Does Medicaid Pay for Nursing Homes in Washington State? (2026)
Yes — Washington's Apple Health (Medicaid) pays for nursing home care if you qualify. Unlike the COPES waiver, Nursing Home Medicaid is an entitlement: there is no waitlist. If you meet the financial and functional requirements and choose a Medicaid-certified nursing facility, coverage begins when you are approved.
Last updated: June 2026 — figures change yearly; confirm with DSHS before applying.
What Nursing Home Medicaid Pays For
Nursing Home Medicaid covers room, board, and skilled or custodial care in a Medicaid-certified nursing facility. The facility must hold a DSHS Nursing Facility Services contract. Care Compare (CMS) and the DSHS facility locator both show which facilities accept Medicaid.
Browse Medicaid-accepting nursing homes in Washington →
Nursing Home Medicaid does not cover care in adult family homes or assisted living communities. For those settings, see COPES.
Who Qualifies — 2026 Financial Limits
You must meet financial eligibility and be assessed as needing Nursing Facility Level of Care (NFLOC).
| Rule | Single | Married (with at-home spouse) |
|---|---|---|
| Monthly income limit | ~$994/mo | ~$1,491/mo for the applicant |
| Countable asset limit | $2,000 | $3,000 for the nursing home resident |
| Community Spouse Resource Allowance | N/A | At-home spouse keeps up to $72,529; if joint assets exceed $145,058, keeps 50% up to a max of $162,660 |
| Home equity exemption | Exempt if equity ≤ $1,130,000 (2026) AND a spouse, child under 21, or disabled child lives there, OR the resident files intent to return home | |
| Lookback | 60 months (5 years) on gifts or below-market transfers; penalty = delay in benefits | |
Apply: DSHS Home & Community Services, 1-877-345-0256, or Washington Connection ↗.
Does Medicaid Take the House in Washington?
Not while the person is alive. The home is exempt from countable assets at the time of eligibility — provided the equity is at or below $1,130,000 (2026) and one of these conditions is met:
- A spouse still lives in the home, or
- A child under 21 or a disabled child lives in the home, or
- The nursing home resident files a statement of intent to return home
What Is Estate Recovery (MERP)?
Washington's Medicaid Estate Recovery Program (MERP) can seek reimbursement for costs paid — but only after the recipient's death, and only under these conditions:
- The recipient was age 55 or older when they received LTC Medicaid benefits
- Recovery is limited to assets that pass through probate — property held in joint tenancy, accounts with payable-on-death designations, and assets with named beneficiaries are generally outside MERP's reach
- Recovery is exempt if a surviving spouse, child under 21, or disabled child survives
Whether and how much MERP recovers depends on probate, surviving family, and asset titling. Consult a Washington elder-law attorney — steps taken before applying can significantly affect exposure.
Things to Know Before Applying
Once approved, nearly all of the resident's monthly income is applied toward their cost of care — called the "patient pay amount." Medicaid pays the balance. The resident keeps a small personal needs allowance (currently $70.28/month for most residents). The community spouse keeps their own income and the CSRA.
Transferring assets for less than fair market value in the 60 months before applying can trigger a penalty period — a delay in when Medicaid coverage begins. The penalty is proportional to the size of the transfer. Never transfer the home or large assets before consulting a Washington elder-law attorney.
Veterans receiving both nursing home Medicaid and VA Aid & Attendance will see the VA pension reduced to approximately $90/month. See VA Aid & Attendance details →
Frequently Asked Questions
Does Medicaid pay for nursing homes in Washington State?
Yes. Washington's Apple Health (Medicaid) pays for room, board, and care in a Medicaid-certified nursing facility. Unlike the COPES waiver (for in-home and residential care), Nursing Home Medicaid is an entitlement — there is no waitlist if you meet the financial and functional requirements. You must need Nursing Facility Level of Care and meet the income and asset limits (single: ~$994/mo income, $2,000 in countable assets; married: $3,000 for the applicant).
Does Medicaid take your house in Washington State?
Not while you are alive. The home is exempt from countable assets at eligibility if home equity is at or below $1,130,000 (2026) AND a spouse, child under 21, or disabled child lives there — or the nursing home resident files intent to return home. Washington's Medicaid Estate Recovery Program (MERP) can make a claim against the estate after death, but only for LTC recipients age 55 or older, only against assets that pass through probate, and only if no surviving spouse, child under 21, or disabled child survives. Consult a Washington elder-law attorney for your specific situation.
What is the income limit for nursing home Medicaid in Washington?
For a single applicant, the monthly income limit is approximately $994/month (2026). For a married applicant with a community spouse (spouse living at home), the limit is approximately $1,491/month for the applicant. The at-home spouse may keep their own income. Nearly all of the nursing home resident's income goes toward the cost of care (the 'patient pay amount'); Medicaid covers the balance. Limits adjust annually — confirm with DSHS before applying.
What is the 5-year lookback rule for Medicaid in Washington?
Washington applies a 60-month (5-year) lookback period when you apply for long-term care Medicaid. DSHS reviews any transfers of assets — including gifts, adding someone to a deed, or selling property for less than fair market value — made in the 60 months before the application date. If a disqualifying transfer is found, the result is a penalty period: a delay in when Medicaid benefits begin, calculated from the value of the transfer. The penalty is not asset seizure — it is a delay in eligibility. Always consult a Washington elder-law attorney before transferring any asset.