Understanding Washington’s WA Cares Fund Long-Term Care Program

Washington State has created the WA Cares Fund, the nation’s first public long‑term care insurance program for workers, funded through a dedicated payroll contribution. The program is designed to help residents pay for essential long‑term care services if they become unable to manage daily activities on their own.

This article explains how WA Cares works, who pays into it, how to qualify for benefits, what those benefits can be used for, and what decisions workers and employers should be thinking about today.

Why Washington Created the WA Cares Fund

Long‑term care is one of the most expensive risks many people face, and most standard health insurance or Medicare does not cover extended custodial care at home or in a facility. In response, Washington enacted the Long‑Term Services and Supports (LTSS) Trust Act in 2019, establishing the WA Cares Fund to provide a basic public insurance benefit for eligible residents.

• Policy goal: Create a dedicated trust fund to help pay for long‑term care services and supports, such as in‑home caregivers, assisted living, or nursing facilities.
• Funding mechanism: A mandatory payroll contribution for most workers, set in statute as a fixed percentage of wages.
• Timing: Payroll deductions began in 2023, while benefit payments are scheduled to start in July 2026.

The program aims to reduce reliance on Medicaid for long‑term care, support family caregivers, and give workers some measure of financial protection as they age.

Who Must Contribute to the WA Cares Fund?

WA Cares contributions are tied to employment in Washington. Most workers who are employed in the state are automatically covered and pay the payroll assessment while they are working.

Workers subject to the payroll contribution

• Full‑time employees working in Washington
• Part‑time and temporary workers whose wages are reported to Washington agencies
• Other workers whose income is treated as wages subject to state payroll reporting

Only work performed in Washington is subject to the WA Cares premium; someone employed entirely outside the state is not required to pay into the fund.

Contribution rate and how it appears on paychecks

The WA Cares premium is set by law at 0.58% of gross wages, equal to $0.58 for every $100 of pay.

The entire premium is paid by the worker; there is no employer match or state general fund subsidy for these contributions.

Employer responsibilities

Employers in Washington are required to withhold the WA Cares contribution from employee pay and remit premiums along with reported wages and hours each quarter.

• Withhold 0.58% of each covered employee’s wages.
• Report wages and hours through state systems for each reporting period.
• Submit the collected premiums to the WA Cares Fund.

Employers do not decide which employees are exempt; instead, employees apply directly to the state for exemptions and must provide approval documentation to their employers where needed.

Exemptions: Who May Opt Out of WA Cares?

Although the program is broadly mandatory, state law allows specific categories of workers to obtain exemptions from paying WA Cares premiums under defined circumstances.

Common exemption categories

• Workers who live outside Washington but have wages reported in-state.
• Spouses or registered domestic partners of active‑duty service members in the U.S. armed forces.
• Workers with certain non‑immigrant work visas who may leave the country after their visa ends.
• Veterans with a service‑connected disability rating of 70% or higher.

Earlier phases of the program also allowed workers with qualifying private long‑term care insurance to apply for permanent exemption; those windows and rules have been revised over time, and more recent legislation has created options to rescind some exemptions so workers can re‑enter the program.

Workers seeking exemption must apply through Washington’s Employment Security Department (ESD). If approved, ESD issues a letter specifying the effective date of the exemption, which the worker must share with their employer to stop payroll deductions.

How Workers Qualify for WA Cares Benefits

Paying into WA Cares does not automatically guarantee immediate access to benefits. Workers must both vest in the program through sufficient contributions and demonstrate a qualifying care need when they apply.

Vesting: minimum work and hours requirements

To become vested and earn lifetime access to WA Cares benefits, workers must meet contribution thresholds based on years of work and minimum hours.

• Standard vesting route:
  Work and contribute for at least 10 years at any point, with no break of five or more consecutive years, and work at least 500 hours in each of those years.
• Shorter‑term vesting route:
  Work and contribute for three of the last six years before applying, with at least 500 hours worked in each of those years.

Once vested, workers retain access to their WA Cares benefit for life, even if they stop working in Washington or retire, so long as other residency or portability conditions are met.

Special rules for near‑retirees

Because WA Cares started relatively recently, the legislature adopted partial benefit rules for people close to retirement when the program launched. These near‑retirees can qualify for a percentage of the maximum benefit based on the number of years they contribute.

• Partial benefits are calculated at 10% of the full benefit for each year worked and contributed, up to the maximum.
• This design tries to balance fairness for workers who cannot reasonably contribute for a full 10‑year vesting period due to age.

These special provisions affect benefit size but do not change the requirement to demonstrate a care need when applying.

Care need: activities of daily living (ADLs)

To receive WA Cares benefits, an applicant must show that they need help with several activities of daily living (ADLs) — basic tasks necessary for independent functioning.

• Mobility (such as transferring or walking)
• Personal hygiene (bathing, grooming)
• Eating
• Medication management
• Cognitive tasks or supervision related to memory and safety

The law generally requires that a person must need assistance with three or more ADLs to qualify. Washington’s Department of Social and Health Services (DSHS) evaluates these needs during the application process.

What WA Cares Benefits Provide

WA Cares offers a defined lifetime benefit amount, paid out in units that can be used to purchase approved services and supports. It is not designed to cover all long‑term care costs, but rather to provide a meaningful supplement to family resources and other coverage.

Lifetime maximum and benefit units

Beginning in July 2026, the initial lifetime benefit available through WA Cares is set at $36,500

• Benefits are measured in benefit units, each initially worth $100 in 2026.
• A fully vested worker will have access to up to 365 benefit units, equaling $36,500 in total coverage.
• The program is designed so that benefit amounts rise over time with inflation, preserving purchasing power.

If the value of benefit units is periodically adjusted for inflation (for example, at 2.5% per year), this can significantly increase the maximum lifetime benefit over a multi‑decade horizon.

Covered services and supports

Once approved, WA Cares benefits can be used to pay for a broad range of long‑term care services and supports chosen by the beneficiary within program rules.

• In‑home care: Professional caregivers who assist with ADLs in the home.
• Residential care: Costs associated with assisted living or nursing facilities, up to the program’s benefit limits.
• Family caregiver support: Compensation for family members providing care, where allowed by program rules.
• Equipment and modifications: Medical equipment, assistive technology, home safety evaluations and renovations to support independent living.

Benefits are paid directly from the WA Cares Fund to providers or for approved expenses, rather than as unrestricted cash to the beneficiary.

Portability for workers who move

Washington has adopted rules that allow some workers to keep and use their WA Cares benefits even if they later move out of state, provided they have met vesting requirements and any applicable portability elections.

• Workers who maintain coverage while relocating out of Washington may still access benefits once they need long‑term care.
• Specific administrative steps and eligibility criteria apply to out‑of‑state use of benefits; these are defined in program regulations.

How to Apply for WA Cares Benefits

When a worker or former worker believes they meet the care need criteria, they must apply to WA Cares through the appropriate state agency before benefits are approved.

1. Confirm vesting and work history
   Review your employment record to ensure you meet the years‑worked and hours requirements (either 10‑year or 3‑of‑6‑year path).
2. Document care needs
   Compile medical or functional assessments, noting which ADLs you need help with and how often.
3. Submit an application
   File an application with the Washington Department of Social and Health Services (DSHS) or other designated program administrator, following official instructions.
4. Participate in evaluation
   DSHS or program staff may conduct interviews, review medical records, and assess your functional limitations to confirm eligibility.
5. Select services
   Once approved, work with care coordinators to decide how to use your benefit units for the services and supports you need.

The process is intended to ensure that benefits go to individuals with genuine long‑term care needs, while allowing flexibility in how care is delivered.

Planning Considerations for Workers

Because WA Cares provides a limited but valuable benefit, workers should view it as one component of their broader long‑term care and retirement planning strategy.

Key questions to ask yourself

• How much long‑term care risk do I face?
  Consider family history, health conditions, and longevity expectations.
• What other coverage do I have?
  Review private long‑term care insurance, disability coverage, savings, and potential Medicaid eligibility.
• Will WA Cares be enough?
  The $36,500 initial lifetime maximum can provide meaningful help but likely will not cover years of full‑time facility care. Determine how you might supplement it.
• Am I eligible or exempt?
  If you fall into an exemption category, weigh the pros and cons of opting out versus paying in to gain WA Cares coverage.

Financial advisers, benefits specialists, or legal counsel can help evaluate how WA Cares interacts with your individual retirement plan, estate planning, and potential Medicaid planning.

Considerations for Employers

While WA Cares is funded by workers, employers play a critical role in implementing the program correctly and communicating with their workforce.

• Payroll system updates: Ensure payroll software calculates the 0.58% premium accurately and remits contributions as required.
• Employee communication: Provide clear information about WA Cares deductions, explaining that contributions fund a state long‑term care program and are not an employer benefit.
• Handling exemptions: Establish procedures for employees to submit exemption approval letters, and train HR staff on when to stop or restart deductions.
• Coordination with benefits packages: Review how WA Cares interacts with any employer‑offered long‑term care insurance or retirement planning services.

Employers who accurately implement WA Cares can reduce compliance risk and help employees understand the program’s value.

Frequently Asked Questions About WA Cares

Is WA Cares the same as the federal CARES Act?

No. The federal CARES Act was a broad COVID‑19 relief law enacted in 2020, providing stimulus payments, business loans, and unemployment enhancements. WA Cares is a Washington‑specific long‑term care insurance program funded by payroll contributions and focused solely on long‑term care benefits.

Can I stop paying WA Cares premiums once I am vested?

Yes. You only pay WA Cares premiums when you are working in Washington and earning covered wages. Once you are no longer employed in the state, contributions stop, but if you are already vested, you retain lifetime access to your earned benefit.

Will WA Cares cover all my long‑term care costs?

Unlikely. The initial lifetime maximum of $36,500 is significant but may not be enough to cover multiple years in a nursing facility or comprehensive in‑home care. WA Cares is best viewed as one part of a broader strategy that may include savings, private insurance, and other programs.

What happens if I move out of Washington?

If you are vested and meet any portability requirements, you may still be able to use your WA Cares benefits after moving out of state. However, administrative rules apply, and you may need to elect to keep coverage when relocating, so it is important to consult official program guidance before you move.

Does WA Cares help family members who provide my care?

Yes, under program rules, WA Cares can compensate approved family caregivers or help pay for respite services, using your available benefit units. This is intended to recognize the significant unpaid work families often perform when supporting loved ones with ADL limitations.

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medha deb

 

Medha Deb is an editor with a master's degree in Applied Linguistics from the University of Hyderabad. She believes that her qualification has helped her develop a deep understanding of language and its application in various contexts.

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