Washington Programs

WA Cares Fund and Medicare

WA Cares is Washington's state long-term care benefit, paid for by a 0.58% premium on workers' wages. Benefits became available on July 1, 2026, for people who have contributed long enough and need help with at least three daily activities. It is separate from Medicare, which does not pay for most long-term care.

By the Benefits Life Editorial Team, licensed insurance agents · Reviewed November 9, 2026

What WA Cares is

The WA Cares Fund is a state long-term care benefit funded by a premium of 0.58% of Washington workers' wages. It was created by the Legislature in 2019 (chapter 50B.04 RCW), began collecting premiums on July 1, 2023, and began paying benefits on July 1, 2026. It is managed by the Department of Social and Health Services (DSHS) with the Health Care Authority and the Employment Security Department (ESD).

WA Cares says the full benefit is 36,500 dollars in 2026, a lifetime amount that grows with inflation. It pays approved providers for long-term services and supports: in-home personal care, home-delivered meals, housework and errands, adaptive equipment, home modifications, emergency response systems, adult day services, transportation, respite and other support for family caregivers, dementia supports, and care in an adult family home, assisted living facility, memory care or nursing home. Most of these are things Medicare does not pay for.

Why this matters for Medicare beneficiaries

Medicare does not pay for most long-term care. Medicare's skilled nursing facility benefit requires a qualifying inpatient hospital stay, lasts up to 100 days per benefit period, and covers only skilled care, not custodial help with daily activities. After that, families typically pay out of pocket, use private long-term care insurance, or apply for Apple Health long-term services and supports.

WA Cares is meant to be a first layer of public coverage for that gap. It is not designed to pay for all long-term care, but it can pay for help at home or in a facility before savings run out. WA Cares says its benefits are not counted as income or resources when you apply for other state programs such as Apple Health, and are not subject to estate recovery.

Who pays in

Employers withhold 0.58% of each covered employee's wages, with no wage cap, so everyone pays the same rate regardless of salary. State law lets the Pension Funding Council set the rate every two years starting in 2026, but never above 0.58%. Self-employed people earn benefits only if they opt in. If you are already retired and no longer work at all, WA Cares says you can't earn benefits; your local Area Agency on Aging can help you find other long-term care options.

Who's exempt

Workers in these groups can apply to ESD for an exemption:

People who live outside Washington but work for a Washington employer
Active-duty service members with an off-duty civilian job
Spouses or registered domestic partners of active-duty service members
Veterans with a service-connected disability rating of 70% or higher

Since January 1, 2026, workers on a nonimmigrant work visa are exempt automatically unless they tell their employer in writing that they want to keep contributing. The exemption for people who had private long-term care insurance is closed to new applicants; people who already have one can give it up and start contributing between January 1, 2026, and June 30, 2028. An exempt worker cannot qualify for benefits unless the exemption is ended.

Contribution requirements

To qualify for benefits, you need to have paid premiums, with at least 500 hours of work in each year counted, for either:

a total of 10 years (the permanent pathway), or
3 of the last 6 years before you apply (the temporary pathway, which you must still meet when you apply)

Near retirees have a third option. If you were born before January 1, 1968, and don't reach 10 years, you can qualify with at least one year of contributions and receive 10% of the full benefit for each year you contributed. If you meet the 3-of-6 test, you can get the full benefit no matter when you were born.

Using your benefit

To use WA Cares, you apply when you need care, online through a SecureAccess Washington account, by phone at 844-CARE4WA (1-844-227-3492), with language assistance available, or with help from your local Area Agency on Aging. ESD confirms your contributions, and a WA Cares team member assesses your needs by phone or in person. You must need help with at least three activities of daily living, such as bathing, dressing, eating, toileting or moving around, for at least 90 days.

Benefits are paid to approved providers. Each service has a maximum rate, and providers can't charge you more for a covered service. A family member who helps you regularly may be able to become your paid caregiver, with training and support. There is no option to cash out your contributions if you never use the benefit.

Moving out of Washington

Under a 2024 change in state law, starting July 1, 2026, a worker who moves out of Washington can choose to keep participating if they paid premiums for at least three years, with at least 500 hours of work in Washington in each of those years, and notify ESD within one year of moving. Out-of-state participants keep paying premiums on their earnings and must report them to ESD; coverage is canceled if they stop. Benefits for out-of-state participants begin July 1, 2030. People with an active exemption can't elect out-of-state participation.

How WA Cares fits with other long-term care funding

The usual sources of long-term care funding for Washington seniors:

Personal savings and retirement income: often the first source
Private long-term care insurance: for those who have it
WA Cares Fund: a first layer for workers who qualify
Apple Health long-term services and supports: for people who meet its financial and functional rules (more on Apple Health)
VA benefits: for qualifying veterans and survivors, such as Aid and Attendance (more on VA benefits)

WA Cares alone will not pay for long-term care for most people who need years of care, but it can extend the time before Apple Health becomes necessary.

Common confusions

"Is WA Cares part of my Medicare?" No. They are separate programs, one state and one federal.
"Does WA Cares replace a Medicare supplement or Medicare Advantage plan?" No. WA Cares pays for long-term services and supports, not doctor or hospital bills. You still need Medicare coverage for medical care. For questions about your Medicare plan choices, a licensed insurance agent with Benefits Life can help at no cost to you: call (206) SENIORS (206-736-4677), TTY 711 or see plans in your ZIP code.
"Can I opt out now?" Only through the exemptions above; the private-insurance exemption is closed to new applicants.
"Will Medicare cover long-term care if I have WA Cares?" Medicare's coverage is the same either way: skilled care for limited periods, not ongoing custodial care.

Sources

Frequently asked questions

Is WA Cares Fund the same as Medicare?

No. WA Cares is a Washington state long-term care benefit funded by a premium on workers' wages and managed by DSHS, the Health Care Authority and the Employment Security Department. Medicare is federal health insurance. Having one does not change the other.

How much can I get from WA Cares?

WA Cares says the full lifetime benefit is 36,500 dollars in 2026 and grows with inflation. People born before 1968 who qualify through the near-retiree pathway get 10% of the full amount for each year they contributed. The benefit is paid to approved providers for covered services, not as cash.

Do I have to sign up to pay into WA Cares?

No. Employers withhold the premium from paychecks automatically, unless you have an approved exemption. Self-employed people take part only if they opt in. To use benefits, you apply when you need care.

Can I still opt out of WA Cares?

The exemption for people with private long-term care insurance is closed to new applicants. Other exemptions remain, for example for people who live outside Washington, military spouses and partners, active-duty service members with civilian jobs, and veterans with a 70% or higher service-connected disability rating.

Can I use WA Cares if I move out of Washington?

Starting July 1, 2026, workers who move away can choose to keep participating if they paid premiums for at least three years with 500 or more hours of work in Washington each year, and tell the Employment Security Department within a year of moving. Benefits for out-of-state participants start July 1, 2030.

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