District of Columbia Medicaid income limits
Last verified: June 2026
Verify current limits with DC Medicaid
DC uses its own income thresholds — adults qualify at 215% FPL, far above the 138% ACA standard
DC Medicaid income limits by coverage group (2026)
| Coverage group | FPL threshold | Monthly limit (household of 1, approx.) |
|---|---|---|
| Adults ages 19–64 | 215% FPL | ~$2,862/mo |
| Children under age 19 (DC Healthy Families) | 319% FPL | ~$4,243/mo |
| Pregnant women | 319% FPL | ~$4,243/mo |
| Seniors and people with disabilities | Separate rules apply | Contact DHCF |
Source: DHCF Medicaid page. Monthly figures are approximate based on 2026 HHS Federal Poverty Guidelines (48-state standard). Verify exact current figures with DHCF at (202) 727-5355.
Why DC uses higher income thresholds than most states
DC established its Medicaid income thresholds before and separate from the ACA expansion framework. As a result, DC's adult income threshold (215% FPL) has exceeded the ACA expansion standard (138% FPL) for years. DC is not bound by the ACA expansion's minimum threshold — it sets its own ceiling using its own Medicaid state plan.
For children and pregnant women, DC's 319% FPL threshold is among the highest in the country alongside Vermont (312% FPL for children). This means a family of four with a household income of approximately $110,000 per year qualifies their children for DC Medicaid — a coverage level that would constitute upper-middle income in most states but reflects DC's cost of living and policy choices.
No asset test for DC Medicaid MAGI groups
MAGI-based DC Medicaid — covering adults, children, and pregnant women — does not use an asset test. Long-term care Medicaid (Elderly and Physical Disabilities waiver, IDD waiver) applies separate financial eligibility rules. Contact DHCF at (202) 727-5355 for LTC eligibility details.
How Medicaid income limits work
Medicaid eligibility is tied to the Federal Poverty Level (FPL), a measure the Department of Health and Human Services updates each January. States set their income limits as a percentage of FPL — so when FPL increases, the dollar thresholds for Medicaid also shift.
The Affordable Care Act established a standard income methodology called Modified Adjusted Gross Income (MAGI) for most Medicaid applicants. Under MAGI, the agency counts wages, salaries, self-employment income, Social Security benefits, and most other taxable income. Assets — a savings account, vehicle, home — are not counted for MAGI-based programs. That changed with the ACA and applies in all states.
States that expanded Medicaid under the ACA cover most adults at or below 138% FPL. In non-expansion states, income limits for adults without dependent children are far lower — sometimes as low as a few hundred dollars per month — or eligibility for that category simply doesn't exist.
These are federal guidelines — state limits may differ
What counts as income under MAGI
MAGI (Modified Adjusted Gross Income) is the income standard for most Medicaid applicants — children, adults under 65, pregnant women, and parents. It includes wages, salary, tips, self-employment income, unemployment benefits, Social Security retirement and disability benefits (SSDI), and most other taxable income.
It does not count child support received, gifts, loans, inheritances that are not generating income, or Supplemental Security Income (SSI) payments. One key MAGI rule: the ACA added a 5% FPL income disregard for most adults, which effectively raises the usable threshold by that amount. So a state with a 133% FPL limit effectively covers adults to about 138% FPL after the disregard.
Assets — a bank account, car, or home — are not counted for MAGI-based programs. That's a major difference from old-law Medicaid, where asset tests were common. If you previously didn't qualify because of assets, your eligibility may have changed after the ACA.
Asset limits and long-term care Medicaid
MAGI-based programs have no asset test. But Medicaid programs that cover long-term care — nursing home care, home and community-based services for seniors — use the old income and asset methodology, which does include asset limits.
Asset limits for long-term care Medicaid vary by state and are updated periodically. Generally, countable assets above the limit must be spent down before an applicant qualifies. Exempt assets — the primary home (in most circumstances), one vehicle, and certain personal property — are not counted.
Specific asset limits for District of Columbia's long-term care programs are on the seniors and long-term care page. The thresholds change, so verify current figures with DC Medicaid directly.