Medicaid Alternative Care (MAC)
WA DSHS HCLA
Medicaid Alternative Care (MAC) is one of two programs offered under Washington's Medicaid Transformation Demonstration (MTD), administered by DSHS/HCLA. MAC supports unpaid family caregivers of Medicaid-eligible older adults by providing services that help the caregiver continue caring for their loved one at home, delaying or preventing the need for paid Medicaid long-term services. As of December 1, 2025, MAC has paused new enrollments and is operating a waitlist due to overspending projections.
Who qualifies
What it covers
Cost
How to apply
Where to get this in Washington
12 organizations deliver this program. Coverage varies, so check the area each one serves.
Free public agency that helps older adults and people with disabilities in central Washington find in-home care, caregiver support, nutrition, transportation, and benefits help.
AAA for the Spokane region; one number connects callers to information, caregiver support, dementia help, Medicaid in-home care, Medicare counseling, and nutrition.
Council-of-governments AAA covering eight southeast Washington counties; one call connects callers to information & referral, case management, nutrition, caregiver support, and Medicaid in-home care.
Free public AAA for the Vancouver/Longview area covering five counties; one stop for caregiver assistance, dementia resources, in-home help, kinship care, Medicare counseling, and WA Cares Fund support.
Home of the Sunshine Garden Chinese Senior Community Center, with culturally tailored elder programs in Cantonese, Mandarin, Russian, Vietnamese, and more across King County.
Kitsap County Human Services division and AAA for Kitsap County. Coordinates information, case management, caregiver support, nutrition, kinship care, and Medicaid in-home services.
Three-county AAA for Lewis, Mason, and Thurston counties offering caregiver support, in-home services, nutrition, and the Senior Farmers Market produce benefit.
AAA for Whatcom, Skagit, Island, and San Juan counties. Helps older adults, adults with disabilities, and family caregivers navigate aging and disability services since 1971.
AAA covering the Olympic Peninsula and southwest Washington coast; offers information & assistance, caregiver support, nutrition, transportation, and Medicaid case management for seniors and adults with disabilities.
Pierce County's AAA and Aging & Disability Resource Center; coordinates long-term services and supports for older adults, adults with disabilities, and caregivers.
Seattle Human Services division that serves as the AAA for King County. Runs Community Living Connections for aging/disability help and administers caregiver support, healthy aging, and age-friendly programs.
Snohomish County's AAA. Partners with Homage to deliver caregiver support, nutrition, kinship care, transportation, and Medicaid in-home services.
Source www.dshs.wa.gov/altsa/stakeholders/medicaid-transformation-demonstration