Medicaid Alternative Care (MAC)
WA DSHS HCLA
Medicaid Alternative Care (MAC) is one of two programs offered under a special Washington Medicaid project run by the state Department of Social and Health Services. MAC supports unpaid family caregivers who look after older adults on Medicaid. It provides services that help the caregiver keep caring for their loved one at home, which can delay or prevent the need for paid Medicaid long-term care. As of December 1, 2025, MAC has paused new sign-ups and is running a waitlist because it is projected to spend more than its budget.
Who qualifies
What it covers
Cost
How to apply
How to apply
MAC paused new enrollment on December 1, 2025 and opened a statewide waitlist. You can join the waitlist, which is first come, first served by request date. There is no set date for when enrollment reopens. People already enrolled keep their services. American Indian and Alaska Native applicants are not subject to the waitlist.
Call Community Living Connections to join the waitlist
Your place on the waitlist is set by the date you ask, so calling sooner matters even though enrollment is paused.
- Community Living Connections 1-855-567-0252
- Community Living Connections Open
- Local Area Agency on Aging or DSHS Home and Community Services office
- Form HCA 18-005, only if not already on Apple Health Open
Documents to gather
- Photo ID
- Proof that the person receiving care already has Apple Health
- Information about daily-living limitations and diagnoses
- Information about the unpaid caregiver (age, relationship, caregiving role)
Enrollment is paused, so there is no meaningful decision timeline right now. Any underlying Apple Health application follows the standard 45 day rule, or 60 days if a disability decision is needed.
Worth knowing
MAC supports the unpaid family caregiver. It is not a new cash benefit for the person receiving care.
There is no asset-transfer penalty and no home equity test for MAC, unlike COPES, Community First Choice, and PACE, which all carry a 60 month lookback.
An unpaid caregiver aged 18 or older is required. Without one, ask about Tailored Supports for Older Adults instead, which has a small personal care benefit.
Enrollment has been paused with a waitlist since December 1, 2025. People already enrolled keep their services.
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
A Matter of Balance
A Matter of Balance is a structured eight-week class developed at Boston University and managed nationally by MaineHealth. Trained coaches lead small groups through discussion and gentle exercises that help participants reduce fear of falling, set realistic goals for activity, change environments to lower fall risk, and exercise to increase strength and balance. The CDC recognizes it as an evidence-based fall prevention program. In Washington it is hosted by Area Agencies on Aging, senior centers, hospitals, and faith communities.
ACRS Care Transitions
ACRS Care Transitions gives short-term help to adults coming home after a hospital stay. Staff help them follow their discharge plan, manage medications, get to follow-up appointments, and connect with ongoing community resources. It works alongside the ACRS Health Home program, which offers longer-term Medicaid care coordination through a health plan built around each person's needs.
ACRS Case Management for Older Adults
ACRS case managers, who speak many languages, meet with homebound older adults and adults with disabilities to understand their needs and build a full care plan around them. The goal is to help older adults live safely at home with support from their families and caregivers. Staff pay close attention to the language and cultural needs of Asian and Native Hawaiian/Pacific Islander communities.
ACRS Food Bank
The ACRS Food Bank gives out healthy foods that fit people's cultures, including rice, tofu, noodles, and fresh produce, matched to the diets of Asian and Native Hawaiian/Pacific Islander families across King County. Anyone in the community can use it, but the food is chosen for Asian and Pacific Islander cooking that most food banks don't carry.
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/medicaid-transformation-demonstration
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