Paying for assisted living in Washington
Most families in Washington begin by paying for assisted living out of pocket. Common sources include retirement savings, Social Security and pension income, proceeds from selling a home, long-term care insurance, and contributions from family. Costs vary widely depending on the part of the state, the size of the apartment, and how much daily help a resident needs. You can see current pricing for communities in your area in the pricing tables below.
Once private funds are spent down, some residents become eligible for help through Medicaid. It is worth understanding those options early, because eligibility and assessments can take time.
Does Apple Health (Medicaid) cover assisted living in Washington?
Washington's Medicaid program, Washington Apple Health, can help pay for the care you receive in a licensed assisted living facility — but it never pays for room and board. Residents are responsible for the housing portion of the cost.
The main pathway is the COPES waiver (Community Options Program Entry System), a Home and Community Based Services waiver administered by DSHS. COPES helps pay for personal care and related services in residential settings, including assisted living facilities that contract with the state.
To qualify, you generally must:
- Meet financial limits for income and assets, and
- Need a nursing-facility level of care, determined through the state's CARE assessment.
COPES is not an entitlement, so a waitlist can form when slots are full. To apply, contact your local Home and Community Services (HCS) office. A specialist handles both the financial review and the in-person needs assessment.
Does Medicare cover assisted living in Washington?
No. Medicare does not pay for room and board or for the ongoing custodial care (help with bathing, dressing, meals, and medications) that assisted living provides.
Medicare may still cover medical services a resident uses while living there, such as doctor visits, hospital stays, and short-term skilled care or rehabilitation after a qualifying hospital stay. It does not cover the cost of the assisted living residence itself.
For free, unbiased help understanding what Medicare does and doesn't cover, contact Washington's SHIBA program (Statewide Health Insurance Benefits Advisors), run by the state Office of the Insurance Commissioner, at 800-562-6900.
