Washington Medicaid pays for home and community care 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 would otherwise need a nursing home 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 Jul 17, 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 Aging and Long-Term Support Administration (ALTSA), and it 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 Jul 17, 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 your own home, a family member's home, an adult family home, or an assisted living facility. The federal government lets states offer these services through a Section 1915(c) waiver, which is a formal agreement that "waives" certain regular Medicaid rules so a state can serve people in the community who would otherwise need a nursing facility.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — WA COPES Waiver (0049.R09.00), State Waivers List. medicaid.gov. Retrieved Jul 17, 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 Jul 17, 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 administered by DSHS through its Home and Community Services offices, which handle the assessment, eligibility, and ongoing case management.
COPES: Washington's Main Medicaid HCBS Waiver
COPES has been Washington's workhorse HCBS waiver for aged and disabled adults for years, 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 Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/83496 The federal waiver agreement behind it is renewed on a multi-year cycle with the Centers for Medicare & Medicaid Services, and DSHS operates it day to day.
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 Jul 17, 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 benefit called Community First Choice, and the COPES waiver adds services on top of it. In practice, almost everyone enrolled in COPES is also enrolled in Community First Choice, and the two work together as one package.
Who Qualifies for COPES
Qualifying for COPES comes down to two tests you have to meet at the same time: a functional test about your care needs and a financial test about your income and assets.
The functional test is a nursing-facility level of care. To meet it, Washington evaluates you through the state's Comprehensive Assessment Reporting Evaluation (CARE) assessment, an in-person review of how much help you need with daily activities. If that assessment finds you meet the level of care a nursing facility would provide, and you choose community services instead of nursing-home placement, you meet the functional side. You also have to 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 Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/83496
The financial test uses Washington's institutional Medicaid rules. An applicant must meet the Supplemental Security Income (SSI) disability criteria and qualify for the institutional categorically needy coverage group. For 2026, that means 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 Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/83496 Some assets, like your home in many situations, are not counted, and married couples are treated under separate spousal rules; 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 Jul 17, 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
- Home-delivered meals
- Environmental modifications, meaning changes to the home like ramps or grab bars
- Nursing services and skilled nursing services
- Specialized medical equipment and supplies
- Transportation
- A community choice guide to help you plan a move from an institution back into the community
These services can be delivered in your own home, in a licensed adult family home, or in 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 Jul 17, 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. A case manager meets with you, usually in your home, and works through the assessment to determine whether you meet the nursing-facility level of care and, if you do, to build a plan of the services you need.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — WA COPES Waiver (0049.R09.00), State Waivers List. medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/83496 Alongside that, DSHS confirms that you qualify financially under the institutional categorically needy coverage group.
Because a 1915(c) waiver is approved to serve a set number of people and 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
You apply for COPES and other Apple Health long-term services and supports through DSHS Home and Community Services, the same office that runs the CARE assessment.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — WA COPES Waiver (0049.R09.00), State Waivers List. medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/83496 Apple Health is the name Washington uses for its Medicaid program.
Federal Medicaid rules let you apply through several channels: online, by phone, by mail, or in person at a local office.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. The state generally has up to 45 days to decide most Medicaid applications, and up to 90 days when eligibility is based on disability.U.S. Government Publishing Office. (2024). 42 CFR 435.912 Timely determination and redetermination of eligibility (2024 ed.) — govinfo.gov. govinfo.gov. Retrieved Jun 25, 2026, from https://www.govinfo.gov/content/pkg/CFR-2024-title42-vol4/pdf/CFR-2024-title42-vol4-sec435-912.pdf 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, and you do not apply for them separately. Community First Choice (CFC) is the Medicaid benefit that pays for the hands-on personal care, help with activities of daily living such as bathing and dressing, while COPES adds the wraparound services around it, such as adult day care, home-delivered meals, home modifications, and transportation. DSHS Home and Community Services enrolls eligible COPES clients in both through the same assessment, so a single process covers the pair.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — WA COPES Waiver (0049.R09.00), State Waivers List. medicaid.gov. Retrieved Jul 17, 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 your own home, in a licensed adult family home, or in an assisted living facility.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — WA COPES Waiver (0049.R09.00), State Waivers List. medicaid.gov. Retrieved Jul 17, 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?
Both require the same nursing-facility level of care, but COPES is for people who meet that level of care and choose to stay in the community instead of moving into a nursing facility.Centers for Medicare & Medicaid Services. (n.d.). Medicaid.gov — WA COPES Waiver (0049.R09.00), State Waivers List. medicaid.gov. Retrieved Jul 17, 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. If you qualify for one, you generally qualify for the other on the care-needs side; the difference is where you want to 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 Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/83496 Some assets, such as your home in many situations, are not counted, and married couples are treated under separate spousal rules, so a couple's numbers can differ from a single applicant's.
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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.