Adult Day Center

Adult day health is a daytime program for adults who need skilled nursing care or licensed rehabilitative therapy. Centers provide skilled nursing services, physical/occupational/speech-language therapy, brief psychological or counseling services, plus the personal care, meals, social activities, and health monitoring offered at adult day centers.

"Apple Health" is Washington's name for all of its state medical assistance programs, including Medicaid. "Classic Medicaid" is the part of Apple Health for people who are 65 or older, blind, disabled, or who need long-term care. These programs count your income the same way Supplemental Security Income (SSI) does, rather than using the tax-based rules that apply to younger adults and families. The state Health Care Authority runs most Apple Health programs. The Department of Social and Health Services (DSHS) runs SSI-related coverage, the state-funded Medical Care Services program, and the Medicare Savings Programs that help pay Medicare costs. If you have both Medicare and Apple Health, Apple Health acts as your second layer of coverage and picks up costs Medicare does not, such as deductibles, copays, hearing aids, and dental. It can also pay for long-term care.

Apple Health for Workers with Disabilities lets working adults age 16 or older who are blind or disabled buy into Medicaid. It provides full Apple Health coverage. Unlike most disability-based Medicaid, it has no asset test and no upper income limit. You qualify based on your disability (using the federal disability rules) and being employed, full or part time, including self-employment. You pay a monthly premium that goes up with income but never goes above 7.5% of your total income. American Indians and Alaska Natives pay no premium. While you are enrolled, you can put earnings into a separate designated account that will not count toward your eligibility for other Medicaid programs.

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.