Long Term Care

Washington Long Term Care Costs & Insurance Partnership Program

The State of Washington ranks third in the United States with the highest expenses for home health aide (Medicare-certified) services, amounting to as much as $192,955 annually. Rates in nursing facilities across the state currently average at $96,482 each year while those for assisted facilities are at $51,000. These were according to Genworth Financial's 2012 Cost of Care, an extensive study on the current trends of the Long Term Care industry in the country. The following are the present costs of care in various areas in the State of Washington.

Region Homemaker Services Hourly Rate
Home Health Aide Hourly Rate
(Medicare Certified)
Assisted Living Facility Monthly Rate
(Private room)
Nursing Home Daily Rate
(Semi-private room)
Nursing Home Daily Rate
(Private room)
Bellingham $22 $25 $3,898 $223 $241
Bremerton - Silverdale $24 $24 $3,500 $254 $303
Kennewick - Pasco - Richland $20 $20 $3,750 $225 $235
Longview $20 $21 $4,575 $198 $220
Mount Vernon - Anacortes $21 $22 $3,690 $239 $263
Olympia $23 $23 $4,465 $269 $230
Seattle - Tacoma - Bellevue $25 $25 $4,500 $257 $289
Spokane $21 $21 $3,800 $272 $295
Wenatchee $20 $20 $4,113 $228 $243
Yakima $20 $20 $3,750 $203 $223
Rest of State $20 $22 $4,000 $240 $272
Washington Long Term Care Insurance

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Long Term Care Services

Medicaid may help pay for these Long Term Care services. Medicaid is a public insurance program made available only to those with very limited assets and income. Therefore, individuals applying for Medicaid coverage must meet financial requirements. These financial criteria depend on the services needed. Income and asset limits often change. To obtain the most up-to-date information, residents of the State of Washington must contact their Home and Community Services office.

Medicaid is the last third-party payer for Long Term Care needs. Meaning, care costs must be paid first, either by self-pay or other third-party payers such as private insurance or employer-sponsored insurance. Only when all benefits are availed shall Medicaid step in. Residents are then forced to exhaust personal savings and resources in order to apply.

With the aim of enabling the people to protect assets and be assured of a dignified life in the future, the State of Washington has adopted the Partnership Program, following in the footsteps of other states currently with Partnership status.

The Washington Long Term Care Partnership Program

The Washington State Long Term Care Partnership Program is a collaborative effort between the private insurance industry and state government agencies Washington State Health Care Authority, Washington State Office of Insurance Commissioner and the Department of Social and Health Services.

Under Chapter 388-513-1400 of the Washington Administrative Code (WAC), individuals who purchase a Partnership-qualified Long-Term Care insurance policy can apply for Medicaid without spending down their assets should their long term care needs go beyond their policy’s coverage. In other words, they will be able to keep an amount of assets higher than Medicaid’s asset limit during the eligibility process because a Partnership-qualified policy bears the Dollar-for-Dollar Asset Protection.

The amount of assets that will not be counted towards Medicaid eligibility is equal to the insurance benefits paid by the Partnership policy.

Washington Long Term Care Partnership Policy

According to WAC 284-83-410, a long term care insurance policy is regarded as a Partnership policy if it complies with the following requirements:

  1. Policy was issued or exchanged on or after January 1, 2012
  2. Policyholder should be a resident of Washington or another state that participates in the reciprocity agreement when coverage first became effective under the policy
  3. Policy is tax qualified and satisfies federal tax rules as defined in Section 7702B(b) of the Internal Revenue Code of 1986 (26 U.S.C. 7702B(b)
  4. Policy should provide a certain level of inflation protection based on the age of the policyholder at the time coverage was purchased. Below are the accepted levels of inflation protection:

    • 60 and younger –annual compound inflation protection
    • Between 61 and 75 – simple or compound inflation protection
    • 76 and older – inflation protection may be offered but it is not a requirement

Policies shall provide coverage for nursing home care and an alternative plan of care, and not require policyholders' prior hospitalization or confinement in a nursing home in order to receive insurance benefits. Policies shall provide an optional coverage benefit for home and community-based care. Policies shall be guaranteed renewable. They shall provide at least 6-month grace period to reinstate retroactive to the date of termination should the policyholder fail to pay premiums due to cognitive impairment (certified by physician).

Participating insurance companies, on the other hand, shall offer case management services and provide policyholders a notice about the Long Term Care consumer education program. They must have a system for keeping records of policies and payments of benefits made under the policy. Insurers shall likewise submit to the Insurance Commissioner each year a report of Long Term Care insurance data as specified by the Commissioner.

To provide information on the availability of Long Term Care insurance and eligibility guidelines to avail asset protection, a consumer education program shall be established by the combined efforts of Partnership insurance companies and state agencies, i.e. Department of Social and Health Services and Office of the Insurance Commissioner.

Washington Long Term Care Insurance References