COPES Waiver
WA Department of Social and Health Services
The 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.
Who qualifies
What it covers
Cost
How to apply
How to apply
Call Community Living Connections to ask for a long-term care assessment
One call starts the referral to your local Home and Community Services office, which runs both the care assessment and the financial track.
- Community Living Connections 1-855-567-0252
- Washington Connection Open
- Form HCA 18-005, the aged, blind, disabled and long-term care application Open
- Find your local Home and Community Services office Open
Documents to gather
- Photo ID
- Proof of income (Social Security award letter, pensions, wages)
- Statements for all bank and asset accounts
- Property records, deeds, life insurance, annuities, and records of any gifts or transfers
- Medicare card and any other insurance
- Information about daily-living limitations, diagnoses, and current caregivers
- Social Security number and citizenship or immigration status
Apple Health applications are decided within 45 calendar days, or 60 days if a disability decision is required. In practice COPES can take longer, because the care assessment and the financial review must both finish. Treat 45 to 60 days as the floor rather than a promise.
Worth knowing
The 2026 income limit is $2,982 a month, which is 300 percent of the federal benefit rate, and the resource limit is $2,000. Both reset every January 1.
COPES carries a 60 month lookback on assets transferred for less than fair value, and transfers can create a penalty period. Waiver services confer institutional status, which is what triggers the penalty.
COPES is a waiver, not an entitlement, so capacity is capped and it can carry a waitlist. Community First Choice is a state plan benefit and cannot.
You must meet nursing facility level of care as well as the financial limits. Both gates apply.
COPES is usually paired with Community First Choice, which provides the base personal care while COPES adds waiver-only services such as home modifications and home-delivered meals.
If your spouse stays at home, the 2026 figures protect them: a maintenance needs allowance up to $4,066.50 a month and a resource allowance up to $162,660. The home equity limit is $1,130,000.
See your next step, the documents you will need, and how to apply. Save it to your account to track your progress.
Where to go from here
Adult Day Center
Adult day centers are daytime programs for adults who need some level of supervision and care but not skilled nursing or rehabilitative therapy. Services typically include personal care, social activities, education, routine health monitoring, therapeutic activities, meals and snacks, transportation coordination, first aid, and emergency care.
Adult Day Health
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 Classic Medicaid (SSI-related / Aged, Blind, Disabled)
"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 (HWD)
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.
Not sure this one fits your situation? Your local Area Agency on Aging can check what you qualify for and point you to the right programs, for free. No one will sell your information, and no one will cold-call you.
Source www.dshs.wa.gov/altsa/stakeholders/hcbs-%E2%80%93-copes-waiver-amendment
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