Why Long-Term Care Insurance Can Make Sense for Retirees in Washington and Oregon

Why Long-Term Care Insurance Can Make Sense for Retirees in Washington and Oregon

For many retirees in Washington and Oregon, long-term care may be one of the most important planning conversations that still gets pushed to the side.

It is easy to understand why. People often assume Medicare will cover it, or they believe they can simply address it later if a need arises. In reality, long-term care planning is often most effective when it is considered before a health event, before a cognitive decline diagnosis, and before options begin to narrow.¹

That may be especially true in the Pacific Northwest, where many retirees want to preserve flexibility, protect assets, and avoid placing unnecessary stress on spouses or adult children.

Why this matters more than many retirees realize

Long-term care is not just nursing home care. It can include help with bathing, dressing, eating, mobility, medication support, supervision related to memory loss, and other services provided at home, in assisted living, or in a skilled nursing setting. Medicare generally does not pay for this kind of custodial long-term care, which means many families face these costs largely out of pocket unless they qualify for Medicaid or have private coverage in place.²

The need is also more common than many people expect. According to the Administration for Community Living, someone turning 65 today has almost a 70 percent chance of needing some form of long-term care services and supports, and 20 percent will need care for longer than five years.³

That combination, a high likelihood of need and limited Medicare coverage, is a major reason long-term care insurance can make sense for retirees who want a plan instead of a scramble.⁴

Why long-term care insurance can make sense

Long-term care insurance can help retirees in Washington and Oregon address several planning goals at once.

First, it can help protect retirement assets. Without a dedicated plan, ongoing care costs can force withdrawals from investment accounts, savings, or other resources that were intended to support a spouse, legacy goals, or long-term retirement income.

Second, it can help preserve choice. Families who plan ahead may have more options around where care is received, who provides it, and how quickly support can begin.

Third, it can help reduce pressure on loved ones. Even when family members are willing to help, the emotional, physical, and financial burden can be significant.

Fourth, it can create coordination between private resources and public programs. In both Washington and Oregon, certain qualified long-term care partnership policies can help protect assets if a person later needs to apply for Medicaid.^5-9

Washington and Oregon both offer partnership policy advantages

One of the strongest reasons long-term care insurance may be worth evaluating in these two states is the availability of long-term care partnership programs.

In Washington, the state explains that qualified partnership policies can allow a person to protect assets up to the amount of insurance benefits paid, and those protected assets generally are not counted the same way for long-term care Medicaid eligibility or later estate recovery. Washington also recognizes qualifying partnership policies from other states through reciprocity rules.

Oregon offers a similar concept. The Oregon Division of Financial Regulation explains that qualified partnership policies let people protect more of their assets if they later require long-term care, run out of money, and need to apply for Medicaid. Oregon also notes that these policies must meet state and federal minimum standards, including inflation protection rules for certain ages.

For retirees, that matters because long-term care insurance is not always just about paying for care directly. In many cases, it is also about protecting part of what you built if care needs extend longer than expected.^10-12

How state reimbursements differ and why that matters

Washington and Oregon both use Medicaid to help pay for long-term care for people who qualify, but the reimbursement structures are not the same.

Washington publishes facility-specific nursing facility Medicaid rates and also lists a current swing bed rate of $357.36 per day effective July 1, 2025 through June 30, 2026. The state notes that nursing facility rates are facility specific and based on each facility’s costs.

Oregon, by contrast, publishes a 2026 Aging and People with Disabilities rate schedule showing community-based care monthly reimbursement amounts by setting and care tier. As of January 1, 2026, Oregon lists monthly rates ranging from $2,863 to $5,172 for residential care facilities, $2,332 to $7,773 for adult foster homes, and $1,980 to $4,649 for assisted living facilities, with separate hourly exception rates as well.

That does not mean one state is simply better than the other. It means the systems are structured differently. Washington emphasizes facility-specific and rate-history-based reimbursement in key areas, while Oregon publicly posts a tiered community-based schedule. For retirees, the takeaway is this: public long-term care support is highly state-specific. Coverage pathways, provider reimbursement, care settings, and practical access can vary depending on where you live and what kind of care you need.

That is one reason long-term care insurance can make sense. A private policy may provide another layer of flexibility rather than leaving your future care choices entirely dependent on state program rules, provider participation, or Medicaid eligibility timing.^13-15

A Washington-specific issue retirees should not ignore

For Washington residents, there is an additional planning wrinkle: WA Cares.

Beginning July 2026, eligible individuals can access WA Cares benefits of up to $36,500, with inflation adjustments over time. The program can help pay for care at home or in a residential setting.¹⁶

That is meaningful, but for many retirees it may be better viewed as a starting point rather than a full long-term care solution. Depending on the length and type of care needed, a private long-term care insurance policy may still play an important role in filling gaps, extending options, or coordinating with other resources.¹⁷

Why this may be especially relevant in Washington and Oregon

Retirees in Washington and Oregon often have planning considerations that make long-term care conversations even more important.

Many households in the region have built substantial home equity, retirement savings, or taxable investment assets over time. They may not consider themselves ultra-wealthy, but they also may not want to spend down a meaningful portion of their estate before qualifying for public help.

Many also want to age with dignity and independence, ideally at home for as long as possible. Since long-term care can happen gradually rather than all at once, having a strategy in place may give families more room to respond thoughtfully instead of react under pressure.

And because both states have partnership policy frameworks, long-term care insurance can be about more than paying bills. It can be part of a broader retirement strategy designed to protect choice, preserve assets, and create a more organized response if care becomes necessary.

The bottom line

Long-term care insurance is not the right fit for every retiree. But for many people in Washington and Oregon, it is worth serious consideration.

When Medicare does not cover most custodial long-term care, when the odds of needing some form of support are high, and when state reimbursement systems and Medicaid pathways differ, planning ahead can be the difference between having options and having very few.

For retirees who want to protect assets, preserve independence, and reduce uncertainty for their families, long-term care insurance can make a great deal of sense.

References

1. National Institute on Aging. (2023). What is long-term care?S. Department of Health and Human Services.
   https://www.nia.nih.gov/health/long-term-care/what-long-term-care
2. National Institute on Aging. (2023). What is long-term care?S. Department of Health and Human Services.
   https://www.nia.nih.gov/health/long-term-care/what-long-term-care
3. Administration for Community Living. (2024). How much care will you need?S. Department of Health and Human Services.
   https://acl.gov/ltc/basic-needs/how-much-care-will-you-need
4. Centers for Medicare & Medicaid Services. (n.d.). Long-term care.gov.
   https://www.medicare.gov/coverage/long-term-care
5. National Institute on Aging. (2023). What is long-term care?S. Department of Health and Human Services.
   https://www.nia.nih.gov/health/long-term-care/what-long-term-care
6. Administration for Community Living. (2024). Paying for long-term care.S. Department of Health and Human Services.
   https://acl.gov/ltc/costs-and-who-pays/paying-long-term-care
7. Centers for Medicare & Medicaid Services. (n.d.). Long-term care partnership programs.gov.
   https://www.medicaid.gov/medicaid/long-term-services-supports/long-term-care-partnership-program/index.html
8. Washington State Health Care Authority. (n.d.). Long-term care partnership program.
   https://www.hca.wa.gov/free-or-low-cost-health-care/i-help-others-apply-and-access-apple-health/long-term-care-partnerships
9. Oregon Division of Financial Regulation. (n.d.). Long-term care partnership program.
   https://dfr.oregon.gov/insure/health/long-term-care/pages/qualified-partnership-program.aspx
10. Washington State Health Care Authority. (n.d.). Long-term care partnership program.
    https://www.hca.wa.gov/free-or-low-cost-health-care/i-help-others-apply-and-access-apple-health/long-term-care-partnerships
11. Oregon Division of Financial Regulation. (n.d.). Long-term care partnership program.
    https://dfr.oregon.gov/insure/health/long-term-care/pages/qualified-partnership-program.aspx
12. Centers for Medicare & Medicaid Services. (n.d.). Long-term care partnership program.
    https://www.medicaid.gov/medicaid/long-term-services-supports/long-term-care-partnership-program/index.html
13. Washington State Department of Social and Health Services. (2025). Nursing facility rates and reports.
    https://www.dshs.wa.gov/altsa/management-services-division/nursing-facility-rates-and-reports
14. Oregon Department of Human Services. (2026). Aging and people with disabilities rate schedule.
    https://www.oregon.gov/odhs/providers-partners/seniors-disabilities/Documents/rate-schedule.pdf
15. Centers for Medicare & Medicaid Services. (n.d.). Medicaid and long-term services and supports.
    https://www.medicaid.gov/medicaid/long-term-services-supports/index.html
16. S. Census Bureau. (2023). American Community Survey 1-year estimates.
    https://www.census.gov/programs-surveys/acs
17. Federal Reserve Board. (2023). Survey of Consumer Finances (SCF).
    https://www.federalreserve.gov/econres/scfindex.htm
18. (2021). Home and community preferences survey: A national survey of adults age 18-plus.
    https://www.aarp.org/research/topics/community/info-2021/2021-home-community-preferences.html
19. National Institute on Aging. (2023). What is long-term care?S. Department of Health and Human Services.
    https://www.nia.nih.gov/health/long-term-care/what-long-term-care
20. Board of Governors of the Federal Reserve System. (2023). Survey of Consumer Finances (SCF).
    https://www.federalreserve.gov/econres/scfindex.htm
21. Centers for Medicare & Medicaid Services. (n.d.). Long-term care partnership program.
    https://www.medicaid.gov/medicaid/long-term-services-supports/long-term-care-partnership-program/index.html

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