Washington Long-Term Care Planning

Quick answer: Washington has both categorically needy and medically needy routes into long-term care Medicaid. The 2026 special income level is $2,982 a month, but income above it doesn't automatically require a trust, because the medically needy pathway may apply.

Washington offers both a categorically needy and a medically needy route into long-term-care Medicaid. The institutional rule applies the special income level for categorically needy eligibility, then sends SSI-related applicants who fall outside that category to a separate set of medically needy rules; certain HCS waiver programs likewise get a higher calculation for applicants whose income sits above the special income level but whose net income stays under the medically needy threshold.

That structure is exactly why planners shouldn't assume that income over $2,982 a month in 2026 automatically forces a particular trust strategy. The $2,982 figure confirms the federal 300-percent standard, but Washington's own medically needy pathway means the right calculation depends on the applicant's actual circumstances, not a blanket rule.