Abundant natural beauty combined with the amenities of a top global city makes Washington a desirable option for retirees. With three national parks and 124 state parks, Washington residents have plenty of opportunities for outdoor recreation. Approximately 15.9% of Washington’s overall population of slightly more than 7.7 million citizens are those aged 65 and over. Washington’s major metro, Seattle, has a diverse art, culture and culinary scene and has a walkable downtown core and great public transportation. There are 15 hospitals in the Seattle area, including the highly rated University of Washington Medical Center and Virginia Mason Medical Center. 

The lack of a state income tax means that retirees won’t have to pay taxes on retirement income such as Social Security or pension payments. Housing costs, however, are above the national average. The average monthly cost of assisted living facilities in Washington is $6,000; however, the state’s Medicaid program offers three waivers to help seniors pay for the costs associated with assisted living. 

This guide explores assisted living expenses in Washington and discusses some available options for covering costs and a list of agencies designed to promote a good quality of life among seniors. 

How Much Does Assisted Living Cost in Washington?

According to the 2021 Genworth Cost of Care Survey, the average assisted living facility in Washington is $6,000 per month, which is significantly higher than the national average of $4,500. Those in the neighboring states of Idaho, Nevada, and Oregon pay less than their counterparts in Washington at $3,838, $3,750 and $5,045, respectively. However, prices rise to $6,830 in Alaska to the north. 

The Cost of Living in Washington’s Top Cities

As to be expected, the highest assisted living costs are found in Washington’s largest city, Seattle, at an average of $6,750 per month. Prices are quite a bit lower at the southern end of the state in Longview at $5,300, while their counterparts in Washington’s northernmost city, Bellingham, pay an average of $4,600 per month. Residents of assisted living facilities in Washington’s capital city, Olympia, pay $4,805, while those in the Central Washington community of Yakima pay a monthly average of $4,975. The lowest costs across the Cascade Mountain Range in the southeastern corner of the state in Walla Walla are at just $3,211 per month. Assisted living facilities in Washington’s second-largest city, Spokane, average $4,888 per month. 

The Cost of Assisted Living vs. Other Types of Care

Assisted living costs in Washington are higher than the average monthly cost of adult day health care at $2,600. However, other types of care come with higher price tags in Washington. Homemaker services average $6,547 per month, while the cost of a home health aide averages $6,578. Residents of nursing homes in Washington pay an average of $9,429 per month for a semiprivate room. 

Can You Use Medicaid to Pay for Assisted Living in Washington?

Seniors have several options when it comes to paying part of the costs of assisted living through Washington’s Medicare program, Apple Health. Programs funded through Apple Health include the Medicaid Personal Care Program (MCP), which helps cover the costs of routine activities of daily living, such as bathing, dressing and grooming, and the Community First Choice Option (CFCO), which covers respite for caregivers, assistive technology, medication assistance and other supportive services designed to delay or prevent recipients from entering nursing homes. The New Freedom Medicaid Waiver is available to residents of King and Pierce counties and provides those who need a nursing home level of care with supportive services to help them remain living in their own homes or in assisted living facilities. 

Medicaid’s Coverage of Assisted Living in Washington

Apple Health programs cover costs of basic services for low-income seniors, including a private apartment and assistance with routine tasks. Covered services include the following:

• Help with basic grooming, bathing and dressing
• Assistance with medication management
• Transportation to medical and dental appointments
• Occupational, physical and speech therapy
• Care coordination and management
• Nurse delegation
• Personal emergency response systems

Waiver Programs for Assisted Living in Washington

Community First Choice Option 
The Community First Choice Option is a waiver that provides supportive services to allow those who need nursing home level of care to remain living in their own communities, including assisted living facilities. This program promotes optimal independence by allowing recipients to manage their own care. Seniors can choose their own paid caregivers, including family members, and receive assistance with transportation, housework, personal care and laundry. 

Seniors must first apply for Medicaid to be considered for Community First Choice Option. If deemed eligible for Medicaid, a needs assessment will be performed to determine the level of care the individual requires. Applicants can apply for Medicaid by person, by mail or online. 

• Fill out an online application, or
• Print forms to mail.
• Address: Cherry Street Plaza, 626 8th Avenue SE, Olympia, WA 98501

Seniors may call the main phone number at (844) 461-4436 if they have questions.

The New Freedom Medicaid Waiver
This waiver is only available to residents of King and Pierce counties who are already enrolled in Apple Health. This is a self-managed program that allows recipients to manage their own care budgets and customize their care plans by choosing from a menu of services.

King County residents who are already enrolled in Medicaid can apply for the waiver through their caseworker. Those who are not already enrolled in Medicaid can apply for it online, through the mail or in person. 

• Fill out an online application for Medicaid
• Address (Seattle metro area): 1737 Airport Way S Suite 130, Seattle 98134

Seniors who would like more information can call (206) 341-7600.

Eligibility for Medicaid in Washington

Washington’s Medicaid program is available to those aged 65 and over and residents with disabilities. Recipients must meet qualifying income limits. 

The current income limit for single applicants for Medicaid in Washington State is $10,092 per year, while the asset limit is $2,000. For two-person households where only one person is applying, the annual income limit is $15,132, and the asset limit is $137,400. When both people in a two-person household are applying for Medicaid, the income limit is also $15,132, but the asset limit drops to $3,000.

2022 Medicaid Income Limits in Washington  

	Income Limits*	Asset Limits
Single Applicant	$10,092	$2,000
Two-Person Household (only one person applying)	$15,132	$137,400
Two-Person Household (both people applying)	$15,132	$3,000

 * Per year

Applying for Medicaid in Washington 

Seniors can apply for Medicaid in Washington in person, online or by mail. After the application is filled out and turned in, the agency will perform a financial review to determine eligibility. Applicants who are deemed eligible for services are given a needs assessment to determine the level of care they need. 

The most efficient way to apply for Medicaid is to fill out the online form.  

Those who prefer to apply in person or by mail can download the application from the HCA website and take it or mail it to their local HCA office. The address of the HCA’s main building is: Cherry Street Plaza, 626 8th Avenue SE, Olympia, WA 98501

The main phone number for the HCA is (844) 461-4436.

Before You Apply

The following documentation is necessary for a successful application:

• Proof of residency or citizenship
• Proof of income and assets
• Proof of age
• Health insurance information, if any 

Where to Go to Get Help

Navigating the red tape involved in applying for government services can be challenging. The following resources are available to help those who would like assistance with the application process.

Resource	Contact	Service
Washington Connection	(877) 501-2233	Washington Connection provides assistance with filling out forms when applying for Medicaid and filing Medicaid appeals. Assistance is available online and by telephone.
Office of the Insurance Commissioner	(800) 562-6900	Those with Medicaid and other health insurance-related issues can get help from the Office of the Insurance Commissioner.
Washington Law Help.org	https://www.washingtonlawhelp.org/contact-us	Created and maintained by the Northwest Justice Center, Washington Law Help.org is a free service that helps those with Medicaid appeals and related legal issues.

Can You Use Medicare to Pay for Assisted Living in Washington?

Unfortunately, Medicare does not cover the cost of assisted living in Washington. Unlike nursing homes, assisted living facilities are not considered to be “clinical settings’ and so are not eligible for Medicare coverage. That being said, you can still use Medicare to cover the cost of approved medications, doctor visits, medical equipment, etc.

For more information about Medicare visit medicare.gov.

Are There Other Financial Assistance Options for Assisted Living in Washington?

	How to Apply	How It Works
Aid and Attendance	Apply online at va.gov.	If you are a veteran and you receive a VA pension, you may also be eligible for the Aid and Attendance benefit. This benefit takes the form of a monthly cash allowance that you receive in addition to your standard pension. This benefit is used by veterans who need long-term care services, including care received at an assisted living facility.
Reverse Mortgages	Research and learn about the different types at ftc.gov	If you own a home, you may be able to use a reverse mortgage to access some of the equity in your home. Like traditional loans, reverse mortgages do need to be repaid with interest, typically within 12 months, so seniors should carefully weigh this option alongside other financing methods.
Long-Term Care (LTC) Insurance	Learn about how to receive LTC insurance benefits at acl.gov.	While those who currently need assisted living will typically not be eligible, if you purchased an LTC insurance policy in the past, you may be able to use it to help pay for assisted living. While most policies cover at least a portion of the cost, you still need to check the specific terms of your policy.

Free and Low-Cost Resources for Seniors in Washington

There are several nonprofit organizations and state and federal agencies designed to help older adults maintain independence and good quality of life. Some of the following services also help seniors find care that best suits their needs and apply for Medicare and other benefits. 

Resource	Contact	Service
Washington Association of Area Agencies on Aging	(360) 485-9761	Washington has 13 regional Area Agencies on Aging. These agencies are part of a national network designed to provide direct and indirect services that promote independence and good quality of life among older people. Direct services include Medicare and Medicaid counseling, balance workshops, wellness screenings and case management. Other services include referrals to other relevant local, state and federal programs and services. Area Agencies on Aging also provide caregiver support for family members and professional caregivers.
Washington State Department of Veterans Affairs	1 (800) 562-2308	Veterans and their immediate families can get help applying for service-based benefits from the Washington State Department of Veterans Affairs. The agency also maintains four veterans’ homes throughout the state and a counseling and wellness division.
Washington State Long Term Care Ombudsman Program	1 (800) 562-6028	The Long Term Care Ombudsman program safeguards the legal rights of those living in long-term care facilities, including assisted living communities. Residents and their loved ones who have concerns about their care or who suspect neglect or abuse can contact this office for free and confidential investigative services.
Washington State Association of Senior Centers	[email protected]	Senior centers provide opportunities for older adults to socialize with their peers, enjoy congregate midday meals as part of the Senior Nutrition Program, participate in group exercise opportunities, find volunteer options and get information about community-based services. The Washington State Association of Senior Centers can help seniors locate a senior center in their community.
Social Security Offices	(800) 772-1213	Washington has several Social Security field offices scattered throughout the state. Seniors can access applications for Social Security and screenings for Medicaid by visiting these offices.
Washington State Bar Association Moderate Means Program	(855) 741-6930	Those with limited financial resources can get legal help for a variety of civil issues from the Washington State Bar Association Moderate Means Program. Covered areas include housing, benefits and family and elder law. The program also provides referrals to sources of pro bono legal assistance.

COVID-19 Rules for Assisted Living in Washington

The following information is based on research done on several government websites, including dshs.wa.gov/altsa/covid-19 and cdc.gov/coronavirus. These rules apply to nursing homes and other types of senior living facilities. We’ve most recently updated this data on 2/15/2022, but since COVID-19 is a rapidly evolving pandemic, contact your local senior living facility or Area Agency on Aging for more specific and up-to-date information.

Visiting Loved Ones

Can I visit my relative in person if he/she wants emotional support from me?	Yes (Conditions Apply)
Can I visit my relative in person for end-of-life compassion care?	Yes
Will my loved one be required to self-quarantine after I visit him or her?	No
Do I need to wear PPE and/or a cloth mask if I do visit my relative in person?	Yes
Are Hairdressers and other non-medical contractors still allowed in senior living facilities?	Yes
Does the state recommend or require that senior living facilities assist families with setting up virtual visit alternatives?	Yes
Are visitors being screened for elevated temperatures?	Yes
Are visitors being asked questions about health, travel, and potential virus contact?	Yes

Outings and Group Activities

Are residents allowed to leave the facility for non-medical reasons?	Yes
Are residents of senior living facilities who leave and return required to self-quarantine?	No (Conditions Apply)
Are senior living facilities required to cancel all group outings?	No
Are residents still eating together in the dining hall?	Yes (Conditions Apply)
Are facilities still allowed to host group activities within the community?	Yes (Conditions Apply)

Safety Measures for Staff & Contractors

Are staff members and contractors being screened for elevated temperatures?	Yes
Are staff members and contractors being tested for Coronavirus?	Yes (Conditions Apply)
Are staff members and contractors being asked questions about health, travel, and potential virus contact?	Yes

Safety Measures for Residents

Are staff members required to regularly screen residents for coronavirus symptoms?	Yes
Are residents relied on to screen themselves and self-report potential coronavirus symptoms?	No
Are staff members required to take residents’ temperatures?	Yes
Are residents being tested for coronavirus?	Yes (Conditions Apply)

Assisted Living Laws and Regulations in Washington

All long-term care facilities in Washington state are regulated by the Aging and Long-Term Support Administration. These facilities are required to be in compliance at all times with all relevant regulations and rules pursuant to staffing, medication, accommodations and other aspects of their operations.