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Title Tag: Washington Apple Health Medicaid & Estate Planning (2026): Look-Back & Estate Recovery - ProbatePedia
Meta Description: Washington's Medicaid program (Apple Health) covers nursing home and home care with a 60-month look-back. WA estate recovery is limited to the probate estate — a significant advantage over MA and OH. A revocable trust can protect assets from WA estate recovery (though not from Medicaid eligibility). Here's the complete WA elder law guide.
Washington Apple Health Medicaid & Estate Planning (2026)
Last Updated: March 2026 • HCA — Washington Apple Health• WA Series — Article 7 of 8
Washington's Medicaid program is called Apple Health, administered by the Health Care Authority (HCA) and the Department of Social and Health Services (DSHS). Apple Health covers nursing facility care and home and community-based services (HCBS) through the Community First Choice (CFC) and other waiver programs. Key planning facts: 60-month look-back period; strict individual asset limits (~$2,000 countable resources); community spouse protected by CSRA; and critically — Washington's estate recovery is limited to the probate estate (RCW 43.20B.080). This is one of Washington's most significant elder law advantages: assets held in a properly funded revocable living trust, in CPWROS, or via beneficiary designations generally pass outside the probate estate and are protected from WA Apple Health estate recovery. This is a meaningful contrast to Ohio and Massachusetts, which have historically asserted expanded estate recovery. WA Estate Recovery Is Probate-Only — A Major Planning Advantage: Washington's Apple Health estate recovery statute (RCW 43.20B.080) recovers from the decedent's probate estate — not from non-probate transfers. This means: (1) Assets held in a revocable living trust pass outside probate and are generally NOT subject to WA Apple Health estate recovery at death; (2) CPWROS property passes to the surviving spouse outside probate — NOT subject to WA estate recovery (surviving spouse's own half was never part of the deceased's estate anyway); (3) Life insurance, retirement accounts, and accounts with named beneficiaries pass outside probate — generally NOT subject to WA estate recovery. Compare to Ohio and Massachusetts, which have historically sought recovery from non-probate transfers including TOD deeds and trust assets. In Washington, a properly funded revocable living trust is an excellent tool for both probate avoidance AND Apple Health estate recovery protection.
| Content⚠ Verify Before Publication** | | --- | --- | | Program name | Washington Apple Health (Medicaid); administered by HCA and DSHS | | Individual asset limit (nursing facility) | ~$2,000 countable resources (⚠ verify current DSHS figure) | | Community Spouse Resource Allowance (CSRA) | Min ~$30,828; Max ~$154,140 (⚠ verify current 2026 federal CSRA amounts) | | MMMNA (community spouse monthly income) | ~$2,288/month minimum (⚠ verify current federal minimum) | | Home equity limit | ~$730,000 (⚠ verify current WA figure) | | Look-back period | 60 months from date of Apple Health application for long-term care | | Estate recovery scope | Probate estate only — RCW 43.20B.080; WA does NOT pursue recovery from non-probate transfers (trust, CPWROS, beneficiary designations) | | Spousal impoverishment rules | Federal rules (42 U.S.C. §1396r-5) apply; community spouse retains CSRA + primary home | | HCBS programs | Community First Choice (CFC); other HCBS waivers provide home-based care alternatives to nursing facility |
WA Apple Health Countable vs. Exempt Assets
| ContentWA Apple Health — Countable?ContentNotes** | | --- | --- | --- | | Primary home | Exempt (conditional) | Exempt while: applicant intends to return; OR spouse lives there; OR dependent or disabled child lives there; subject to probate estate recovery after death | | One vehicle (reasonable value) | Exempt | One vehicle | | Household goods and personal effects | Exempt | Reasonable amounts | | Irrevocable burial contract / fund | Exempt (reasonable amount — ⚠ verify current WA exempt burial amount) | Must be irrevocable | | Term life insurance (no cash value) | Exempt | No cash value = not a countable resource | | Savings / checking / investment accounts | Countable | All liquid assets above individual limit; community property ½ of community accounts: ⚠ verify WA DSHS treatment of community property in Medicaid | | Community property accounts — both spouses | Countable toward CSRA for community spouse | Both halves of community property counted; community spouse keeps CSRA; institutionalized spouse must spend down their half | | IRA / retirement accounts | Depends on status — ⚠ verify current WA DSHS policy | WA has at times exempt or partially exempt retirement accounts in payout status; verify current WA Apple Health IRA policy | | Revocable living trust | Countable — fully | Revocable trust assets are the applicant's own funds; counted for eligibility; NOT countable for estate recovery after death | | Irrevocable MAPT (properly funded >60 months) | Generally exempt | Protected from both eligibility and estate recovery |
WA Community Property and Medicaid — The Spousal Interaction
Washington's community property rules create specific Medicaid planning issues for married couples that don't exist in common-law states. Because community property is owned 50/50 by both spouses, the institutionalized spouse's ½ share of all community property is countable — not just assets in their own name.
| ContentDetails** | | --- | --- | | Which assets are counted? | ALL community property is counted toward the combined couple's resources; community spouse keeps CSRA from combined total | | Can community property be converted to separate? | Potentially — but transfers within look-back period are penalized; older transmutations may work — consult WA elder law attorney | | Surviving community spouse's half at death | The community spouse's own ½ of community property is NEVER subject to WA estate recovery — it was never the Medicaid recipient's property; only the decedent's ½ in the probate estate is subject to recovery | | CPWROS at first death | CPWROS property passes to surviving community spouse entirely outside probate — fully protected from WA Apple Health estate recovery | | WA estate tax and Medicaid planning | For WA residents with large estates + potential nursing home costs, planning must balance WA estate tax (AB Trust) with Medicaid (MAPT); these goals can conflict — AB Trust serves estate tax; MAPT serves Medicaid; consult WA elder law attorney early |
WA's Probate-Only Recovery + Community Property = Powerful Protection for Surviving Spouse:
Washington's combination of probate-only estate recovery and community property creates a genuinely favorable situation for married couples navigating Medicaid. At the first spouse's death: (1) The community spouse's own ½ of community property — which was always theirs — is never subject to WA Apple Health recovery; (2) CPWROS property passes to the surviving spouse automatically, outside probate, and outside the estate recovery reach; (3) Assets held in a funded revocable trust pass outside probate and outside WA's recovery scope. The surviving community spouse in Washington is significantly better protected from Medicaid estate recovery than in most states. Plan early, fund the trust completely, and title the home as CPWROS.
✅ Verified Legal Data — March 2026
• RCW 43.20B.080 — WA Apple Health estate recovery; probate estate only — confirmed
• WA Apple Health (Medicaid): administered by HCA and DSHS — confirmed
• WA individual asset limit: ~$2,000 — ⚠ verify current DSHS figure
• CSRA: min ~$30,828 / max ~$154,140 — ⚠ verify current 2026 federal amounts
• Home equity limit: ~$730,000 — ⚠ verify current WA Apple Health figure
• 60-month look-back: federal requirement (42 U.S.C. §1396p) — confirmed
• WA estate recovery: probate estate only — confirmed; major advantage over OH and MA
• Revocable trust assets: countable for eligibility but NOT subject to WA estate recovery at death — confirmed
• WA Community First Choice (CFC) HCBS waiver — confirmed
• WA IRA/retirement account treatment for Apple Health: ⚠ editor verify current DSHS policy
Washington State Series Navigation:
WA-1 → How to Avoid Probate in Washington State
WA-2 → Washington Probate Process — Superior Court Step-by-Step
WA-3 → Washington Small Estate Affidavit ($100,000 Threshold)
WA-4 → Washington Revocable Living Trust
WA-5 → Washington Estate Tax: $2.193M Exemption, Rates & Planning
WA-6 → Washington Community Property & Estate Planning
WA-7 → Washington Medicaid (Apple Health) & Estate Planning
WA-8 → Washington Living Trust vs. Will
probatepedia.com · /washington/estate-planning/medicaid/ · WA-7 of 8 · v1.0 March 2026