Ultimate Guide to DC Medicaid

Medicaid is both a federal and state-funded program for individuals and families with low income. Eligibility and benefits can change slightly in each state. This guide can help you determine what you are eligible for if you live in D.C.

Click below to learn more about DC Medicaid:

DC Medicaid Benefits

D.C. Medicaid includes benefits like: 

  • Ambulance travel and services
  • Dental
  • Doctor visits
  • Home and community-based services
  • Hospice
  • Hospital services
  • Labs and radiology
  • Medical supplies
  • Mental health
  • Transplants
  • Vision

Covered items must be considered medically necessary to apply.

DC Medicaid Transportation

The D.C. area offers a lot of transportation options for elderly and disabled residents. 

MTM (Medical Transportation Management) can bring Medicaid beneficiaries to covered medical appointments within the D.C. area. Make sure to request a ride at least three days before your scheduled appointment by calling 866-796-0601.

Additionally, MetroAccess can provide transportation for disabled people beginning at $2.50 per ride. For more information about MetroAccess, call 301-562-5360.

Washington Elderly and Handicapped Transportation Services (WEHTS) provides transportation on weekdays for elderly Washington D.C. residents. Eligible locations include medical appointments, dialysis treatments, public benefit offices (Medicaid, food stamps, Social Security, etc.), banks, etc. You can call them at 202-724-5626.

Finally, the “Call ‘N’ Ride” program provides discounted taxi services for residents over the age of 60.  Eligible seniors will be given “coupons” for rides. For more information, call the ADRC (Aging and Disability Resource Center) at 202-724-5626.

Washington DC Medicaid Eligibility

Eligibility for D.C. medical assistance programs is based largely on your income level and household size. If you have low income and are unable to pay your medical bills, it may be worth applying to find out if you are eligible. Applying is the only way to know for sure.

Washington DC Medicaid Eligibility

DC Health Care Alliance

If you don’t qualify for Medicaid but you live in Washington D.C. and need help with your medical bills, you may qualify for the DC Healthcare Alliance. The Alliance is a local program serving those who are not eligible for Medicare or Medicaid and have no other form of insurance. 

To be eligible, you must be at least age 21 and have income below 200% of the Federal Poverty Level. You also cannot have resources worth more than $4,000 for a single person or $6,000 for a couple or family. 

DC Alliance covers doctor visits, preventive care, prenatal care, prescription drugs, labs, medical supplies, and $1000 worth of dental services. It does not cover vision, mental health, non-emergency transportation, long-term care (more than 30 days), cosmetic surgery, open heart surgery, or transplants. 

You can apply for DC Health Care Alliance at any of the following locations. It may take up to 30 days to get an answer.

DC Medicaid Eligibility

Generally, the following groups can be eligible for DC Medicaid when couples with low-income:

  • Low-income Individuals
  • Kids in foster care or subsidized adoption, up to age 26
  • Kids and adults with disabilities
  • Pregnant women
  • Women with breast or cervical cancer
  • Low-income Medicare beneficiaries

You also must legally be a North Dakota resident and a U.S. citizen or lawful alien. 

The best way to find out for sure whether or not you are eligible is to go ahead and apply. There is no charge to complete the application.

The following are income limits for qualifying for DC Medicaid. Taxes, work expenses, health insurance premiums, dependent care expenses, child support, and other costs may not be counted.

DC General

1900 Massachusetts Ave., SE

Washington, DC 20003

Hunt Place Clinic

4130 Hunt Place, NE

Washington, DC 20019

Woodridge Clinic

2146 24th Place, NE

Washington, DC 20018

Anacostia Clinic

1328 W Street, SE

Washington, DC 20020

Southwest Community Clinic

850 Delaware Ave., SW

Washington, DC 20024

Greater Southeast Hospital

1310 Southern Ave., SE

Washington, DC 20032

Walker-Jones Clinic

1100 First St., NW

Washington, DC 20001

Medicare Games

DC Medicaid Application

The easiest way to apply for D.C. Medicaid is by visiting the D.C. Health Link website and creating an account. You can also apply for D.C. Medicaid in person sat your local IMA (Income Maintenance Administration) Service Center.

DC Health Link Medicaid

You can use DC Health Link to view plan information and apply for assistance (including Medicaid). You can also use it to renew your Medicaid benefits every year. If you need help, you can call the Health Link customer service line at 855-532-5465.

DC Medicaid Office Locations

The following service centers can help you complete your D.C. Medicaid application and answer your questions: 

  • Anacostia: 2100 Martin Luther King Avenue, SE (202-645-4614)
  • Congress Heights: 4049 South Capitol St., SW (202-645-4525)
  • Fort Davis: 3851 Alabama Avenue, SE (202-645-4500)
  • H Street: 645 H Street, NE (202-698-4350)
  • Taylor Street: 1207 Taylor Street, NW (202-576-8000)

How to get Both Medicare and Medicaid in D.C.

If you qualify for Medicare based on your age or disability status, and you also qualify for D.C. Medicaid, you might qualify for a Dual-Eligible Medicare Advantage Special Needs Plan, or DSNP. DSNPs can provide coverage for additional services and often come at no or very little cost.

You can qualify for Medicare by:

Think you’re eligible for both programs? Give us a call at 844-431-1832 for help finding a Special Needs Plan near you.

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