This depends on your asset level, health status, and risk tolerance. Self-funding makes sense if you have $3-5+ million in investable assets and can absorb $200,000-$400,000 in potential care costs without jeopardizing your spouse's financial security. LTC insurance is most valuable if you have $500,000-$3 million in assets—enough to protect but not enough to easily absorb major care costs. Those with under $500,000 may rely more on Medicaid planning. Many Bellevue retirees, particularly those transitioning from Microsoft, Amazon, or Boeing careers with substantial savings, use a hybrid approach: insurance to cover some years plus dedicated reserves for additional needs.

he WA Cares Fund is Washington State's public long-term care insurance program—the first of its kind in the nation. Most W-2 employees in Washington contribute a small payroll tax (0.58% of wages) and in return earn up to $36,500 in lifetime LTC benefits (indexed to inflation). Benefits become available after you've paid into the program for a qualifying period and need assistance with at least three activities of daily living. While the benefit amount is modest relative to actual care costs in the Bellevue area, it provides a baseline that can be layered with private insurance or personal savings for a more complete strategy.

Hybrid policies combine life insurance or annuities with long-term care benefits, addressing the "use it or lose it" concern with traditional LTC insurance. With a life-insurance-based hybrid, if you never need care, your beneficiaries receive a death benefit. If you do need care, the policy accelerates the death benefit to pay for services. Annuity-based hybrids work similarly—your money grows tax-deferred and you can access enhanced benefits for care needs. While often requiring a larger upfront premium, hybrids offer guaranteed benefits regardless of whether care is needed, making them increasingly popular with Bellevue retirees seeking certainty in their planning.

Washington's Medicaid long-term care program (Apple Health) covers nursing home and some home and community-based care services for those who meet strict income and asset limits. For 2025, individuals generally must have under $2,000 in countable assets. Homes may be exempt if a spouse resides there, subject to equity limits. Washington's Medicaid program has a five-year "lookback" period—asset transfers within five years of applying can result in penalties that delay eligibility. Strategic planning with a knowledgeable advisor can help protect some assets while positioning you or your spouse to qualify for benefits when needed.

Washington is a community property state, which means assets acquired during marriage are generally considered equally owned by both spouses. In a long-term care context, this can affect which assets are considered available to pay for one spouse's care. However, federal and state protections allow a "community spouse" to retain the home, one vehicle, and specified assets (around $148,620 in 2025) plus minimum monthly income, even when the other spouse requires Medicaid-covered nursing home care. Strategic planning through proper titling, trusts, and spend-down strategies can protect additional assets for the healthy spouse while maintaining eligibility for the spouse needing care.