Medicare and WA Cares do different jobs
Medicare pays for medical care: hospital stays, doctor visits, tests, and short-term skilled care. It generally doesn't pay for long-term custodial care, the everyday help with bathing, dressing, eating or getting around that many people need as they age or after an illness. Medicare's limits are narrow:
- Skilled nursing facility care only after a qualifying inpatient hospital stay of at least three days, and only for skilled care, for up to 100 days per benefit period. In 2026 you pay $217 a day for days 21 to 100.
- Home health care only when you need part-time skilled nursing or therapy and are homebound. Medicare doesn't pay for round-the-clock care at home or for personal care alone.
- Hospice for people with a terminal illness who choose comfort care.
WA Cares covers what falls outside those limits. Once approved, you can use your benefit for services such as in-home personal care (including a paid family caregiver), home-delivered meals, housework and errands, adaptive equipment, home modifications, personal emergency response systems, transportation, adult day services, respite for family caregivers, and care in an assisted living facility or adult family home.
Who qualifies
You must meet two requirements:
- Contributions. Most Washington workers contribute automatically through payroll. You earn the full benefit by contributing for 10 years, or for at least 3 of the 6 years before you apply. People born before January 1, 1968 can also earn a partial benefit of 10% of the full amount for each year they contributed. A year counts if you worked at least 500 hours. People with an approved exemption can't qualify.
- Care need. A WA Cares team member must find that you need help with at least three activities of daily living, such as bathing, eating, medication management, mobility, transferring or toileting, and will keep needing help for at least 90 days.
The full benefit is a lifetime amount set by state law that grows with inflation each year; WA Cares lists the current amount on its website. It is paid directly to registered providers, not to you.
WA Cares, Apple Health and Medicare together
Under RCW 50B.04.150, WA Cares benefits don't count as income or resources when Apple Health or another means-tested program decides your eligibility. WA Cares says that if you have both Apple Health and WA Cares, Apple Health won't pay for services you could have gotten through WA Cares, so you would use WA Cares first for covered long-term care. Your Medicare coverage, whether Original Medicare or a Medicare Advantage plan, keeps paying for medical care as before. Medicare Advantage plans may offer extra benefits that Original Medicare doesn't cover, such as dental, vision, hearing or fitness. Extra benefits vary by plan and county, may have limits and costs, and not every plan offers them. Check a plan's Summary of Benefits or Evidence of Coverage.
How to apply
Create a WA Cares benefits account through SecureAccess Washington and fill out the online application, or call WA Cares at 844-CARE4WA. For in-person help, your local Area Agency on Aging can assist; find it through Community Living Connections at 1-855-567-0252. See also WA Cares Fund, Community Living Connections and caregivers' guide to Medicare.
Get help with Medicare
For questions about how your Medicare plan covers skilled care, home health and hospice, a licensed insurance agent with Benefits Life can help at no cost to you: (206) SENIORS (206-736-4677), TTY 711.
Related questions
Does Apple Health pay Medicare premiums?
Medicare Savings Programs in Washington.
Does Medicare cover Death with Dignity?
End-of-life care, hospice and Washington's law.
What is Washington's Medicare phone number?
Official numbers, including aging services.
Sources
- WA Cares Fund — Qualifying for benefits
- WA Cares Fund — Covered benefits
- WA Cares Fund — Using your benefits (Apple Health coordination)
- WA Cares Fund — WA Cares Fund benefits now available (July 1, 2026)
- RCW 50B.04.150 — Benefits not income or resource
- Medicare.gov — Long-term care
- Medicare.gov — Skilled nursing facility care
Frequently asked questions
Do I need Medicare to use WA Cares?
No. WA Cares eligibility depends on your contributions while working in Washington and on your care needs, not on Medicare. Many people who use it will have Medicare, and the two cover different things.
I'm already retired. Can I get WA Cares?
Possibly. Workers began contributing July 1, 2023. People born before January 1, 1968 can earn a partial benefit through the transition pathway: 10% of the full benefit for each year they contributed, counting years with at least 500 hours of work. People who contributed for at least 3 of the last 6 years, or 10 years in all, can get the full benefit.
Will WA Cares benefits affect my Apple Health eligibility?
No. State law says WA Cares benefits aren't counted as income or resources for Medicaid or other means-tested programs. But if you have both, Apple Health won't pay for services you could have gotten through WA Cares.
Does WA Cares pay my Medicare premiums or copays?
No. WA Cares pays registered providers for approved long-term care services and supports. It doesn't pay Medicare premiums, deductibles or plan cost sharing.
Medicare in your Washington county
Plans, local agents and help, county by county: Adams · Asotin · Benton · Chelan · Clallam · Clark · Columbia · Cowlitz · Douglas · Ferry · Franklin · Garfield · Grant · Grays Harbor · Island · Jefferson · King · Kitsap · Kittitas · Klickitat · Lewis · Lincoln · Mason · Okanogan · Pacific · Pend Oreille · Pierce · San Juan · Skagit · Skamania · Snohomish · Spokane · Stevens · Thurston · Wahkiakum · Walla Walla · Whatcom · Whitman · Yakima
