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How WA Cares Works Together With Supplemental Coverage
WA Cares gives Washington workers a strong start. Supplemental LTC insurance builds on that foundation by extending your options for care.
A Simple, Layered Approach to Long-Term Care Protection
Your WA Cares benefit and Supplemental LTC insurance policy are independent, but complementary. Here is how they fit together, broadly speaking:
Step 1
Contribute to WA Cares
Enrollment is mandatory for most Washington workers, consisting of a 0.58% premium assessment on all wage income.
You earn your full $36,500 benefit (indexed) after 10 years of payments, but can also apply for benefits if you've paid for 3 years within the last 6.
Step 2
Apply for Supplemental LTCI (Voluntary)
This private product is underwritten based on age and health at issue, with premiums paid over chosen durations (eg over 10-years, or one's lifetime), but are often waived while on claim.
When you purchase, the issuer must request consent to share this info with DSHS to assist with potential care coordination.
Step 3
Need Care? Start with WA Cares
You'll apply for benefits online: eligibility is determined within 45 days.
At the same time, DSHS will ask if you have SPLTCI, and request consent to contact your insurer to assist with potential care coordination.
Step 4
Apply for Supplemental Benefits
This policy pays after WA Cares benefits have been exhausted, but must last at least 12 months.
Because its benefit triggers will be different than those used by WA Cares, you may have to re-qualify. Claim decisions are made within 30 days.
Step 5
Continue Your Same Providers
Unless it's demonstrably unsafe, your Supplemental policy must continue coverage of your care settings and providers, including family providers, that you were receiving under WA Cares.
Public and Private Coverage Side-by-Side
WA Cares Fund
$36,500 initial benefit
Automatically inflates by CPI-W Seattle
Covers W2s (self-employed may opt-in)
No residual or cash value
Tax rate must be raised by Legislature
Reimbursements are payment in full
Supplemental LTC Insurance
Minimum duration of 12 months
Must offer CPI-W Seattle or 3% comp
No at-work requirement generally
May be LTC, Life Insurance, Group, etc.
Rate increases must be approved by OIC
May incur balance billing
Important
A new Consumer Guide, Outline of Coverage, and Personal Worksheet are being developed which will make all prospective shoppers aware of that there may be a gap if the benefits provided by the WA Cares Fund are exhausted before you become eligible for benefits under your Supplemental LTC insurance policy.
How a Supplemental Long Term Care Plan Works
Let's see how WA Cares and Supplemental coverage might work for a typical Washington resident.
Meet Maria
Maria is a 52-yr old High School Counselor from Spokane who started paying into WA Cares in 2023.
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She applies for a private Supplemental LTC policy with a $100,000 initial benefit maximum.
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At age 82, Maria suffers a stroke, requiring both formal and informal care in her home.
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Until claim, both benefits have inflated by the CPI (we'll use 3.3%).
How it Plays Out
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At claim, Maria has access to over $360,000 in combined benefits.
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Allowing WA Cares to pay first lets her buy more for less.
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In this example, up to $264,000 could potentially be protected from Medicaid spenddown and estate recovery.
WA Cares $96,000
Supplemental LTC Insurance $264,000 >>>
