Washington Medicaid for Nursing Home Care (2026)
In Washington, nursing home Medicaid is called Washington Apple Health long-term care and is run by the Washington State Health Care Authority and DSHS. Here are the rules that decide who qualifies, in plain English, with links to the official sources.
Countable savings and property a single applicant can keep. The home, one car, personal belongings and a burial fund usually do not count.
Income above the limit goes toward the cost of care (a “spend-down”), and Medicaid pays the rest.
What the resident keeps each month for personal items. Most other income goes to the nursing home.
Gifts or transfers for less than fair value in this window can delay coverage.
Figures for 2026. Checked against official sources October 2026.
If the applicant is married
Federal “spousal impoverishment” rules protect the spouse who stays at home, so they are not left without money.
- Savings the at-home spouse can keep: between $32,532 and $162,660 in 2026, depending on how Washington applies the rule and the couple’s total assets.
- Monthly income for the at-home spouse: at least $2,705 a month and up to $4,066.50, topped up from the resident’s income if needed.
- The home: usually protected while a spouse lives there. Without a spouse at home, equity above $752,000 (up to $1,130,000 in some states) can make an applicant ineligible.
How to apply
- Start early. States must decide most applications within 45 days, but missing paperwork often makes it longer. Ask whether coverage can be backdated to the months before you applied.
- Gather records: ID, Medicare and insurance cards, proof of income, and bank and investment statements (often for the full look-back period).
- Apply with the Washington State Health Care Authority and DSHS: official application page, or call 877-429-7019 (DSHS Home and Community Services Intake).
- Ask the nursing home for help. Most have a business office or social worker who handles Medicaid applications every week.
Good to know in Washington
Washington does not use income trusts: income up to $2,982 a month qualifies directly, and people with more can qualify if their income is below the cost of nursing home care. The $108.74 personal needs allowance is higher than most states. Apply through Washington Connection or call DSHS Home and Community Services.
Nursing homes in Washington that accept Medicaid
189 of the 193 nursing homes in Washington on Medicare’s list accept Medicaid. Medicaid beds can be limited, so ask each home whether it has one available and whether it will keep a resident who moves from private pay to Medicaid.
Find homes that accept Medicaid in Washington → All nursing homes in Washington Best-rated homes in Washington
Free help
The Washington Long-Term Care Ombudsman (1-800-562-6028) helps nursing home residents and families with problems, including Medicaid admissions and discharges, at no cost. For planning around a home, savings or a spouse, a certified elder law attorney can advise on what is allowed.
Questions about Medicaid in Washington
Does Medicaid pay for nursing homes in Washington?
Yes. Washington Apple Health long-term care pays for long-term nursing home care for people who need that level of care and meet the income and asset rules. Medicare, by contrast, covers only short rehab stays after a hospital admission.
How much money can you have to qualify for Medicaid in Washington?
A single applicant can have up to $2,000 in countable assets (2026 figure). The home, one car and personal belongings usually do not count.
What is the Medicaid look-back period in Washington?
60 months. Gifts or sales below value during that time can cause a period when Medicaid will not pay for care.
How much income does a nursing home resident on Medicaid keep in Washington?
$108.74 a month for personal needs. Most other income goes toward the cost of care, after any allowance for a spouse at home.
Sources
- Washington Apple Health Income and Resource Standards (hca.wa.gov, PDF)
- HCA program standards page (hca.wa.gov)
- SIL is 300% of FBR and the maximum gross income level for… (hca.wa.gov)
- Resource standard for a single person applying for long-term care is… (app.leg.wa.gov)
- Medically needy institutional coverage for people with income over… (app.leg.wa.gov)
- 60-month look-back for asset transfers (app.leg.wa.gov)
- How to apply (dshs.wa.gov)
- HCA long-term services page (hca.wa.gov)
- Washington State Long-Term Care Ombudsman Program toll-free… (waombudsman.org)
- CMS: 2026 SSI and spousal impoverishment standards
- CMS: spousal impoverishment standards effective July 1, 2026
This page explains the general rules and is not legal or financial advice. Medicaid rules change, and each case depends on the details: confirm with the state agency before making decisions. Medicare vs. Medicaid · Nursing home cost planner · VA benefits for veterans