The approximately 1.2 million seniors who proudly call the Evergreen State home benefit from numerous programs and resources, made available by the Washington Department of Social and Health Services and the agencies it oversees. Seniors who wish to age in place can have peace of mind about hiring assistance, thanks to the state’s strict regulation of home care agencies. They can expect to pay an average monthly cost of $5,720, which is higher than the median amount paid nationally.

Read on to learn more about in-home care costs in Washington, financial assistance options to help pay for care and available free and low-cost aging-related resources.

The Cost of In-Home Care in Washington

In-Home Care Costs in Nearby States

Home care in Washington costs an average of $5,720 per month, according to Genworth’s Cost of Care Survey 2019. This is $1,430 more than the national median of $4,290 and higher than the price paid in surrounding states. In comparison, seniors in Wyoming pay an average of $5,339 per month, while those in California pay almost as much, at $5,335. The average monthly rate is just $5,148 in Oregon, but residents of Montana pay only $4,576, a savings of almost $1,150 compared to the cost in Washington.




United States Average









Cost of Other Types of Care in Washington

There are significant price differences for senior care in Washington, which are primarily related to the care type and setting. Home care and home health services are quite close in cost at $5,720 and $5,815, respectively. Adult day care provided at a group center for a few hours on weekdays has the lowest average cost, at just $1,441 per month. Assisted living services in a residential setting average $5,500 per month, while skilled care in a nursing facility costs the most, with a monthly average of $9,112.


In-Home Care


Home Health Care


Adult Day Care


Assisted Living Facility


Nursing Home Care

The Cost of In-Home Care in Washington’s Top Cities

Comparing Costs Across Washington

The cost of in-home care is fairly consistent between Washington’s most populous cities. In Bellingham, the monthly average is $5,815. In Spokane, the cost averages $5,750, which matches the state median. It’s slightly lower in Kennewick, at $5,506 per month, while the average monthly rate in Yakima is just $72 less at $5,434. The sole exception is Seattle, where the average cost of home care is significantly higher, at $6,244 per month.











Financial Assistance for In-Home Care in Washington

Medicaid Personal Care Program

Medicaid Personal Care is a state Medicaid entitlement program, so any Washington resident who meets the eligibility criteria automatically qualifies for assistance. The program covers the cost of in-home personal care and homemaker services, as well as nurse assessments, care coordination and intermittent skilled nursing care. Program participants may choose their own home care provider, who may be a family member.

Who Is Eligible?
Individuals must be aged 65 or older and need help with at least three activities of daily living to be eligible for the MPC program. Financially, they must have a monthly income at or below the current Federal benefit rate.

How to Apply
Interested seniors may contact the Home and Community Services office in their county to apply for Medicaid and begin the MPC program assessment process.

Community First Choice Option Program

The Community First Choice Option is another entitlement program of Washington Medicaid that provides in-home care to eligible seniors who would otherwise be at risk of nursing home admission. CFCO participants have a choice of letting Medicaid arrange their care services, or they can pick a friend or relative as their paid caregiver. In addition to in-home care, the program covers other expenses, including community transition assistance, nursing care, personal emergency response systems and transportation services.

Who Is Eligible?
Washington residents aged 65 and older may qualify for the CFCO program if they are assessed as needing the level of care normally provided in a nursing facility, have a monthly income no greater than 300% of the Federal benefit rate and have no more than $2,000 in countable assets.

How to Apply
Interested individuals may contact their local Area Agency on Aging to start the application process.

Medicaid Alternative Care and Tailored Supports for Older Adults

Washington offers the Medicaid Alternative Care and Tailored Supports for Older Adults programs that provide up to $550 per month in financial assistance for eligible individuals in need of in-home care. The MAC program helps cover respite relief for unpaid family caregivers, while the TSOA program also offers seniors the option of hiring their own caregiver. These programs may also provide specialized medical supplies and equipment, caregiver training, adult day care services, counseling visits and access to information and support groups.

Who Is Eligible?
All applicants must be aged 55 or older and assessed as needing some assistance with normal daily living activities. To qualify for the MAC program, an individual must be enrolled in Washington’s Medicaid program. Eligibility for the TSOA program is based on specific income and asset limits, but Medicaid enrollment isn’t a requirement.

How to Apply
To learn more or to apply for the MAC or TSOA programs, Washington residents may call 855-567-0252 or contact their local Area Agency on Aging.

Community Options Program Entry System Waiver

The COPES waiver is a Washington Medicaid program designed to help nursing home-eligible seniors remain living independently in their own homes. The program provides comprehensive care management and the supportive services necessary to meet an enrollee’s care needs, such as home health and personal care, adult day care, home-delivered meals, transportation and other benefits.

Who Is Eligible?
Washington residents aged 65 or older, or younger if disabled, may be eligible if they need extensive help with two or more activities of daily living, such as personal hygiene, dressing, mobility and maintaining continence. Applicants must also meet the financial criteria for Medicaid coverage.

How to Apply
To complete an application for the COPES program, Washington seniors may contact their county Home and Community Services office.

New Freedom Medicaid Waiver

The New Freedom Medicaid waiver provides in-home services and supports to seniors who need daily assistance. Program participants receive help determining their care needs and a budget to pay for various necessary goods and services. The waiver covers comprehensive medical care and health maintenance support, along with a number of other benefits, such as in-home personal care and assistance, home and vehicle modifications, home-delivered meals and personal emergency response systems.

Who Is Eligible?
To qualify, applicants must be aged 65 or older, or younger if disabled, and financially and functionally eligible for Washington Medicaid. At this time, only Pierce and King County residents may apply for the program.

How to Apply
For more details about the program, or to apply, seniors may contact the Area Agency on Aging in either Pierce or King County.

More Ways to Pay for In-Home Care

While the above programs help many people finance in-home care, they will not cover all costs for everyone. There are other ways to pay for in-home care, including out-of-pocket arrangements with siblings, annuities, reverse mortgages, private insurance and more. Read’s Guide to In-Home Care Costs to learn more about these alternative payment options.

Free and Low-Cost In-Home Care Resources in Washington

Seniors who want to retain their independence and age in place in their own homes can access a variety of free and low-cost resources. There are nutrition programs, caregiver and respite support, legal assistance, wellness programs and other valuable resources available throughout the state.

ContactServices Provided
Home-Delivered MealsContact the Area Agency on Aging serving your countySenior nutrition programs organized by Washington’s 13 AAAs deliver healthy, prepared meals to the homes of eligible seniors aged 60 and older. Meals are often provided at no charge.
Family Caregiver Support ProgramContact the FCS program office in your countyThe FCS program supports unpaid caregivers throughout the state. It offers free or low-cost caregiver training, counseling, connections to support groups and other local resources and short-term financial help with respite assistance.
Lifespan Respite WashingtonCall 800-572-7368, extension 110, for more information or to apply for a voucherLRW provides information, education and a $1,000 yearly voucher that eligible seniors and their unpaid caregivers can put toward respite relief services.
Legal HelpCall the NJP senior hotline at 888-387-7111The Northwest Justice Project provides eligible Washington residents aged 60 and older with free help for a variety of civil legal matters.
Senior Farmers Market Nutrition ProgramContact the program’s state office at 800-422-3263, or your local Area Agency on AgingThe SFM nutrition program provides low-income Washington residents aged 60 and over with vouchers, which are redeemable for healthy, fresh produce from participating roadside stands and farmers markets throughout the state.
SAIL ProgramCall 509-393-9113 for more information, or find a class in your areaStay Active and Independent for Life offers strength, balance and fitness classes for seniors aged 65 and older. Free or low-cost classes are held at various locations across Washington.
Home Care Association of Washington425-775-8120The WHCA sets high industry standards and best practices, advocates for clients and educates the public about home care and available resources.

In-Home Care Laws and Regulations in Washington

The Washington State Department of Health is responsible for licensing home care agencies that provide nonmedical services to seniors. The DOH also conducts on-site, unannounced surveys periodically to ensure licensed agencies are operating according to state rules and requirements. The following table provides an overview of the rules and regulations governing Washington home care agencies.

Scope of CareHome care agencies in Washington may provide various nonmedical services to clients. These include assistance with personal hygiene, dressing, toileting, ambulation, transferring and eating. Home care aides may also perform household chores and essential shopping tasks, prepare meals, accompany clients to medical appointments and provide respite support to family caregivers.
Care Plan RequirementsA credentialed agency employee must develop a written care plan to be approved by the client, based on an on-site assessment and discussion. The plan must include the client’s nutritional needs/food allergies, functional limitations and the specific nonmedical services an HCA will provide and how often. The plan must be updated after any change in the client’s condition or needs and every 12 months at minimum.
Medication Management RequirementsHome care aides may provide reminders about taking medication, and may even hand a medication to a client, as long as the senior is fully aware of what they are doing.
Staff Screening RequirementsIndividuals who are already certified as home care aides must have a fingerprint background check completed by the DSHS when applying for work with a home care agency.
Staff Training RequirementsBefore individuals can begin work as home care aides, they must complete a 75-hour DSHS-approved training program and pass the HCA certification exam. Twelve hours of continuing education must be completed annually for a worker to maintain their certification.
Medicaid CoverageWashington Medicaid offers several programs that may help pay for in-home care. Eligible seniors may qualify for assistance through the Medicaid Personal Care, Community First Choice Option and Medicaid Alternative Care entitlement programs. Other alternatives are the Community Options Program Entry System and New Freedom waiver programs.
Reporting AbuseSuspected neglect, exploitation or abuse of a vulnerable Washington resident aged 60 or older may be reported to Adult Protective Services online via the agency’s central intake form or by calling 877-734-6277.

Frequently Asked Questions

Are There Programs to Cover Home Modifications in Washington?

There are five government programs in Washington that offer financial assistance for accessibility and safety modifications: The Medicaid Alternative Care, Community First Choice Option, Community Options Program Entry System and New Freedom Medicaid programs, as well as the non-Medicaid Tailored Supports for Older Adults program.

Does Washington Medicaid Pay for In-Home Care?

The Washington Medicaid plan offers several programs that may cover some or all of the cost of in-home care. Eligible seniors may qualify for assistance through Medicaid’s Personal Care, Alternative Care and Community First Choice Option entitlement programs or the COPES and New Freedom waiver programs.

How Much Does In-Home Care Cost in Washington?

According to the Genworth Cost of Care Survey 2019, home care in Washington costs an average of $5,720 on a monthly basis. This is over $1,400 higher than the national median cost, but $95 less per month than home health care services.

What Support Can Help Me Age at Home?

There are various forms of support available. Home care aides offer help with daily personal care, medication reminders and household tasks. Home health aides may provide wound care and administer medications or injections. Intermittent skilled nursing care and speech, physical and occupational therapies may also be provided in-home.

What Types of Services Does a Home Care Aide Provide?

Home care aides can assist with daily living activities, such as bathing, dressing, grooming and self-administering medications. They can also perform basic housekeeping tasks, prepare meals, provide transportation and accompany clients to medical appointments and for errands.

Home Care Services in Washington (235)