What long-term care insurance covers
Long-term care insurance covers the cost of in-home care, adult day services, assisted living, nursing homes, and memory-care facilities when you can no longer perform daily activities independently. Long-term care is triggered by a health condition (usually permanent disability or advanced age) requiring hands-on assistance with activities of daily living (ADLs) such as bathing, dressing, eating, and toileting.
Washington's WA Cares Fund program
Washington created the WA Cares Fund, a mandatory state long-term-care insurance program funded by a payroll tax of 0.58% on workers' wages. Employees who worked in Washington with this tax withheld become eligible for a modest long-term-care benefit (roughly $36,500 in today's dollars, adjusted for inflation). Most workers received a limited enrollment window (already closed) to apply for an exemption by buying private long-term-care insurance instead. WA Cares provides basic coverage but is modest compared to actual long-term-care costs.
Why private long-term-care insurance still matters in Washington
WA Cares provides a one-time benefit of roughly $36,500 (inflation-adjusted). Average cost of nursing home care in Washington exceeds $100,000 annually. Private long-term-care insurance fills this gap, offering daily benefits of $150–$300+ and benefit periods of 3–5 years or lifetime, giving you choice of care setting and provider rather than relying solely on the state program.
Types of long-term-care products in Washington
- Traditional LTC insurance. pays daily benefits ($150–$300+) for eligible long-term-care expenses; hybrid policies combine LTC with life insurance or annuity
- Hybrid life/LTC policies. provide a death benefit and a long-term-care rider; if you don't use LTC benefits, your heirs receive the death benefit
- Hybrid annuity/LTC policies. provide guaranteed income and a long-term-care benefit; popular for retirees seeking both retirement income and care protection
- Elimination period. typically 30–90 days of care before benefits begin; longer elimination periods reduce premiums
Who buys long-term-care insurance in Washington
- Older workers considering coverage before WA Cares only provides a modest benefit
- High-net-worth Washingtonians protecting assets and maintaining control of care choices
- Couples where one spouse has health issues making LTC more likely
- Anyone uncomfortable relying solely on Medicaid for long-term care (Medicaid requires asset depletion)
Activities of daily living (ADL) triggers
Most long-term-care policies (and WA Cares) pay benefits when you need hands-on help with at least 2 of 6 ADLs: bathing, dressing, eating, toileting, transferring (moving between bed and chair), and continence management. Cognitive decline (dementia) also triggers coverage. Understanding these thresholds is important for assessing whether you'll qualify for benefits.
How to buy long-term-care insurance in Washington through Maru
Maru helps you understand how WA Cares complements private insurance, compare hybrid and traditional LTC products, and choose the right daily benefit and elimination period. Given Washington's new state program, the LTC landscape is changing—we help you navigate the options. Serving Washington statewide, we connect you with carriers that specialize in WA Cares coordination.
Frequently asked questions
What's the difference between WA Cares and private long-term-care insurance?
WA Cares is a modest state benefit (~$36,500 total, inflation-adjusted) funded by payroll tax. Private LTC insurance offers larger daily benefits ($150–$300+) and longer coverage periods, giving you more choice and flexibility. Most Washingtonians supplement WA Cares with private coverage.
Did I miss the exemption window for WA Cares?
Yes, the exemption window closed. If you didn't apply for a private-insurance exemption during that period, you're enrolled in WA Cares. You can still buy private LTC to supplement the state benefit, but you can't avoid the payroll tax.
What are hybrid life/LTC policies?
Hybrid policies combine a life insurance death benefit with a long-term-care rider. If you don't use LTC benefits, your heirs receive the death benefit. This appeals to Washingtonians who want both retirement protection and care coverage without committing to pure LTC insurance.
How much daily long-term-care benefit should I buy?
It depends on local costs. Average assisted living in Washington is $4,000–$6,000/month; nursing home care is $8,000–$12,000+/month. Many buyers choose a daily benefit of $150–$250 to cover 50–70% of costs, supplementing the rest with personal funds or WA Cares.
Vadim — Maru Insurance
Licensed independent insurance agent · WA & FL
Written and reviewed by a licensed Maru advisor. Maru Insurance is an independent agency (WA License WAOIC #1365574, FL License #G363233) representing multiple A-rated carriers across Washington and Florida.