經常問的問題
WA Cares 在確定誰參與該計劃時如何定義“華盛頓工人”？
您是否參加 WA Cares 取決於您的工作是否位於華盛頓州。 WA Cares 使用與該州帶薪家庭和病假計劃相同的本地化定義（參見RCW 50A.05.010 ）。如果您被納入帶薪休假，您也將被納入 WA Cares，除非您獲得批准的豁免。
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歲以下的工人需要繳費嗎？
無論年齡大小，工人都會為西澳關懷計劃做出貢獻。與所有在華盛頓工作的人一樣，18 歲以下的工人每年工作至少 500 小時即可獲得合格年度。一旦年滿 18 歲，如果他們在申請福利之日起的過去六年中至少繳納了三年或繳納了 10 年，則可以在需要時使用福利。
我可以向 WA Cares 額外捐款以獲得額外福利嗎？
WA Cares 是一個類似社會安全的社會保險計劃，而不是儲蓄帳戶。每個滿足繳款要求並有護理需求的人都可以獲得相同的終身福利金額（36,500 美元，每年根據通貨膨脹進行調整）。
WA Cares 正在與保險業合作開發補充私人長期照護保險保單的市場。這些保單將允許那些想要更多保險的人使用他們的 WA Cares 福利作為其私人保單的免賠額。西澳關懷監督機構LTSS 信託委員會在2023 年 1 月的報告中向立法機構提出了創建補充私人保險市場的建議。隨著更多資訊的出現，WA Cares 將更新網站並向WA Cares 郵件清單發送通知。
保費率會隨時間變化嗎？
根據法律規定，保費率不能超過0.58%。立法機關需要修改法律以提高保費率。然而，2022 年完成的精算分析顯示，在大多數情況下，按照當前的保費率，西澳關愛基金預計到 2098 年（報告中評估的整個時期）將完全具備償付能力。
計算保費時使用什麼工資？
通常，這些是您的總工資。就業保障部 (ESD) 使用與帶薪家庭假和病假相同的工資定義。然而，與帶薪休假不同的是，適用 WA Cares 保費的收入不受社會保障應納稅最高限額的限制。
您可以在WAC 192-510-025中找到更多詳細信息，雇主可以使用 ESD 的保費計算器來計算 WA Cares 和帶薪休假的保費金額。
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 如何確定某人是否有護理需求？
社會和健康服務部 (DSHS)將詢問有關您日常生活活動和您需要的支持的問題。如果您在至少三項日常生活活動方面需要幫助，您就有資格獲得福利。這可能基於自我報告，並可由健康專業人員驗證。
DSHS 將詢問您的活動類型包括吃飯、洗澡、行走或坐在輪椅上走動、進出椅子以及您在床上後走動的能力、使用浴室、管理您的藥物、個人衛生和身體護理。 DSHS 還會詢問認知以及影響您日常生活的任何記憶/認知障礙。
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.
為什麼我需要居住在華盛頓才能領取福利？
華盛頓是美國第一個開發一種方法，讓所有老年工人都能負擔得起長期護理的州。該福利僅在華盛頓境內可用，因為所有提供者都必須與該州簽訂合同，並且每個州對於如何使某人有資格提供長期護理都有不同的法律。
西澳關懷監督機構LTSS 信託委員會在 2023 年 1 月的報告中向立法機構建議，西澳關懷福利應為符合繳款要求但在需要護理之前搬到另一個州的人提供。如果立法機關對法律進行修改，WA Cares 將更新網站並向 WA Cares 郵件列表發送通知。
如果您不符合使用福利的要求或不需要護理，是否有現金價值？
WA Cares 的運作方式類似於保險計劃，而不是儲蓄賬戶。通過我們所有人在整個職業生涯中將少量薪水集中到一個基金中，該計劃可以為需要的人提供長期護理。如果您不使用福利，則無法兌現您所做的供款。
西澳關愛基金的承銷商是誰？
西澳關愛基金是一項全民長期護理計劃，其運作方式類似於社會保障，所有工人都參與並在其職業生涯中獲得保險。該計劃沒有承保，資金全部來自工人工資的匯集，並將其投資於華盛頓州西澳關懷基金受益人，供他們需要長期護理時使用。
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.
您可以將福利金交給配偶或家庭成員嗎？
終身福利金額僅適用於已向該基金供款的合格受益人，不能轉讓給其他家庭成員。通過我們所有人在整個職業生涯中將少量薪水集中到一個基金中，該計劃可以保持負擔得起並從長遠來看覆蓋更多人。如果 WA Cares 福利可轉讓給配偶或家庭成員，保費將需要高得多。
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.
我如何知道我的員工是否已獲得豁免批准？
員工有責任通知您並向您提供 ESD 批准函的副本，其中包含豁免生效的日期。一旦您收到該信函且生效日期已過，您必須停止預扣保費。雇主必須將錯誤扣繳的保費退還給僱員。
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.
新的豁免類型有哪些？我如何知道我是否符合資格？
2022 年的新立法創建了更多豁免類型。您可以從 2023 年 1 月 1 日開始申請這些豁免。新的豁免適用於以下人員：
- 居住在州外——您的主要居住地必須在華盛頓州以外。
- 如果您將主要居住地更改為華盛頓，您將不再符合資格。
- 持非移民簽證在華盛頓臨時工作 – 您必須持有臨時工人的非移民簽證。
- 如果您的非移民簽證身份發生變化並且您成為華盛頓的永久居民或就業公民，您將不再符合資格。
- 現役軍人的配偶或註冊家庭伴侶 – 您必須與美國武裝部隊現役軍人結婚或擁有註冊家庭伴侶關係。
- 如果您的配偶或家庭伴侶退伍或退伍，或者婚姻或登記的家庭伴侶關係解除，您將不再符合資格。
- 具有 70% 或以上因公殘疾的退伍軍人 – 您必須被美國退伍軍人事務部評定為具有 70% 或以上因公殘疾。
- 該豁免是永久性的。
我仍然可以申請私人 LTC 保險豁免嗎？
不需要。那些在 2021 年 11 月 1 日或之前擁有私人長期護理保險的人，可以從 2021 年 10 月 1 日到 2022 年 12 月 31 日期間申請西澳關懷基金的豁免。此選擇退出規定不再可用。
長期護理和傷殘保險有什麼區別？
長期護理保險福利有助於支付無法自行執行日常任務的人們所需的服務費用。
當工人生病或受傷並因無法完成工作而需要請假時，殘疾保險福利將覆蓋他們的部分收入。殘疾保險可以是短期的，也可以是長期的，具體取決於其提供福利的時間長短。
許多僱員可以通過雇主獲得傷殘保險。華盛頓工人還可以享受帶薪家事假和病假，如果他們患有嚴重的健康狀況而無法工作、需要請假來照顧家庭成員或歡迎新生兒，或者某些與軍事相關的事情，他們還可以享受帶薪休假。事件。
WA Cares 將如何與 Medicaid 長期服務和支持合作？
WA Cares 對醫療補助資格幾乎沒有影響，並將被視為服務的第三方付款人（如現在的私人保險）。滿足 WA Cares 繳款要求並需要護理的人通常會首先使用他們的 WA Cares 福利。在他們使用 WA Cares 福利後，如果仍然需要護理，他們將能夠申請 Medicaid 長期服務和支持。
醫療補助將確定他們是否符合經濟條件。獲得 WA Cares 福利將使家庭有喘息的空間來計劃如何支付未來的長期護理費用，包括了解如何有資格獲得醫療補助長期服務和支持。
對於已經接受 Medicaid 長期服務和支持並且工作足以符合 WA Cares 資格的人來說，這可能會受到影響。如果接受醫療補助的個人將其 WA Cares 福利用於部分護理，並且不再支付“參與”醫療補助長期服務和支持的費用，則可能會導致醫療補助的可計算資源過多。接受 Medicaid 長期服務和支持並有資格獲得 WA Cares 福利的工人在計劃如何使用其福利時應牢記這一點。