District of Columbia Medicaid

Last verified: June 2026

What is DC Medicaid?

DC Medicaid is administered by the Department of Health Care Finance (DHCF). DC operates one of the most generous Medicaid programs in the country — it covers adults up to 215% of the Federal Poverty Level, children and pregnant women up to 319% FPL. These thresholds are significantly higher than the ACA expansion standard of 138% FPL used in most states.

Approximately 280,000 District residents are enrolled — roughly 40% of DC's population. That proportion makes DC's Medicaid reach among the highest of any U.S. jurisdiction by percentage of population served.

DC delivers Medicaid through managed care organizations (MCOs). DHCF contracts with AmeriHealth Caritas DC, MedStar Family Choice, and UnitedHealthcare Community Plan for DC Healthy Families, which is the managed care program covering most Medicaid enrollees. Members are enrolled in one of these MCOs and receive coordinated care through the plan's provider network.

Who qualifies for DC Medicaid?

DC uses its own income thresholds, which exceed federal minimums. Per DHCF, any person who meets the eligibility requirements can receive DC Medicaid — there is no restriction based on age, race, or sex, only income, residency, and citizenship or immigration status.

• Adults ages 19–64: at or below 215% FPL — significantly above the 138% ACA expansion standard
• Children under age 19: at or below 319% FPL (through DC Healthy Families)
• Pregnant women: at or below 319% FPL
• Seniors and people with disabilities: separate eligibility pathway through DHCF
• SSI recipients: automatically eligible
• People with intellectual or developmental disabilities: IDD Waiver
• Elderly and people with physical disabilities: EPD Waiver

Source: DHCF Medicaid page (dhcf.dc.gov/service/medicaid). Apply at DHS Income Maintenance Administration (IMA) Service Centers or call (202) 727-5355 to locate your nearest service center.

DC Healthy Families: managed care for DC Medicaid members

Most DC Medicaid enrollees receive care through DC Healthy Families, the managed care program. When enrolled, members choose one of three MCOs — AmeriHealth Caritas DC, MedStar Family Choice, or UnitedHealthcare Community Plan. Each MCO has its own provider network, member services phone number, and care coordination approach.

Most DC Medicaid recipients have freedom of choice in selecting their doctor or clinic, per DHCF — but the provider must be enrolled with DC Medicaid and willing to accept payment. Not all providers accept DC Medicaid despite the program's relatively higher reimbursement rates compared to some states.

What DC Medicaid covers

Per DHCF, DC Medicaid covers a comprehensive set of services. The coverage list is broader than many state programs.

• Doctor visits and physician services
• Inpatient hospital care
• Eye care
• Dental services and related treatment
• Ambulatory surgical center services
• Emergency ambulance
• Dialysis services
• Durable medical equipment
• Hospice services
• Laboratory and radiology
• Mental health services
• Home and Community Based Services (HCBS)
• Transplants (where medically necessary)

Source: DHCF Medicaid page (dhcf.dc.gov/service/medicaid).

District of Columbia Medicaid topics

What does DC Medicaid cover?

Medicaid covers a broad range of health services. Federal law mandates certain benefits — inpatient and outpatient hospital care, physician services, lab work, X-rays, and nursing facility services, among others. States add optional services on top of those. Dental, vision, and long-term home care coverage vary by state.

The national benefits overview lists required and commonly optional services. Check the DC Medicaid website for the current state-specific benefit package.

How to apply

Most people can apply online through District of Columbia's Medicaid portal, by phone, or in person at a local eligibility office. The how to apply page walks through each method, what documents you'll need, and what to expect during the review period.

Under 42 CFR 435.912, states must process most standard Medicaid applications within 45 days (90 days for disability-based applications). District of Columbia must follow that federal timeline.