Washington Medicaid pays for home and community care for aged and disabled adults mainly through one program: the Community Options Program Entry System, known as COPES. These are Washington Medicaid HCBS waivers, short for home and community-based services (HCBS), delivered under federal 1915(c) waiver authority so that adults who meet a nursing-facility level of care can receive their long-term care where they live instead.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — WA COPES Waiver (0049.R09.00), State Waivers List. medicaid.gov. Retrieved Oct 13, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/83496
COPES is a Section 1915(c) waiver run by the Washington Department of Social and Health Services (DSHS) through its Home and Community Services offices, which sit inside the DSHS Home and Community Living Administration (HCLA), the administration formerly named the Aging and Long-Term Support Administration, or ALTSA. The waiver serves more than 51,000 clients across the state.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — WA COPES Waiver (0049.R09.00), State Waivers List. medicaid.gov. Retrieved Oct 13, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/83496 It is built for people who meet a nursing-facility level of care but want to stay in their own home, an adult family home, or an assisted living facility.
In This Guide
- What Washington Medicaid HCBS Waivers Are
- COPES: Washington's Main Medicaid HCBS Waiver
- Who Qualifies for COPES
- What COPES Covers
- How Enrollment and the CARE Assessment Work
- How to Apply for Washington Medicaid HCBS Waivers
What Washington Medicaid HCBS Waivers Are
Home and community-based services, or HCBS, are the long-term care supports Medicaid pays for outside of an institution. In Washington, that means care for people living in their own homes, adult family homes, or assisted living facilities, delivered under a federal Section 1915(c) Medicaid waiver.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — WA COPES Waiver (0049.R09.00), State Waivers List. medicaid.gov. Retrieved Oct 13, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/83496
Washington uses that authority to run COPES, the Community Options Program Entry System, as its principal HCBS waiver for aged and disabled adults.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — WA COPES Waiver (0049.R09.00), State Waivers List. medicaid.gov. Retrieved Oct 13, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/83496 The point of the waiver is straightforward: if you need the level of care a nursing home provides but you would rather stay in the community, COPES is the program designed to make that possible. It is operated by DSHS through its Home and Community Services offices.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — WA COPES Waiver (0049.R09.00), State Waivers List. medicaid.gov. Retrieved Oct 13, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/83496
COPES: Washington's Main Medicaid HCBS Waiver
COPES has been Washington's workhorse HCBS waiver for aged and disabled adults since it was first established in 1982, and today it serves more than 51,000 clients living in their own homes, adult family homes, or assisted living facilities.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — WA COPES Waiver (0049.R09.00), State Waivers List. medicaid.gov. Retrieved Oct 13, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/83496 The current federal approval of the waiver runs from January 1, 2024 through December 31, 2028, and DSHS operates the program day to day.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — WA COPES Waiver (0049.R09.00), State Waivers List. medicaid.gov. Retrieved Oct 13, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/83496
One feature of COPES surprises many families, so it helps to understand it early. Since July 1, 2015, personal care, meaning hands-on help with the activities of daily living like bathing, dressing, and eating, is no longer delivered through COPES itself.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — WA COPES Waiver (0049.R09.00), State Waivers List. medicaid.gov. Retrieved Oct 13, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/83496 Instead, COPES clients receive that personal care through a companion Medicaid state plan benefit called Community First Choice, and the COPES waiver adds services on top of it. That shapes who qualifies, too: COPES is for people whose needs go beyond what Community First Choice alone provides.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — WA COPES Waiver (0049.R09.00), State Waivers List. medicaid.gov. Retrieved Oct 13, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/83496
Who Qualifies for COPES
Qualifying for COPES means meeting every one of its requirements at the same time, not just some of them. They fall into two groups: a functional side about your care needs and a financial side about your income and assets.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — WA COPES Waiver (0049.R09.00), State Waivers List. medicaid.gov. Retrieved Oct 13, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/83496
The functional side centers on a nursing-facility level of care. Washington evaluates you through the state's Comprehensive Assessment Reporting Evaluation (CARE) assessment, and its algorithm determines whether you meet that level of care, or whether you will likely need it within 30 days unless waiver services are provided. You must also choose community services under the waiver instead of nursing facility services, have needs that go beyond what Community First Choice provides, and fit one of the program's basic categories: age 18 or older and blind or disabled, or age 65 or older.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — WA COPES Waiver (0049.R09.00), State Waivers List. medicaid.gov. Retrieved Oct 13, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/83496
The financial side uses Washington's institutional Medicaid rules. DSHS's Long-Term Care Manual lists meeting the Supplemental Security Income (SSI) disability criteria and qualifying for the institutional categorically needy coverage group. That SSI wording sits alongside the age categories above, which separately admit anyone 65 or older with no blindness or disability requirement, so a non-disabled applicant 65 or older is not shut out by it.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — WA COPES Waiver (0049.R09.00), State Waivers List. medicaid.gov. Retrieved Oct 13, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/83496 For 2026, a single applicant can have countable income up to the Medicaid Special Income Level of $2,982 per month, which is set at 300 percent of the federal SSI benefit rate, and no more than $2,000 in countable assets.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — WA COPES Waiver (0049.R09.00), State Waivers List. medicaid.gov. Retrieved Oct 13, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/83496 That $2,000 is not a test of everything you own: the same state chart sets a 2026 home equity limit of $1,130,000, and for a married applicant it protects resources for the spouse at home, up to a federal maximum of $162,660 in 2026.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — WA COPES Waiver (0049.R09.00), State Waivers List. medicaid.gov. Retrieved Oct 13, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/83496 Income above the special income level does not automatically rule you out, either. DSHS's Long-Term Care Manual describes a route it calls "Mega COPES," under which a person with income above that level can still be income-eligible for HCS waiver services if net income, after medically needy deductions such as health insurance premiums other than Medicare and outstanding medical bills, is no greater than the one-person medically needy income level; a person who qualifies this way pays toward the cost of care and room and board.app.leg.wa.gov. (n.d.). WAC 182-515-1508 — HCB waiver services authorized by HCS: financial eligibility using SSI-related institutional rules (Washington State Legislature). Retrieved Oct 3, 2026, from https://app.leg.wa.gov/wac/default.aspx?cite=182-515-1508 Our income and asset limits guide walks through how the counting works.
What COPES Covers
Because personal care is delivered through Community First Choice (CFC), the CFC benefit is what pays for the everyday, hands-on help with activities of daily living.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — WA COPES Waiver (0049.R09.00), State Waivers List. medicaid.gov. Retrieved Oct 13, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/83496 COPES then acts as a wraparound, adding the services that fill out a full home-care plan.
Under COPES, that wraparound array includes:
- Adult day care and adult day health
- Client support training and wellness education
- Community supports (goods and services)
- Home-delivered meals
- Environmental modifications
- Nursing services and skilled nursing services
- Specialized medical equipment and supplies
- Transportation
- A community choice guide
These services can be received in a private residence or a licensed residential setting, such as an adult family home or an assisted living facility, so the waiver follows you to whichever of those community settings fits your situation.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — WA COPES Waiver (0049.R09.00), State Waivers List. medicaid.gov. Retrieved Oct 13, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/83496
How Enrollment and the CARE Assessment Work
Enrollment in COPES runs through DSHS Home and Community Services, and the CARE assessment is the center of it. The CARE assessment determines whether you meet the nursing-facility level of care, or are likely to need it within 30 days without waiver services, and waiver services cannot be authorized until you sign the Acknowledgment of Services form (DSHS 14-225).Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — WA COPES Waiver (0049.R09.00), State Waivers List. medicaid.gov. Retrieved Oct 13, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/83496 Alongside that, DSHS checks that you qualify financially, through the institutional categorically needy coverage group or, if your income is above the special income level, the Mega COPES route described above.app.leg.wa.gov. (n.d.). WAC 182-515-1508 — HCB waiver services authorized by HCS: financial eligibility using SSI-related institutional rules (Washington State Legislature). Retrieved Oct 3, 2026, from https://app.leg.wa.gov/wac/default.aspx?cite=182-515-1508
Because the details of capacity and timing can change, the most reliable step is to contact DSHS Home and Community Services directly to confirm the current process and any wait for your situation before you plan around it. They can tell you what applies now, rather than what applied in a past program year.
How to Apply for Washington Medicaid HCBS Waivers
Washington's Medicaid program is called Apple Health, and the Health Care Authority sends anyone 65 or older, anyone blind or disabled, and anyone who needs long-term services and supports to its Classic Medicaid application.Washington State Health Care Authority. (n.d.). Apply for or renew coverage — Washington State Health Care Authority (Apple Health). hca.wa.gov. Retrieved Oct 3, 2026, from https://www.hca.wa.gov/free-or-low-cost-health-care/apply-or-renew-coverage You can apply online through Washington Connection, on paper with the Application for aged, blind, disabled/long-term care coverage (HCA 18-005), by calling 1-877-501-2233 to request an application, or in person at a local DSHS office, where a Home and Community Services office handles long-term services and supports.Washington State Health Care Authority. (n.d.). Apply for or renew coverage — Washington State Health Care Authority (Apple Health). hca.wa.gov. Retrieved Oct 3, 2026, from https://www.hca.wa.gov/free-or-low-cost-health-care/apply-or-renew-coverage
Federal Medicaid rules require the state to accept applications through several channels: online, by phone, by mail, or in person.U.S. Government Publishing Office. (n.d.). 42 CFR 435.907 — Application (eCFR, current). ecfr.gov. Retrieved Jul 13, 2026, from https://www.ecfr.gov/current/title-42/section-435.907 Once your application is in, those same federal rules set a decision clock. Outside unusual circumstances, the state may take no more than 45 days to decide most Medicaid applications, and no more than 90 days when you apply on the basis of disability, and it may not use those limits as a waiting period or as a reason to deny you.U.S. Government Publishing Office. (2026). 42 CFR 435.912(c)(3) — Timely determination of eligibility (eCFR current text, as revised eff. July 31, 2026). ecfr.gov. Retrieved Aug 7, 2026, from https://www.ecfr.gov/current/title-42/section-435.912 If you are applying for COPES on the basis of disability, plan on the longer window; an applicant 65 or older who is not applying on that basis falls under the 45-day limit.U.S. Government Publishing Office. (2026). 42 CFR 435.912(c)(3) — Timely determination of eligibility (eCFR current text, as revised eff. July 31, 2026). ecfr.gov. Retrieved Aug 7, 2026, from https://www.ecfr.gov/current/title-42/section-435.912 For a step-by-step walkthrough, see our guide on how to apply for Washington Medicaid.
If you are weighing home care against a nursing home, it helps to see both sides together; our guide to Washington Medicaid and nursing home care covers the institutional side of the same eligibility rules.
Frequently Asked Questions
Is COPES the same as Community First Choice?
No, but they work as a pair. Community First Choice (CFC) is the Medicaid state plan benefit that pays for COPES clients' personal care, while COPES adds the wraparound services around it, such as adult day care, home-delivered meals, home modifications, and transportation. To qualify for COPES, your needs must go beyond what CFC alone provides.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — WA COPES Waiver (0049.R09.00), State Waivers List. medicaid.gov. Retrieved Oct 13, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/83496
Can I use COPES in an assisted living facility?
Yes. COPES services can be received in a private residence or a licensed residential setting, and COPES clients live in their own homes, adult family homes, or assisted living facilities.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — WA COPES Waiver (0049.R09.00), State Waivers List. medicaid.gov. Retrieved Oct 13, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/83496 The waiver is designed to support you in whichever of these community settings fits your needs, rather than only in a private residence.
How is COPES different from Washington Medicaid nursing home coverage?
COPES is for people who meet a nursing-facility level of care, or are likely to need it within 30 days without waiver services, and who choose community services under the waiver instead of nursing facility services.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — WA COPES Waiver (0049.R09.00), State Waivers List. medicaid.gov. Retrieved Oct 13, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/83496 Nursing home coverage pays for care delivered inside a facility, so the central difference is where you receive the care.
What are the income and asset limits for COPES in 2026?
For 2026, a single applicant can have countable income up to Washington's Medicaid Special Income Level of $2,982 per month, which equals 300 percent of the federal SSI benefit rate, and no more than $2,000 in countable assets.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — WA COPES Waiver (0049.R09.00), State Waivers List. medicaid.gov. Retrieved Oct 13, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/83496 The same state chart sets a 2026 home equity limit of $1,130,000 and protects resources for a spouse at home, so a couple's numbers can differ from a single applicant's.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — WA COPES Waiver (0049.R09.00), State Waivers List. medicaid.gov. Retrieved Oct 13, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/83496 Income above the special income level can still qualify through the route DSHS calls "Mega COPES," which compares net income after medically needy deductions with the one-person medically needy income level.app.leg.wa.gov. (n.d.). WAC 182-515-1508 — HCB waiver services authorized by HCS: financial eligibility using SSI-related institutional rules (Washington State Legislature). Retrieved Oct 3, 2026, from https://app.leg.wa.gov/wac/default.aspx?cite=182-515-1508
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