经常问的问题
WA Cares 在确定谁参与该计划时如何定义“华盛顿工人”？
您是否参加 WA Cares 取决于您的工作是否位于华盛顿州。 WA Cares 使用与该州带薪家庭和病假计划相同的本地化定义（参见RCW 50A.05.010 ）。如果您被纳入带薪休假，您也将被纳入 WA Cares，除非您获得批准的豁免。
What services are covered under WA Cares?
While WA Cares benefits can be used to pay for care in a residential setting like assisted living, they are primarily designed to cover services and supports to help you stay at home. This could include services like:
- Hiring a home care aide as your primary caregiver or as respite to so your unpaid family caregiver can take a break
- Paying a qualified family member (including a spouse) to provide care and getting them training they need to feel supported
- Making home modifications so you can get around better or purchasing a home safety evaluation so you can prevent avoidable falls
- Having meals delivered to your door
- Getting transportation to appointments and errands like grocery shopping
- Purchasing equipment, assistive devices, medication reminder devices
These are just some of the services WA Cares Fund will offer. Others include dementia supports, memory care, care transitions, personal emergency response systems, and more. Learn more about benefits covered by WA Cares.
Can people who are already retired contribute?
Only people who are working contribute to WA Cares. Some people who are retired from their career still work part-time, either as an employee or on a self-employed basis. If you are working more than 500 hours per year (about 10 hours per week) as an employee, you will be contributing and earning WA Cares benefits.
If you are self-employed, you can choose to opt in to WA Cares and earn benefits. If you are already retired and no longer work at all, you won’t be able to earn WA Cares benefits, but may be able to access other long-term care services. To learn more about services in your area, reach out to your local Area Agency on Aging.
18 岁以下的工人需要缴纳费用吗？
无论年龄大小，工人都要向 WA Cares 缴纳费用。与所有在职华盛顿人一样，18 岁以下的工人每年工作至少 500 小时，即可获得一年的资格。年满 18 岁后，如果他们在申请福利之日起的过去六年中至少缴纳了三年，或者缴纳了十年，他们就可以在需要时使用福利。
我可以向 WA Cares 额外捐助以获取额外福利吗？
WA Cares 是一项类似社会保障的社会保险计划，而不是储蓄账户。符合缴费要求且有护理需求的每个人都可以获得相同的终身福利金额（36,500 美元，每年根据通货膨胀进行调整）。
WA Cares 正在与保险行业合作，开发补充私人长期护理保险单市场。这些保单将允许想要获得更多保险的人使用他们的 WA Cares 福利作为私人保单的免赔额。WA Cares 监督机构LTSS 信托委员会在其2023 年 1 月的报告中向立法机构提出了关于创建补充私人保险市场的建议。随着更多信息的出现，WA Cares 将更新网站并向WA Cares 邮件列表发送通知。
保费率会随时间变化吗？
根据法律规定，保费率不能超过0.58%。立法机关需要修改法律以提高保费率。然而，2022 年完成的精算分析显示，在大多数情况下，按目前的保费率，西澳关爱基金预计到 2098 年（报告中评估的整个时期）将完全具备偿付能力。
计算保费时使用什么工资？
通常，这些是您的总工资。就业保障部 (ESD) 使用与带薪家庭假和病假相同的工资定义。然而，与带薪休假不同的是，适用 WA Cares 保费的收入不受社会保障应纳税最高限额的限制。
您可以在WAC 192-510-025中找到更多详细信息，雇主可以使用 ESD 的保费计算器来计算 WA Cares 和带薪休假的保费金额。
Is there a chance the program’s costs could exceed its revenue?
According to a 2022 study completed by Milliman, an independent actuarial firm, the WA Cares Fund is projected to be fully solvent through 2098 (the full period evaluated in the study) under most evaluated scenarios.
While the current analysis shows the program is on solid financial ground, actual results may vary from these projections. Fortunately, there are processes in place to identify any risks to the program’s finances promptly, giving the Long-Term Services and Supports Trust Commission and the legislature plenty of time to adjust the program as needed to stay on course.
Learn more about solvency.
DSHS 如何确定某人是否有护理需求？
社会和健康服务部 (DSHS)将询问有关您日常生活活动和您需要的支持的问题。如果您在至少三项日常生活活动方面需要帮助，您就有资格获得福利。这可能基于自我报告，并可由健康专业人员验证。
DSHS 将询问您的活动类型包括吃饭、洗澡、行走或坐在轮椅上走动、进出椅子以及您在床上后走动的能力、使用浴室、管理您的药物、个人卫生和身体护理。 DSHS 还会询问认知以及影响您日常生活的任何记忆/认知障碍。
Can I still get benefits if I contribute to the fund but don’t meet contribution requirements?
No. Because the WA Cares Fund is self-funded by worker contributions, benefits can only be paid to people who have paid in as workers for a number of years. You may be able to access other long-term care services and can reach out to your local Area Agency on Aging.
How long will the benefit amount last?
WA Cares is designed to help you stay in your home as long as possible, which most people with long-term care needs can do with the right support. A few hours of help each day with basic tasks like bathing, meal preparation and transportation can keep you living independently.
While the benefit won’t cover 100% of care for everyone, it could cover around 20 hours per week of home care for about a year. This is the amount of in-home care the average Medicaid client receives right now.
About a third of people need care for a year or less, and for those people WA Cares may be able to cover all the care they need. For others, WA Cares provides families with immediate relief and time to plan for future care costs.
为什么我需要居住在华盛顿才能领取福利？
华盛顿是美国第一个开发一种方法，让所有老年工人都能负担得起长期护理的州。该福利仅在华盛顿境内可用，因为所有提供者都必须与该州签订合同，并且每个州对于如何使某人有资格提供长期护理都有不同的法律。
西澳关怀监督机构LTSS 信托委员会在 2023 年 1 月的报告中向立法机构建议，西澳关怀福利应为符合缴款要求但在需要护理之前搬到另一个州的人提供。如果立法机关对法律进行修改，WA Cares 将更新网站并向 WA Cares 邮件列表发送通知。
如果您不符合使用福利的要求或不需要护理，是否有现金价值？
WA Cares 的运作方式类似于保险计划，而不是储蓄账户。通过我们所有人在整个职业生涯中将少量薪水集中到一个基金中，该计划可以为需要的人提供长期护理。如果您不使用福利，则无法兑现您所做的供款。
西澳关爱基金的承销商是谁？
西澳关爱基金是一项全民长期护理计划，其运作方式类似于社会保障，所有工人都参与并在其职业生涯中获得保险。该计划没有承保，资金全部来自工人工资的汇集，并将其投资于华盛顿州西澳关怀基金受益人，供他们需要长期护理时使用。
Can I withdraw money from WA Cares?
No. WA Cares is an insurance program, not a savings account. By all of us pooling a small amount of our paycheck into one fund throughout our careers, the program can provide access to long-term care for the people who need it. Everyone who meets contribution requirements and has a care need gets access to the same lifetime benefit amount (starts at $36,500 and will grow over time with inflation). The only exception is near-retirees born before 1968, who earn partial benefits for each year they contribute.
您可以将福利金交给配偶或家庭成员吗？
终身福利金额仅适用于已向该基金供款的合格受益人，不能转让给其他家庭成员。通过我们所有人在整个职业生涯中将少量薪水集中到一个基金中，该计划可以保持负担得起并从长远来看覆盖更多人。如果 WA Cares 福利可转让给配偶或家庭成员，保费将需要高得多。
What requirements will family caregivers have to meet to become paid caregivers through WA Cares?
When WA Cares benefits become available in July 2026, your loved one may be able to make you their paid caregiver. First, they must become eligible for WA Cares benefits. Once their application is approved, they will be able to choose you as their provider and pay you for the care you provide.
The next step is for you to sign up as a provider through WA Cares. Family members can be paid through the Consumer Direct Care Network of WA (CDWA), an organization that supports family members who wish to be paid by the state to provide personal care. A home care agency can also employ a family member as a certified home care aide. DSHS is also developing a third option to pay family caregivers to provide more flexibility for WA Cares beneficiaries. All paid family caregivers will need to participate in some training to ensure the health and safety of themselves and their loved one.
我如何知道我的员工是否已获得豁免批准？
员工有责任通知您并向您提供 ESD 批准函的副本，其中包含豁免生效的日期。一旦您收到该信函且生效日期已过，您必须停止预扣保费。雇主必须将错误扣缴的保费退还给雇员。
What types of providers will WA Cares register?
WA Cares will register a range of qualified long-term services and supports providers, including:
- Personal emergency response system providers
- Adaptive equipment and technology providers
- In-home caregivers
- Individual providers
- Home care agency providers
- Respite providers
- Paid family caregivers
- Adult day health and adult day care centers
- Adult family homes
- Assisted living facilities
- Nursing homes
- Environmental modification service providers
- Home-delivered meal service providers
- Transportation service providers
What requirements will providers have to meet to contract with WA Cares?
Providers will need to meet basic laws of doing business in Washington and may need to meet licensing or certification requirements, depending on the type of services and supports they offer.
The LTSS Trust Commission, the program’s oversight body, is currently developing recommendations on provider qualifications for each type of provider. Those recommendations will be published by January 2025. Details on the process, including public meetings where interested parties can provide input, are available online.
新的豁免类型有哪些？我如何知道我是否符合资格？
2022 年的新立法创建了更多豁免类型。您可以从 2023 年 1 月 1 日开始申请这些豁免。新的豁免适用于以下人员：
- 居住在州外——您的主要居住地必须在华盛顿州以外。
- 如果您将主要居住地更改为华盛顿，您将不再符合资格。
- 持非移民签证在华盛顿临时工作 – 您必须持有临时工人的非移民签证。
- 如果您的非移民签证身份发生变化并且您成为华盛顿的永久居民或就业公民，您将不再符合资格。
- 现役军人的配偶或注册家庭伴侣 – 您必须与美国武装部队现役军人结婚或拥有注册家庭伴侣关系。
- 如果您的配偶或家庭伴侣退伍或退伍，或者婚姻或登记的家庭伴侣关系解除，您将不再符合资格。
- 具有 70% 或以上因公残疾的退伍军人 – 您必须被美国退伍军人事务部评定为具有 70% 或以上因公残疾。
- 该豁免是永久性的。
How do I find my exemption letter?
1. Go to secureaccess.wa.gov.
On the login page:
- Enter your Username under “LOGIN”.
- Enter your Password.
- Click Submit.
2. From your list of services, click Access Now to the right of “Paid Family and Medical Leave”.
3. On the “Now Accessing” page, click Continue.
4. On your “My WA Cares Exemption” homepage, click on the “Exemption ID” associated with your letter.
5. On the “WA Cares Exemption Summary” page, use the hyperlink under “Document Name” to access a copy of your decision letter.
我仍然可以申请私人 LTC 保险豁免吗？
不需要。那些在 2021 年 11 月 1 日或之前拥有私人长期护理保险的人，可以从 2021 年 10 月 1 日到 2022 年 12 月 31 日期间申请西澳关怀基金的豁免。此选择退出规定不再可用。
长期护理和伤残保险有什么区别？
长期护理保险福利有助于支付无法自行执行日常任务的人们所需的服务费用。
当工人生病或受伤并因无法完成工作而需要请假时，残疾保险福利将覆盖他们的部分收入。残疾保险可以是短期的，也可以是长期的，具体取决于其提供福利的时间长短。
许多雇员可以通过雇主获得伤残保险。华盛顿工人还可以享受带薪家事假和病假，如果他们患有严重的健康状况而无法工作、需要请假来照顾家庭成员或欢迎新生儿，或者某些与军事相关的事情，他们还可以享受带薪休假。事件。
WA Cares 将如何与 Medicaid 长期服务和支持合作？
WA Cares 对医疗补助资格几乎没有影响，并将被视为服务的第三方付款人（如现在的私人保险）。满足 WA Cares 缴款要求并需要护理的人通常会首先使用他们的 WA Cares 福利。在他们使用 WA Cares 福利后，如果仍然需要护理，他们将能够申请 Medicaid 长期服务和支持。
医疗补助将确定他们是否符合经济条件。获得 WA Cares 福利将使家庭有喘息的空间来计划如何支付未来的长期护理费用，包括了解如何有资格获得医疗补助长期服务和支持。
对于已经接受 Medicaid 长期服务和支持并且工作足以符合 WA Cares 资格的人来说，这可能会受到影响。如果接受医疗补助的个人将其 WA Cares 福利用于部分护理，并且不再支付“参与”医疗补助长期服务和支持的费用，则可能会导致医疗补助的可计算资源过多。接受 Medicaid 长期服务和支持并有资格获得 WA Cares 福利的工人在计划如何使用其福利时应牢记这一点。