Washington Medicaid for Seniors & Long-Term Care

The income limit for nursing facility Apple Health is 300% of the Social Security Federal Benefit Rate — approximately $2,982 per month as of 2026. Income above this threshold must be applied to the cost of care (patient share/co-pay); Medicaid covers the remainder.

The asset (resource) limit for a single nursing facility applicant is $2,000. The family home is generally exempt during the lifetime of the applicant or their spouse, up to a home equity limit — Washington elects the higher federal maximum of $1,130,000 (in 2026) rather than the federal floor of $752,000, so a home with equity under that amount does not disqualify an applicant. Prepaid burial plans, one vehicle, and personal property are also typically exempt.

Washington offers several 1915(c) waiver programs through ALTSA, providing alternatives to nursing home placement for people who meet nursing facility level of care criteria.

When one spouse needs nursing home care, federal law protects the other spouse from complete impoverishment. The community spouse (the one still at home) is entitled to keep a minimum amount of assets — the Community Spouse Resource Allowance (CSRA) — and a minimum monthly income. The community spouse's own income is not counted toward the institutionalized spouse's Medicaid eligibility, and if the community spouse has insufficient income, a portion of the institutionalized spouse's income may be allocated to them — the minimum monthly maintenance needs allowance (MMMNA).

Washington participates in estate recovery. The state may seek reimbursement from the estate of a Medicaid member who received long-term care services at age 55 or older. The home is typically exempt during the member's lifetime and during the lifetime of a surviving spouse or disabled child. Contact ALTSA or an elder law attorney for guidance before making estate planning decisions for a family member who receives or may receive Apple Health long-term care services.