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Washington Medicaid COPES Waiver: Eligibility and Benefits
What are Medicaid Waivers?
Medicaid pays for long term care services in nursing homes. For nursing home qualified persons that choose to live at home or in a residential community, Medicaid will pay for those services if they can be obtained at a lower cost. These are called Home and Community Based Services, Waiver Funded Services, Medicaid Waivers or simply Waivers.
Overview of the Washington COPES Waiver
The Community Options Program Entry System, or COPES for short, is a Washington State Medicaid program designed to enable individuals who require nursing home level care, to receive that care in their home or community living environment such as an assisted living residence.
The waiver allows for consumer or participant direction. Based on the Medicaid Cash and Counseling model, this means the individual receiving care services under this waiver has the option of self-directing their personal care. In other words, they can choose their personal care provider instead of having the state assign one. Included among the persons eligible to provide personal care are certain family members such as the adult children. Spouses, however, are ineligible to be paid caregivers. In 2012, caregivers were paid approximately $10 / hour.
The waiver allows for consumer or participant direction. Based on the Medicaid Cash and Counseling model, this means the individual receiving care services under this waiver has the option of self-directing their personal care. In other words, they can choose their personal care provider instead of having the state assign one. Included among the persons eligible to provide personal care are certain family members such as the adult children. Spouses, however, are ineligible to be paid caregivers. In 2012, caregivers were paid approximately $10 / hour.
Qualifications for Washington’s COPES Waiver
In addition to requiring assistance with two or more activities of daily living or nursing home level care, individuals must be financially qualified for Medicaid. This is a complicated process involving a review of a family’s income, assets and asset transfers as far back as 5 years.
Washington Medicaid has an individual income limit in 2012 of $2,094 / month. However, the COPES program has a lower individual income limit of $931 / month. There is a countable asset limit in 2012 of $2,000. This figure does not include the value of one's home or primary vehicle.
It is important to note that if an individual is married and their spouse is not applying for Medicaid, the assets and incomes limits are considerably higher to allow the "community spouse" sufficient resources to continue living independently. It is advisable to consult with a Medicaid planning expert in this situation. IMPORTANT* Even though, one's income or assets may exceed these limits, most individuals can still qualify for Medicaid.
Many families find themselves in an awkward position where their loved one has enough income and assets that they do not qualify for Medicaid but not enough so that they can afford to pay for their care. Fortunately, there are many exceptions to what is considered income and countable assets. For example, one's car and home can be considered exempt from their countable assets. Income in excess of the limit can be allocated to a pooled income trust thereby enabling the individual to meet the Medicaid limit and qualify for assistance.
Creating a funeral trust is another simple and common technique used to help qualify for Medicaid. Given the expense of funerals and the fact that everyone will eventually require one, it makes sense to allocate money in advance to cover the funeral and associated expenses. A funeral trust is considered an exempt asset from Medicaid, therefore by creating one, a family can prepare for an inevitable need without having to plan the details and lower their countable assets to help qualify for Medicaid. Learn more about establishing a funeral trust.
Not qualifying for Medicaid can be devastating to the comfort of an individual, their family’s finances and even their health. For these reasons, Medicaid planners exist to ensure families have the best chance of acceptance into the program. With care costing $1000’s / month, there is a strong incentive to use a Medicaid Planner. Find assistance applying for Medicaid.
Washington Medicaid has an individual income limit in 2012 of $2,094 / month. However, the COPES program has a lower individual income limit of $931 / month. There is a countable asset limit in 2012 of $2,000. This figure does not include the value of one's home or primary vehicle.
It is important to note that if an individual is married and their spouse is not applying for Medicaid, the assets and incomes limits are considerably higher to allow the "community spouse" sufficient resources to continue living independently. It is advisable to consult with a Medicaid planning expert in this situation. IMPORTANT* Even though, one's income or assets may exceed these limits, most individuals can still qualify for Medicaid.
Many families find themselves in an awkward position where their loved one has enough income and assets that they do not qualify for Medicaid but not enough so that they can afford to pay for their care. Fortunately, there are many exceptions to what is considered income and countable assets. For example, one's car and home can be considered exempt from their countable assets. Income in excess of the limit can be allocated to a pooled income trust thereby enabling the individual to meet the Medicaid limit and qualify for assistance.
Creating a funeral trust is another simple and common technique used to help qualify for Medicaid. Given the expense of funerals and the fact that everyone will eventually require one, it makes sense to allocate money in advance to cover the funeral and associated expenses. A funeral trust is considered an exempt asset from Medicaid, therefore by creating one, a family can prepare for an inevitable need without having to plan the details and lower their countable assets to help qualify for Medicaid. Learn more about establishing a funeral trust.
Not qualifying for Medicaid can be devastating to the comfort of an individual, their family’s finances and even their health. For these reasons, Medicaid planners exist to ensure families have the best chance of acceptance into the program. With care costing $1000’s / month, there is a strong incentive to use a Medicaid Planner. Find assistance applying for Medicaid.
Services Provided under the COPES Waiver
-Adult Day Care / Adult Day Health Care
-Assisting Living / Adult Family Homes
-Durable Medical Equipment
-Environmental Accessibility Modifications to one's Home or Vehicle
-Home Care / Home Health Care
-Home Delivered Meals
-Hospice Care
-Personal Care
-Personal Emergency Response Services
-Transportation Assistance
Availability of the COPES Waiver Program
This program is available statewide across Washington. One can apply by calling 1-800-562-3022 or get more information online on the following webpage.
Use our Locator Tool to Find Other Options for which You're Eligible
