part A (hospital insurance) plus Part B (medical insurance). It lets you use any doctor or hospital that takes Medicare, anywhere in the U.S., meaning all 50 states, DC, Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa. With Original Medicare you can add a separate Part D drug plan and buy a Medigap (Medicare Supplement) policy to help cover the 20% coinsurance and other out-of-pocket costs. Medicare Advantage (Part C) is an alternative run by private health plans that Medicare approves. These plans bundle Parts A and B and usually Part D, often with extra benefits like vision, hearing, and dental. They typically use a network and require approval ahead of time for some services. They have a yearly cap on out-of-pocket costs, so you do not need Medigap.
Apple Health LTSS is the set of long-term care programs under Washington Medicaid. It splits into two groups. The first is for people who need help with daily activities but do not need nursing-home level care: Community First Choice, Medicaid Personal Care, and coverage in an assisted living facility. The second uses nursing-home level rules and includes PACE, Roads to Community Living, Hospice, and the home and community based waivers such as COPES, Residential Support, and New Freedom. The Washington Health Care Authority sets the rules. The state's Home and Community Services office handles your application, the CARE assessment of what help you need, and ongoing case management. To qualify you must meet both a financial limit and a finding that you need nursing-home level care (or the equivalent for a waiver). For long-term care you receive at age 55 or older, the state may later recover those costs from your estate.
Volunteer Chore Services connects low-income adults with volunteers who help with everyday tasks at home. It is intended to fill the gap for people who can't afford private in-home help but don't meet the financial or functional thresholds for Medicaid-funded long-term care.
Medicaid Personal Care is a Washington Medicaid benefit for people who qualify two ways: they need help with daily activities based on the state's assessment, and they qualify financially for an Apple Health program that does not require nursing-home level care. It covers people whose needs fall below the nursing-home level of care that Community First Choice and the home and community based waivers require. You can get services at home, in an adult family home that contracts with the state, or in a licensed assisted living facility that is contracted to provide adult residential care.