What Is the Washington Cares Act: Costs, Benefits, Exemptions

The Washington Cares Act is a state-run long-term care insurance program that takes 0.58% of your gross wages through payroll deductions and, in exchange, gives qualifying workers up to $36,500 in lifetime benefits to pay for care when they can no longer manage daily tasks on their own. Codified at RCW Chapter 50B.04, it’s the first program of its kind in the country, and statewide benefits become available on July 1, 2026.¹² Nearly every W-2 employee in the state is already contributing.

What the Premium Costs You

The rate is 0.58 percent of gross wages. Fifty-eight cents for every hundred dollars earned. Unlike Social Security, there is no wage cap, so the premium applies to every dollar you make.³ A worker earning $75,000 a year pays about $435 annually.

Your employer withholds the premium from your paycheck and remits it quarterly to the Employment Security Department (ESD). The cost falls entirely on the worker. Employers are not required to contribute, though they may voluntarily chip in.⁴

Starting in January 2026, the Pension Funding Council sets the rate every two years. It cannot exceed 0.58 percent but could be set lower if the fund’s actuarial health allows.³

One recent change caught some workers off guard. Employees previously exempt because of a collective bargaining agreement lost that exemption on December 31, 2025. Employers must now withhold premiums on their wages paid starting January 1, 2026, and hours worked during the CBA exemption period do not count toward benefit eligibility.⁵

What You Get in Return

Beginning in July 2026, each qualified participant can access up to $36,500 in lifetime long-term care benefits. The amount is designed to grow with inflation. There is no daily or monthly cap on how fast you can use it; the earlier $100-per-day limit was eliminated.²⁶

The benefit covers a wide range of services whether care happens at home, in an assisted living facility, or in a nursing home. Common uses include:

In-home caregivers, including a qualified family member or spouse hired to help with personal care
Residential care in an adult family home, assisted living facility, or nursing home
Home modifications such as grab bars, wheelchair ramps, widened doorways, and home safety evaluations
Home-delivered meals and transportation to medical appointments or grocery shopping
Equipment and supplies, including bath chairs, personal emergency response systems, and incontinence supplies
Caregiver training, respite care, and care coordination for family caregivers

For scale, assisted living facilities across the country run roughly $4,000 to $6,000 per month, so $36,500 covers about six to nine months of residential care. For about a third of people, though, the benefit could cover all the care they need over a lifetime, particularly those who mostly need in-home help.²

How You Qualify for Benefits

Paying premiums doesn’t automatically unlock benefits. You have to meet a contribution requirement and also show a qualifying care need.

The Three Contribution Pathways

Permanent pathway (full benefit). Contribute for at least ten years, working at least 500 hours in each qualifying year. Most workers will eventually qualify this way.
Temporary pathway (full benefit). Contribute for at least three of the six years immediately before you apply. Each year still requires a minimum of 500 hours.
Transition pathway (prorated benefit). Available only to people born before January 1, 1968. You earn 10 percent of the full benefit for each qualifying year, so five years of contributions unlocks $18,250 of the $36,500. The pathway exists because near-retirees may not have enough working years left to hit ten.

Only the transition pathway prorates. The permanent and temporary pathways both deliver the full benefit.⁷

The Care Need Standard

To draw benefits, you must need help with at least three activities of daily living, and that need must be expected to last at least 90 days. The Department of Social and Health Services (DSHS) conducts the evaluation and aims to complete it within 45 days of your request.⁸

Activities of daily living are the basic self-care tasks most people do without thinking: bathing, dressing, eating, toileting, transferring (moving from a bed to a chair, for example), and continence management. Cognitive impairment also counts. If you need someone to supervise or cue you through an activity because of memory or decision-making problems, that counts as needing help with it.²

Who Can Get Out of Paying

Several categories of workers can avoid WA Cares premiums, but the rules differ sharply by category.

Permanent Exemptions

Veterans with a service-connected disability rating of 70 percent or higher qualify for a permanent exemption. You apply through ESD and submit your disability award letter. Once approved, you never pay premiums and never receive benefits.⁹

Workers who had private long-term care insurance before November 1, 2021, could also apply for a permanent exemption, but that window closed on December 31, 2022. If you missed it, you’re in the program. Workers who did get the private insurance exemption and now want back in can reverse it between January 1, 2026, and June 30, 2028.⁹

Conditional Exemptions

Two groups can apply for conditional exemptions that last only as long as the qualifying circumstance continues:

Workers who live outside Washington but work in the state, with proof of out-of-state residency
Spouses or registered domestic partners of active-duty U.S. military service members, with proof of the relationship and military status

If your circumstances change, you move to Washington or your spouse leaves active duty, you must notify ESD and your employer within 90 days and begin paying premiums again.¹⁰

Automatic Exemption for Non-Immigrant Visa Holders

As of January 1, 2026, workers on non-immigrant visas are automatically exempt. No application is required. If you want to participate and build toward benefits, you must tell your employer in writing that you’d like to keep contributing.⁹

How the Application Works

For exemptions that require an application, you create a SecureAccess Washington (SAW) account and submit through the Paid Family and Medical Leave portal. ESD mails an exemption letter showing the effective date, which is the first day of the quarter after approval. You are responsible for giving a copy of that letter to every current and future employer. Your employer cannot stop withholding premiums until they have the letter and the exemption has taken effect.¹¹

Think carefully before opting out. The veteran and private insurance exemptions are irreversible (except for the narrow private insurance reversal window noted above), and you permanently forfeit access to the benefit. For a younger worker who might need long-term care decades from now, that’s a serious financial calculation.

Self-Employed Workers Can Opt In

If you’re self-employed, premiums are not automatically withheld from your earnings. You can voluntarily opt in, and the deadline is June 30, 2026, or within three years of becoming self-employed for the first time, whichever is later.¹²

Enrollment runs through the same SAW portal. Add the Paid Family and Medical Leave service and select “Elect Coverage as Self-Employed.” Contributions begin the following quarter, and you file quarterly reports.

Opting in is permanent. You cannot withdraw once enrolled. If you retire or stop being self-employed, you notify ESD to cancel your account, but that doesn’t undo the commitment for your working years. ESD can also cancel coverage if you fail to make payments or file reports.¹³

If You Leave Washington

Starting in July 2026, workers who have contributed for at least three qualifying years (500 hours each) can opt to become out-of-state participants. You must opt in within one year of leaving the state and continue paying premiums on your earnings elsewhere.¹⁴

Two caveats. Benefits for out-of-state participants won’t be available until July 2030. And the care need standard is different: out-of-state beneficiaries must need help with at least two activities of daily living for at least 90 days, or require substantial supervision due to severe cognitive impairment.⁸

Taxes and Medicaid

WA Cares benefit payouts are not subject to federal income tax. Whether the premiums you pay are federally deductible is less clear; the WA Cares Fund does not advise on that question and suggests consulting a tax professional.⁶

The Medicaid interaction is where the program shows its real planning value. WA Cares benefits do not count as income or resources for Medicaid eligibility, so using the benefit won’t push you over Medicaid asset limits or delay eligibility if you exhaust the WA Cares amount and need further help. The benefits are also not subject to Medicaid estate recovery; the state cannot claw back WA Cares payments from your estate after death.⁶

For most workers who die before accessing benefits, the premiums are not refundable. They function like any other social insurance contribution.

1
Justia. Revised Code of Washington Title 50B Chapter 50B.04 – Long-Term Services and Supports Trust Program
2
WA Cares Fund. Benefit Coverage
3
Washington State Legislature. RCW 50B.04.080 – Premium Assessment, Rate, Collection
4
Washington State’s Paid Family and Medical Leave. Estimate Your Paid Leave Payments
5
Washington State’s Paid Family and Medical Leave. Collective Bargaining Agreements
6
WA Cares Fund. Frequently Asked Questions
7
WA Cares Fund. How the Fund Works
8
Washington State Legislature. RCW 50B.04.060 – Eligible Beneficiaries, Determination, Services
9
WA Cares Fund. Exemptions
10
WA Cares Fund. WA Cares Toolkit Long Content
11
WA Cares Fund. Apply for an Exemption
12
WA Cares Fund. Self-Employed Opt-In
13
WA Cares Fund. WA Cares Basics for Self-Employed Workers
14
WA Cares Fund. Portable Benefits: Taking Your WA Cares Benefit Out of State