Washington New Freedom Waiver: Washington 2026 Guide
Washington’s New Freedom Waiver is a self-directed Medicaid waiver that gives participants a monthly budget to buy personal care and other supports they choose. It is available in limited counties and is administered by DSHS Aging and Long-Term Support Administration.
This page explains who can use the New Freedom Waiver in 2026, how family members can be paid, what the program covers, how to apply, and how it fits with nursing home Medicaid. For the full statewide rules on income, assets, spouses and the look-back, see our Washington Medicaid guide.
Figures change periodically. Double-check current amounts before relying on them.
What the New Freedom Waiver is
Instead of authorized hours, New Freedom participants receive a budget based on their CARE assessment and work with a consultant to plan how to spend it. They can hire caregivers, including family members other than spouses, and buy goods and services that support independence.
Family caregiver and self-directed programs let a Medicaid member, or a representative, choose who provides care and, in many cases, pay a relative or friend. Payroll and paperwork usually run through an agency, so the family does not act as an employer alone. Rules on which relatives can be paid differ; many programs allow adult children, fewer allow a spouse.
Who qualifies in 2026
Eligibility for the New Freedom Waiver rests on two tests, care need and finances, plus an available slot. In general, an applicant must:
- be 18 or older;
- meet nursing facility level of care through CARE;
- be eligible for Apple Health long-term care;
- live in a county where New Freedom is offered; and
- be able to direct the budget, or have a representative.
The money test. the New Freedom Waiver uses Washington’s long-term care Medicaid financial rules, which are usually the same income and asset limits used for nursing home Medicaid. Countable assets include bank accounts, investments and property other than the home, while the home, one car, personal belongings and certain burial funds are usually not counted. The five-year look-back on gifts and below-value transfers applies here too, so large gifts in the past five years can delay services.
The 2026 special income level is $2,982 a month, and the single-person asset limit is $2,000.
For reference, these are Washington’s key 2026 long-term care Medicaid figures:
| Item | 2026 figure |
|---|---|
| Income limit (applicant) | $2,982 a month (special income level) |
| Asset limit (single applicant) | $2,000 |
| Asset limit (couple, both applying) | $3,000 |
| Home equity limit | $1,130,000 |
| Spouse at home: resource allowance | The greater of $72,529 or half the couple’s assets, up to $162,660 |
| Spouse at home: monthly income allowance | Minimum $2,705 (from July 1, 2026) / maximum $4,066.50 |
| Personal needs allowance (nursing home) | $108.74 a month |
| Look-back period | 60 months (5 years) |
If you are married. The spouse who stays home is protected: federal spousal impoverishment rules let them keep a share of the couple’s assets and, if their own income is low, part of the applicant’s income. The spousal allowance pages explain how these amounts are figured.
Services the New Freedom Waiver can cover
the New Freedom Waiver can pay for:
- personal assistance
- consultation
- treatment and health maintenance supplies
- goods and services that support independence
- home and vehicle modifications
- personal emergency response systems
- training
What is usually not covered. Payment is for care tasks in the plan, not for rent, food or household bills. Payments to a caregiver are usually taxable income, though some live-in caregiver payments get special tax treatment.
How to apply for the New Freedom Waiver
The steps below describe the usual path. Many people apply for Medicaid and request the waiver at the same time, so that the money and care tests run side by side.
- Contact the local Home and Community Services (HCS) office of DSHS Aging and Long-Term Support Administration, or the local Area Agency on Aging, and ask for a long-term care assessment.
- Apply for Washington Apple Health long-term care coverage through DSHS, online or on paper, if not already enrolled.
- A DSHS or Area Agency on Aging case manager completes the CARE assessment, which decides eligibility and the number of hours.
- Choose an individual provider (often a family member) or a home care agency, or a residential setting where that applies.
- Services start under the plan, with reassessments at least yearly.
Practical tips. Keep copies of everything you send and note the name of each person you speak with. Assessors only see one visit, so describe what a difficult day looks like and have a regular helper in the room. Supervision needs, confusion and falls matter as much as hands-on help. A denial notice explains the fair hearing process and its deadline.
Waiting lists and timing
Enrollment is limited by available slots and county availability.
Starting the process early keeps options open if a wait develops. In the meantime, families often combine state plan personal care, adult day, PACE in areas that have it, and Area Agency on Aging services. The waiver waiting lists page explains common rules.
How it relates to nursing home Medicaid
the New Freedom Waiver and nursing home Medicaid serve the same group of people; the difference is where care is given. Nursing home coverage cannot be capped, but waiver enrollment sometimes is. If care at home becomes unsafe, a participant can move to a nursing home and keep Medicaid, though the share of income paid toward care changes. Moving the other way is often given priority, and Money Follows the Person can help.
Planning ahead for the New Freedom Waiver
Most families come to the New Freedom Waiver during a change: a fall, a hospital stay, or a caregiver who can no longer keep up. Planning a little ahead makes each step easier. Begin with a list of daily tasks, the people who handle them, and the gaps that appear when a caregiver is away. The same list helps at the assessment and makes it clear where paid help matters most.
On the financial side, gather recent bank statements, income letters such as Social Security and pension notices, health insurance cards, and proof of age and residence in Washington. If long-term care Medicaid may be needed later, five years of records will matter, so it helps to keep them now. A durable power of attorney and health care directive, signed while the person can still make decisions, let a family member handle applications and appeals without court involvement.
Check in on how the arrangement is working every few months; a reassessment can adjust hours or services. A running log of health changes helps with every later review.
Tips for families
Discuss the arrangement openly with siblings, and plan for the caregiver’s own job, health and time off. Track tasks and hours from the start. Without a written caregiver agreement, earlier payments to relatives can be treated as gifts in the look-back. Have a backup plan for illness or vacations.
Working with a Certified Medicaid Planner is often the fastest way through the New Freedom Waiver. A planner who handles Washington cases regularly can spot eligibility problems before Washington DSHS does, organize the records and help plan around any wait. Costs range widely, from about $150 to $600 an hour, about $500 to $6,000 for application help, and about $2,500 to $15,000 or more for full planning.
Related pages
- Washington Medicaid guide
- Washington Community First Choice
- Paid family caregivers
- Consumer-directed care
- Caregiver agreements
- HCBS waivers explained
- In-home care and Medicaid
Last updated for 2026. General information only, not legal or financial advice. Medicaid Answers is a free educational resource published by Medicaid Answers Foundation.