Paying for Long-Term Care in Bellingham: Washington Options Explained
For Bellingham families, the cost of care for an aging parent can feel daunting. Washington's prices are higher than the national average. But Washington also offers more ways to help pay for care than many states, including Medicaid coverage in adult family homes and assisted living, and, since July 2026, the WA Cares Fund. This guide explains each option and where Whatcom County families can get free help.
Start with the cost
CareScout's 2025 survey reports a median of $6,650 a month for assisted living in the Bellingham area, compared with $7,600 for Washington as a whole (CareScout Cost of Care tool). Adult family home rates are not reported separately and vary widely. Our guide to assisted living costs in Bellingham explains what shapes a quote.
1. Private funds
Most families pay at least partly from their own resources:
- Social Security and pensions
- Savings, investments, and retirement accounts
- Proceeds from selling or renting a home
- Help from adult children
A financial planner or elder law attorney can help you decide which resources to use first.
2. Washington Medicaid
DSHS explains that if you are eligible, Medicaid pays for long-term care services in your own home, in a community residential setting such as an adult family home or assisted living facility, or in a nursing facility. Once you receive Medicaid, you may have to contribute some of your income toward the cost of care, known as your participation. If you live in a residential care setting, you keep some income for personal needs (DSHS, Medicaid and long-term care services for adults).
DSHS also notes that the setting must be licensed by Washington and accept Medicaid payment, and that Medicaid plus your participation is payment in full for care, though homes and facilities may charge for items not covered in the Medicaid rate.
Programs such as Medicaid Personal Care and COPES pay for personal care services. The Washington Health Care Authority explains that Medicaid Personal Care may be provided in a department-contracted adult family home or a contracted assisted living facility, and that residents pay room and board up to a state standard (HCA, Medicaid Personal Care).
What this means: A parent may be able to live in an adult family home or assisted living with Medicaid's help, if the home accepts Medicaid. Ask each provider before move-in.
3. The WA Cares Fund
Washington is the first state with a public long-term care insurance program. Workers began contributing to WA Cares in July 2023, and benefits became available on July 1, 2026. In 2026, the full lifetime benefit is $36,500, growing with inflation. To qualify, a person must meet a contribution requirement and need help with at least three activities of daily living (WA Cares Fund FAQ).
Covered services include in-home care and care in a facility, including assisted living and adult family homes (WA Cares Fund benefits). People born before January 1, 1968 may qualify for partial benefits of $3,650 for each year they contributed (WA Cares Fund, qualifying). For many retirees, the benefit will be modest, but it can help with the early months of care.
4. VA benefits
Eligible wartime veterans and surviving spouses with limited income may qualify for a VA pension with Aid and Attendance. For December 1, 2025, through November 30, 2026, the VA lists these maximum annual rates (VA pension rates):
| Situation | Maximum annual rate |
|---|---|
| Veteran with no dependents | $29,093 |
| Veteran with one dependent | $34,488 |
| Two veterans married to each other | $46,143 |
The net worth limit is $163,699. VA Puget Sound Health Care System serves veterans in western Washington (VA Puget Sound health care). Accredited veterans service officers can help with a claim at no cost.
5. Long-term care insurance
Check the policy's benefit trigger, waiting period, daily or monthly maximum, and whether it covers adult family homes. WA Cares notes that it can help cover a private policy's waiting period. Call the insurer early.
6. Other resources
- Life insurance with accelerated or chronic illness benefits
- Home equity, through sale or rental, after getting independent advice
- Family contributions, ideally with a written agreement
Free local help
Northwest Regional Council is the Area Agency on Aging for Whatcom, Skagit, Island, and San Juan counties. Its Aging and Disability Resources staff can explain Medicaid long-term care coverage and the application process, in-home care, caregiver support, and residential options. Call (360) 738-2500 for Whatcom County; the office is at 600 Lakeway Drive in Bellingham (Northwest Regional Council).
A worked example
A Bellingham mother has $2,900 a month in income and $60,000 in savings. If she moves to a setting near the $6,650 assisted living median, her monthly gap is $3,750, so savings would last about 16 months. If she was born before 1968, worked and contributed to WA Cares for two years, and qualifies for the transition benefit, she might have $7,300 in benefits to help, adding about two months. Her family chooses a home that accepts Medicaid, so that when savings run low she can apply without moving.
Talking as a family
Money conversations can be hard, especially among siblings in different places. Share the numbers openly, agree on who will handle bills and applications, and keep your parent's wishes at the center. A neutral advisor can keep the discussion on track.
Common mistakes
- Waiting until a crisis to look into benefits and eligibility
- Assuming Medicare pays for long-term care (it does not pay for long-term custodial care)
- Choosing a home without asking whether it accepts Medicaid
- Giving away assets without advice
- Overlooking VA benefits or WA Cares eligibility
Putting together a plan
- Get written quotes.
- Add up income and assets.
- Find the monthly gap.
- Check Medicaid, WA Cares, VA, and insurance.
- Talk with an elder law attorney if needed.
- Put powers of attorney in place now.
About Gracious Living Adult Family Home
Gracious Living Adult Family Home is at 1511 Edwards Street in Bellingham. Please call (360) 746-2481 to confirm whether the home is currently accepting residents and which payment sources it accepts, or see our pricing page.
Frequently asked questions
Does Washington Medicaid pay for adult family homes and assisted living?
Yes, for eligible people in homes and facilities that are licensed and accept Medicaid. Residents may contribute part of their income and pay room and board up to a state standard.
What is the WA Cares Fund?
It is Washington's public long-term care insurance program. Benefits became available July 1, 2026, with a full lifetime benefit of $36,500 in 2026, growing with inflation.
Can WA Cares be used for an adult family home?
Yes. WA Cares lists adult family homes and assisted living facilities among covered services.
Who can help Bellingham families with Medicaid long-term care questions?
Northwest Regional Council's Aging and Disability Resources, (360) 738-2500.
Sources
- CareScout Cost of Care Survey tool (2025 data)
- DSHS: Medicaid and long-term care services for adults (PDF)
- Washington Health Care Authority: Medicaid Personal Care
- WA Cares Fund FAQ
- WA Cares Fund: Benefits
- WA Cares Fund: Qualifying for benefits
- VA: Veterans pension rates
- VA Puget Sound health care
- Northwest Regional Council: Aging and Disability Resources