Long-term care help in Washington
Help at home, help for the person doing the caring, and what to do when staying at home is no longer working. Starting with the thing most people have wrong.
Medicare does not cover long-term care
Medicare generally does not pay for ongoing custodial care — help with bathing, dressing, eating and getting around. It can cover limited skilled care in specific circumstances, which is a different thing.
People assume this is handled and do no planning at all. That assumption is expensive, and it is the reason this page exists.
Start with a phone call, not a search
Long-term care is one of the few areas where a phone call genuinely beats research. The people below do this every day, know what is actually available near you, and charge nothing.
If you only do one thing: call the Area Agency on Aging for your county.
Area Agency on Aging & Disabilities of Southwest Washington
Older adults, people with disabilities and family caregivers in Clark, Cowlitz, Klickitat, Skamania and Wahkiakum counties.
What it can help with
- Caregiver support
- Dementia resources
- In-home assistance
- Long-term care information
- Aging and disability services
- American Senior Choices is not affiliated with this agency.
- Clark County office: 201 NE 73rd St, Vancouver, WA 98665.
Official source: Area Agency on Aging & Disabilities of Southwest Washington · Last reviewed 2026-08-30
Community Living Connections
Washington residents looking for long-term services and supports, and the people caring for them.
What it can help with
- Help finding in-home care, adult family homes and other long-term support
- Connection to your local aging network
- We do not publish a direct phone number for this service because DSHS pages have shown differing numbers. Washington 211 can connect you.
Official source: Washington DSHS · Last reviewed 2026-09-08
Washington Long-Term Care Ombuds
Residents of nursing homes, assisted living and adult family homes, and their families.
What it can help with
- Free, confidential help with problems in a long-term care facility
- Advocacy on residents' rights
- Free and confidential. They advocate for the resident, not for the facility and not for the state.
Official source: Washington State Long-Term Care Ombuds Program · Last reviewed 2026-09-08
WA Cares Fund
Washington workers who have contributed and now need long-term care.
What it can help with
- Qualifying long-term care services and supports
Eligibility limits change periodically. Please verify the current limits with the program before applying.
- Baseline from resource-center brief, 2026-08-30. Not yet verified.
- Benefits became available in July 2026.
- Not everyone receives the full amount. Eligibility depends on your contribution history and your care needs, and some older workers qualify for a prorated benefit through a transition pathway.
- WA Cares is not Medicaid and not Medicare.
- Medicare generally does not pay for ongoing custodial long-term care.
Official source: WA Cares Fund · Last reviewed 2026-08-30
If you are the one doing the caring
Caregiver support is the most under-used help in this whole area. Respite care so you can get a break, training, support groups, and someone to talk to who understands the situation.
People wait until they are past coping before asking. Ask earlier than feels necessary. The Area Agency on Aging is where to start.
The care settings, briefly
In your own home
In-home caregivers, help with daily activities, home-delivered meals and adaptations. Most people want to stay put, and Washington's aging network is organised around making that possible for as long as it is safe.
Adult family homes
Small licensed homes, usually a handful of residents in a residential house. Often overlooked because people jump straight from home care to thinking about nursing homes.
Assisted living
Larger settings with your own space and help available. Levels of care vary widely between one place and the next, so compare rather than assuming they are equivalent.
Nursing homes
For people who need skilled nursing or a level of care the other settings cannot provide.
Paying for it
- Apple Health long-term services and supports. Washington's Medicaid covers long-term care for people who qualify, including in-home care. This is the main public route. More on Apple Health.
- WA Cares Fund. A lifetime benefit for people who contributed and meet the care requirements. More on WA Cares.
- Long-term care insurance, if you already hold a policy. Read what it actually covers before you need it, not after.
- Paying privately, which is what most families do at first, usually longer than they expected to.
Where we stop and an attorney starts
Medicaid spenddown planning, estate recovery, trusts, gifting, transferring assets and spousal impoverishment rules are legal questions with real financial consequences. Getting them wrong can disqualify somebody at exactly the moment they need care.
Do not take advice on any of that from a website, a friend, or an insurance agent — including us. We are naming them so you know what to ask about, not answering them.
Speak to an elder-law attorney or a qualified state benefits counsellor before moving any asset. SHIBA can also help you understand where you stand, free, at 800-562-6900.
Questions people actually ask
Doesn't Medicare pay for a nursing home?
Generally not for ongoing custodial care — the day-to-day help with bathing, dressing, eating and moving around that most people need. Medicare can cover limited skilled care in specific circumstances, which is different. This misunderstanding is the reason many families do no planning at all.
Where do I even start?
Call the Area Agency on Aging for your county, or Washington 211. In Clark, Cowlitz, Klickitat, Skamania and Wahkiakum counties that is the Area Agency on Aging & Disabilities of Southwest Washington. They do this every day and it costs nothing to ask.
I'm caring for my husband and I'm exhausted. Is there help for me?
Yes, and caregiver support is genuinely under-used. Respite care, training and support groups exist through the Area Agencies on Aging. People wait until they are past coping before asking. Ask earlier than feels necessary.
Should I give my house to my children to qualify for Medicaid?
Do not act on advice about that from a website, from a friend, or from an insurance agent — including us. Transfers, trusts and gifting carry rules and consequences that can disqualify you at exactly the wrong moment. Speak to an elder-law attorney before moving any asset.
Something is wrong at my mother's care facility. Who do I tell?
The Long-Term Care Ombuds. The service is free and confidential, and they advocate for the resident — not for the facility and not for the state. Contact them before things escalate rather than after.
Official sources
- Washington DSHS — Aging and Long-Term Support Administration
- Washington Long-Term Care Ombuds
- WA Cares Fund
- Eldercare Locator — if you are outside Washington
Related
- WA Cares Fund explained
- Apple Health and Medicare
- Medicaid spenddown in Washington
- What help should I check?
While you are sorting this out
Long-term care sits outside Medicare, but the Medicare side still matters — particularly which doctors and hospitals a plan covers if care needs are changing. Tim can review the plans he represents against your situation.
Talk With Tim About Medicare: (360) 472-4261This line is recorded, as Medicare requires for plan conversations.
Last reviewed September 2026. American Senior Choices does not determine eligibility for government assistance programs and does not provide legal or financial planning advice. Program rules and benefits can change.
Disclaimer: American Senior Choices is not affiliated with or endorsed by the U.S. government or the federal Medicare program. We do not offer every plan available in your area. Currently we represent 5 organizations which offer 33 products in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.