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Long Term Care insurance and the WA Cares Fund

At Suzie Health Solutions, we are the full service enrollment center located in Wenatchee, WA. We get asked a lot of insurance questions. If you have not heard. Long term care in Washington State is changing this year.

Long Term Care is the next big insurance problem facing the United States. It is no wonder why Washington state started to address the problem with House Bill 1087 & House Bill 1323.

Long Term Care is not part of health insurance or Medicare. It often falls under Medicaid programs after all the individuals’ resources have been exhausted. That is correct. If you have a private plan then those funds are run out first and then everything else to pay for your care. Yes, you can work hard all your life build up serious assets and if you don't plan for long term care leave little or nothing for your children.

Suzilla live from Wenatchee

The immediate cost is where employees (W-2 that work 500 hours per year) in Washington State are required to pay $0.58 per every $100 that they earn. DSHS have identified with the need of people needing caregivers in 2019 as 1 out of 7 individuals. This will increase to 1 out of 3 individuals by 2040.  

An employee is considered vested into the Long-Term Care Program if:

1.       Worked a minimum of 500 hours per year for three years with in the last six years from application of benefits.

2.       Are permanently vested if they worked at least 500 hours per year for ten years with at least five being consecutively.

Long-Term Care Benefits are simple. A person may receive approved services up to $36,500 over the course of their lifetime. The DSHS will pay, in $100 increments. They can cover adult day services, in-home personal care, assisted living services, nursing home services, dementia supports, home safety evaluation, home delivered meals, respite for family care givers, relative care, professional services, and services to assist family members to care for eligible individuals. 

All individuals who have comparable private long-term care insurance may opt-out if they purchased before November 1st, 2021. The employee must provide to their employer before their employer can waive collecting the fee.

Self-employed individuals may opt-in starting January 1,2022. They have until 2025 or with in three years of becoming self-employed.

The potential problems that you might encounter if you participate:

  • It does not work out of state. If you move out of state, then you get nothing.
  • Not enough benefits, the current home care services cost is $68,640 per year.
  • If you do not use it then you get nothing for your contributions.
  • You are a high earner and it may be cheaper for you to have a private plan. 

We took a look at and wanted  something portable and addresses the three issues. We used a Universal Life product to tackle several of the problems including a lack of portable life insurance that is common in Washington state. We have been setting up benefits for individuals and small business six years from our Wenatchee Office. 

While we do offer LTC, this option no longer fulfills the state requirement!

So if you are looking for an LTC because you want coverage then: Team McColm's Insurance Exchang

You want Universal Life

Death Benefit: Select $100,000 (you cannot go lower than $80,000 at 4% if you want to beat the state)

Long Term Care Rider: With LTC/Chronic Illness

Percentage of Death Benefit per month for LTC: 4%


When we did a quote for a 40-year-old, middle health 5’9” and 190 pounds this is what we got. It is going to very based on health and other underwriting factors. We suggest that you start early in the process as it takes time. To get the following result.


Yes, we use an exchange for our life insurance so that you can shop and select from multiple companies. In this example, we are doing nearly three times the amount of basic coverage with expanded coverages for $71 per month. If they were in great shape or younger then it would be cheaper. It is important to note that this is underwritten and it does take some time to process. It works great for coverage but do not expect it  to fulfill the Washington State Mandate

If you would like additional time to talk about long term care then select a time that works best for your schedule

Additional Resources:

Official Web site for WA Cares Fund:

Department of Social & Health Services: Aging and Long Term Support Administration Fact sheet.

Office of Insurance Commissioner: What qualifies as long-term care insurance:


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