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How Medicaid Can Help Pay for Long-Term Care in Washington State

Washington runs a lesser-known program with a dramatically higher asset limit for people who don't yet need intensive care — worth knowing about before assuming you're not eligible for anything.

WA Washington-specific — figures don't apply nationally
Published August 28, 2026 How we keep this accurate
This page is Washington-specific. Medicaid long-term care rules vary significantly by state. See our national Medicaid Waivers Explained guide if you're elsewhere.

A program with a dramatically different asset limit

Washington's standard HCBS waiver, COPES, uses the familiar $2,000 asset limit. But the state also runs a second program — TSOA (Tailored Supports for Older Adults) — with an asset limit of $84,354 for a single applicant. That's over 40 times higher.

The trade-off: a capped, smaller benefit. TSOA provides a maximum of roughly $830/month in support — meaningfully less than COPES's broader coverage. It's designed for people who have more savings and don't yet need intensive nursing-facility-level care, giving them some help without requiring a full spend-down first.

COPES vs. TSOA, side by side

COPESTSOA
2026 asset limit (single)$2,000$84,354
Benefit levelFull range of HCBS servicesCapped around $830/month
Who it's forThose needing nursing-facility-level careThose with more savings, lower current need

Source: Washington Aging and Long-Term Support Administration (ALTSA), DSHS; figures effective 2026.

COPES: Washington's primary waiver

COPES (Community Options Program Entry System) covers personal care, skilled nursing, adult day services, home modifications, and emergency response systems for seniors and disabled adults needing nursing-facility-level care. It's administered by ALTSA and is not an entitlement — enrollment is capped at roughly 62,450 slots per year, and waitlists can form once slots fill.

Other pathways worth knowing about

Washington has several similar-sounding but distinct programs: Medicaid Personal Care (a lower-bar state plan benefit, fewer services), New Freedom (a self-directed monthly budget, available only in certain counties), and Community First Choice (a state plan option overlapping with COPES). Which one actually fits your situation depends on your specific needs — worth asking a caseworker directly rather than assuming.

If your income is over the limit

Washington's Medically Needy program lets you spend down excess income on medical expenses to meet the $994/month limit — and unlike some states, you can choose a 3- or 6-month spend-down period, giving you some flexibility in how this is structured.

A connection worth knowing about, beyond long-term care

Washington eliminated asset limits for Medicare Savings Programs entirely, effective 2026. If you're also checking Medicare premium assistance, only your income matters now — no asset test at all. See our Medicare Savings by State guide.

How to actually start

1
Contact ALTSA at 1-800-422-3263 to begin a CARE (Comprehensive Assessment Reporting Evaluation) — this determines your level of need and which program actually fits.
2
If your savings are well above $2,000 but you don't yet need intensive care, ask specifically about TSOA rather than assuming you're ineligible for everything.

Common Questions

What is TSOA in Washington State?

A program with an $84,354 asset limit, over 40 times higher than standard waivers, offering a capped ~$830/month benefit for those with more savings and lower current care needs.

What is the difference between COPES and TSOA?

COPES serves those needing nursing-facility-level care with a standard $2,000 asset limit; TSOA serves those with more savings and lower needs, with a smaller capped benefit.

Does Washington still have an asset test for Medicare Savings Programs?

No — eliminated entirely as of 2026, only income is checked now.

Related Guides

Neighboring States

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