Washington residents who need assistance with health care costs may qualify for the state Medicaid plan known as Apple Health. This and similar Medicaid programs across the country provide vital coverage for low-income people through a jointly funded collaboration between individual states and the federal government. In Washington, the state program covers doctors visits, emergency and hospital care, laboratory and X-ray services and long-term care services and supports.
Apple Health offers the Community First Choice Option program to give eligible seniors an alternative to institutional care in a traditional nursing home setting. The program allows seniors to receive services at home or in community settings, such as adult residential care and assisted living facilities. Covered services and supports can include:
- Attendant assistance with activities of daily living
- Nursing care for blood glucose monitoring or insulin injections
- Medication administration assistance
- Respite care
- Personal emergency response systems
- Assistive technology
- Transition services to aid in relocation from a nursing facility
To
qualify for Apple Health coverage for long-term care, seniors aged 65 and older must need an intermediate or nursing facility level of care and meet the following financial criteria:
- An income of less than $2,313 per month for individuals and $4,626 for married couples
- Total countable resources of $2,000 for individuals and $3,000 for couples
All types of income count, including pensions, Social Security benefits, investment income and retirement plan withdrawals. Some resources are excluded, such as one vehicle, a primary home, household furnishings and personal effects.
Seniors who qualify for Supplemental Security Income benefits are automatically eligible for Apple Health long-term care coverage.
Long-term care in a nursing facility and care through the Community First Choice program are entitlements under the Washington state Medicaid plan, so there are no enrollment caps or waiting lists to hinder eligible seniors from receiving covered services.
Bothell seniors can
apply online for long-term care assistance through Apple Health or in person at the
Alderwood Community Service office located at 20311 52nd Ave. W., Ste. 100, in Lynnwood.
Community Options Program Entry System Waiver Apple Health also offers the
COPES home and community-based services waiver that can help cover the cost of long-term care. The waiver’s purpose is to keep seniors who’d otherwise need nursing home placement in their own home or a community setting, such as an assisted living facility. To qualify, applicants must be aged 65 and older and need assistance performing a minimum of two activities of daily living. They must also meet the Apple Health program’s financial criteria for individuals of $2,313 in monthly income and $2,000 in countable resources. The COPES program doesn’t pay for assisted living room and board, but it does cover a range of services including:
- Case management
- Community support goods and services
- Durable medical equipment
- Skilled nursing care
- Personal care
- Nonmedical transportation
- Wellness education
The COPES waiver isn’t an Apple Health entitlement program and is subject to statewide enrollment caps. This means seniors may face a wait to receive services after they’re approved for coverage.
To learn more about the COPES waiver or to apply, Bothell seniors can contact the Snohomish County
Senior Information and Assistance center at (425) 513-1900.