Planning for long‑term care helps you prepare for future needs. Most health insurance plans, including Medicare, do not pay for long‑term care. Many people end up paying with personal savings or relying on Medicaid.
WA Cares helps with these costs. It provides eligible Washington workers with a lifetime benefit up to $36,500 (adjusted each year for inflation) to use for long‑term care.
Insurance companies can also offer supplemental long‑term care (LTC) policies. These optional policies give you extra coverage if you want more protection than WA Cares provides.
Are policies available right now?
Not yet. Insurance companies are not currently selling supplemental LTC policies. This is a new product, and companies need time to develop and file their plans with our office.
Sign up for updates and we’ll let you know when policies are available.
Supplemental LTC insurance consumer guide
Our supplemental long‑term care insurance guide gives you a clear overview of how these plans work with WA Cares. The guide explains who can buy a policy, what it covers, when benefits start, and what to think about before you make a decision.
Download the supplemental long-term care guide (PDF 362.87KB)
Who can buy it
You can buy a supplemental policy if you:
- Meet the WA Cares contribution requirement or currently contributing to WA Cares.
- Live in Washington when you buy the policy.
If you move out of Washington later, you can still use the policy as long as you continue to meet the policy’s eligibility rules.
How it works with WA Cares
Your supplemental LTC policy starts after you spend all your WA Cares benefits. The policy must:
- Provide at least 12 months of coverage.
- Let you keep your current care setting and providers, including approved family caregivers.
An insurance company may only require a change in care setting if there is a clear clinical need. Any change cannot take effect until 90 days after your transition, and you have the right to appeal through an independent review.
Where you can get care
Supplemental LTC insurance can help pay for care provided at:
- Home, by professional caregivers or qualified family members
- Assisted living facilities
- Adult family homes
- Nursing homes
- Community‑based services, such as adult day care or respite care
What it covers
Supplemental long‑term care policies can cover a wide range of services, including:
- Diagnostic and preventive care
- Therapy and rehabilitation
- Maintenance and personal care
- Help with daily activities
Policies pay a daily or monthly benefit. The amount and how long it lasts depend on the options you choose. Some policies cover one year of care; others offer longer or lifetime coverage. All standalone supplemental policies must include inflation protection.
What it does not cover
Policies may not cover every service. Common exclusions include:
- Preexisting conditions
- Treatment for alcohol or drug addiction
- Injuries from war, military service, criminal activity, or suicide
- Services provided outside the United States
When benefits start
Your supplemental policy begins paying benefits only after:
- You use all your WA Cares benefits.
- You meet the policy’s benefit triggers.
- You complete the policy’s elimination (waiting) period.
Benefit triggers
Most policies require that you cannot perform at least two activities of daily living (ADLs), such as bathing or dressing, or that you have a qualifying cognitive impairment. The ADL requirements may differ from WA Cares.
Deductible
A supplemental policy’s deductible cannot be higher than the WA Cares maximum benefit. Once WA Cares is spent, your deductible is considered met.
Elimination period
This is the period of time you pay for services before the policy starts paying. The elimination period cannot be longer than 12 months. It starts when you begin using your WA Cares benefits. Any time you receive WA Cares services counts toward this period.
Near‑retirees (born before 1968)
If your WA Cares benefit is less than the full amount, your supplemental policy may:
- Reduce the deductible to match your WA Cares benefit; or
- Require you to pay the difference between your partial WA Cares benefit and the full WA Cares amount before benefits begin.