The Washington Medicaid income limits for long-term care run through a $2,982 special income level, but Washington asks for no Miller Trust: if you're over, you spend down instead. Washington Apple Health pairs that with one of the country's most generous home-equity rules, letting a homeowner keep up to $1,130,000 in equity and still qualify.
This guide walks through the 2026 income and asset rules for Washington's Medicaid program, which the state calls Apple Health. It covers the special income level and how the medically-needy spend-down works, the asset limit, what a nursing-home resident keeps, the unusually high home-equity allowance, and what a spouse who stays home is protected from.
How the Washington Medicaid income limits actually work: spend-down
For long-term-care Apple Health, Washington applies a special income level of $2,982/month, equal to 300% of the 2026 SSI Federal Benefit Rate of $994.
Here's the part that trips people up. Being over that number does not disqualify you. Washington is a medically needy state, so it runs a spend-down at a medically-needy income level of roughly $994/month: if your income is above the line, the excess becomes the amount you must incur in medical and care costs, and once you've spent that much in a given period, Medicaid covers the rest.
This is why Washington does not require a Qualified Income Trust, also called a Miller Trust. In strict income-cap states, an applicant even a dollar over the limit is shut out unless they route the excess through a special trust each month. Washington has no such cliff. If your income is high, you spend down; you are never simply "too rich" for long-term-care Medicaid.
The asset limit and what counts
A single long-term-care applicant is limited to $2,000 in countable assets; a couple, to $3,000. "Countable" is the load-bearing word. Washington, like every state, exempts a long list of assets from the count: your home (subject to the equity cap below), one vehicle, household goods and personal effects, and prepaid burial arrangements. So the $2,000 applies to things like bank accounts, a second car, and investments, not the roof over your head.
The five-year look-back
Washington reviews asset transfers made in the 60 months before a long-term-care application. Giving away money or property for less than fair market value during that window, signing a house over to a child for a dollar or gifting a grandchild a down payment, can trigger a penalty period during which Medicaid won't pay for long-term-care services, even though you're otherwise eligible.
There are legitimate exceptions (transfers between spouses, transfers to a disabled child, certain caregiver-child home transfers) and legitimate planning approaches, but anything done inside the five-year window deserves an elder-law attorney's review first. For the broader toolkit, see our guide to Medicaid planning strategies.
Washington's $1,130,000 home-equity limit
Every state caps how much equity you can hold in your home and still keep it exempt for long-term-care eligibility. Federal law gives states a choice between a lower and a higher figure, and most states sit at the lower end. Washington elects the higher federal home-equity limit: $1,130,000 for 2026, tied by rule to the maximum CMS posts.
In practice, that means a Washington homeowner with substantial equity, the kind of equity that builds up over decades in markets like Seattle or the Puget Sound region, can still qualify for long-term-care Apple Health while keeping the home exempt, where the same equity would push an applicant over the cap in a state that chose the lower limit. The home remains a countable asset only for equity above $1,130,000.
One thing the equity limit does not change: estate recovery still applies after death (see below). The home being exempt during your lifetime is not the same as the home being shielded from recovery afterward.
Long-term care: what a nursing-home resident keeps
When Apple Health pays for nursing-facility care, the resident contributes almost all of their monthly income toward the cost of care. What they keep is the Personal Needs Allowance (PNA), money reserved for the resident's own small expenses (clothing, a haircut, a phone). Washington's PNA is about $108.74/month, well above the federal floor and higher than many states set.
The same $2,000 asset limit applies to nursing-home applicants. And because Washington uses spend-down rather than a hard income cap, even a resident with substantial monthly income can qualify; they simply contribute more of it toward care. For the national picture on how the allowance works, see our explainer on the Medicaid personal needs allowance.
Protecting the spouse who stays home
When one spouse needs long-term care and the other remains in the community, federal spousal-impoverishment rules keep the at-home spouse from being left destitute. Washington applies the federal framework for 2026:
| Protection | 2026 Amount | What it does |
|---|---|---|
| Community Spouse Resource Allowance (CSRA) | Half the couple's countable assets, up to $162,660 | The most in countable assets the at-home spouse may keep, on top of the applicant's own limit. |
| Minimum Monthly Maintenance Needs Allowance (MMMNA) | $2,643.75 to $4,066.50/month | The monthly income the at-home spouse is allowed to keep; income can be shifted from the applicant to reach it. |
| Home-equity limit | $1,130,000 | Equity in the primary residence above this amount is countable for long-term-care eligibility. |
So a married couple is in a very different position from a single applicant. The community spouse can keep half the couple's countable assets, up to $162,660, and hold income within the MMMNA range while the other spouse receives Medicaid-funded care.
After death: estate recovery
Like every state, Washington runs a Medicaid estate-recovery program. After a recipient who was 55 or older and received long-term-care services dies, the state may seek repayment from the estate, unless the recipient is survived by a spouse or a minor, blind, or disabled child. Federal exceptions and an undue-hardship waiver apply. For how estate recovery works and where families have room to plan, see our Medicaid estate recovery explainer.
How to apply in Washington
Washington Apple Health is administered by the Washington State Health Care Authority (HCA), and long-term-care financial eligibility is processed by the Department of Social and Health Services (DSHS) Home and Community Services. You have three ways to apply:
- Online through Washington Connection at washingtonconnection.org, which handles Medicaid and other benefits together.
- By phone at 1-877-501-2233.
- In person at a local DSHS Home and Community Services office.
Long-term-care applicants also go through a functional assessment to confirm they need nursing-facility-level care. Apply even if you think you're over the limit. Between spend-down, the high home-equity allowance, and the spousal protections, many people who assume they're disqualified are not.
Frequently Asked Questions
For long-term-care Apple Health, Washington uses a special income level of $2,982/month (300% of the 2026 SSI Federal Benefit Rate). But income above that does not disqualify you. Washington is a medically-needy state, so you spend the excess down on medical and care costs each month to qualify.
No. Washington is a medically-needy spend-down state, not an income-cap state, so there is no hard income ceiling for long-term-care Medicaid and no need for a Qualified Income Trust. Over-income applicants qualify through spend-down instead, a key difference from income-cap states like Florida.
$2,000 in countable assets for a single long-term-care applicant and $3,000 for a couple. The home (up to $1,130,000 in equity), one vehicle, household goods, and prepaid burial are exempt from the count.
Up to $1,130,000 for 2026. Washington elects the higher federal home-equity limit, far above the figure most states use, so the primary residence stays exempt for long-term-care eligibility unless equity exceeds that amount. Estate recovery can still apply to the home after death.
For 2026, the at-home (community) spouse can keep half the couple's countable assets up to $162,660 (the Community Spouse Resource Allowance) and monthly income in the $2,643.75 to $4,066.50 range (the Minimum Monthly Maintenance Needs Allowance). The home is generally protected up to $1,130,000 of equity.
A Personal Needs Allowance of about $108.74/month for personal expenses. The rest of the resident's monthly income goes toward the cost of care, after deductions for a community spouse and certain health-insurance premiums.
Learn More
- Medicaid Planning Strategies
- How Medicaid Estate Recovery Works
- The Medicaid Personal Needs Allowance, Explained
Find personalized help working through Washington Apple Health eligibility for your family at brevy.com.
The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.