Applying for Medicaid in the District of Columbia can be done through various channels. One option is to submit an online application using the District of Columbia Health Exchange website. Alternatively, individuals can fill out a paper application, which is available at locations such as community health centers and libraries. If help is needed, applicants can call the D.C. Health Benefit Exchange Call Center or schedule an in-person appointment at a D.C. Health Link Storefront location. The application process typically involves providing personal and financial information, proof of identity and residency, and information about household members. The application is reviewed to determine eligibility, and applicants are notified about the outcome.
Medicaid Eligibility Requirements in District of Columbia
Medicaid is a government-sponsored health insurance program that provides coverage to low-income individuals and families. To be eligible for Medicaid in the District of Columbia, you must meet the following requirements:
- Be a District of Columbia resident.
- Be a U.S. citizen or a qualified non-citizen.
- Meet income and asset limits.
- Be pregnant, a child under 19, a parent or caretaker of a child under 19, disabled, or elderly (age 65 or older).
- Not be eligible for Medicare.
The income and asset limits for Medicaid eligibility in the District of Columbia are as follows:
| Household Size | Income Limit | Asset Limit |
|---|---|---|
| 1 | $17,715 | $2,500 |
| 2 | $23,790 | $3,500 |
| 3 | $29,865 | $4,500 |
| 4 | $35,940 | $5,500 |
| 5 | $42,015 | $6,500 |
| 6 | $48,090 | $7,500 |
| 7 | $54,165 | $8,500 |
| 8 | $60,240 | $9,500 |
If you meet the eligibility requirements, you can apply for Medicaid online, by mail, or in person at a local Department of Human Services office. You will need to provide proof of your identity, income, and assets. You may also need to provide proof of your pregnancy or disability.
Once you have applied for Medicaid, you will be notified of your eligibility decision within 45 days. If you are approved for Medicaid, you will receive a Medicaid card that you can use to get health care services.
Applying for Medicaid in the District of Columbia
Applying for Medicaid in the District of Columbia is easy. Follow these simple steps to apply online, by mail, or over the phone.
Documents Needed to Apply for Medicaid in the District of Columbia
You may need the following documents to apply for Medicaid in the District of Columbia:
- Copy of social security card
- Birth certificate
- Driver’s license or ID
- Proof of income
- Proof of residency
- Proof of pregnancy if applicable
- Information about health insurance and coverage
- Proof of disability if applicable
- Proof of child support
- Proof of assets
You can apply for Medicaid in the District of Columbia online, by mail, or over the phone.
Online: You can apply online at: https://dhs.dc.gov/service/apply-health-care-coverage
By mail: You can mail your application to: DC Health Benefit Exchange, P.O. Box 17304, Baltimore, MD 21297-1304
Over the phone: You can apply over the phone by calling 1-855-532-5465.
| Income | Assets | |
|---|---|---|
| Adults | Less than 138% of the Federal Poverty Level (FPL) | Less than $2,000 for individuals and $3,000 for couples |
| Children | Less than 138% of the FPL | No asset limit |
| Pregnant Women | Less than 185% of the FPL | No asset limit |
Application Process for Medicaid in District of Columbia
The District of Columbia offers a variety of Medicaid programs to provide healthcare coverage to eligible individuals and families. The application process for Medicaid in the District of Columbia is designed to be straightforward and user-friendly. Individuals can apply online, by mail, or in person at a local Department of Human Services (DHS) office. The following information provides an overview of the application process and eligibility requirements.
Who is Eligible for Medicaid in the District of Columbia?
- Individuals and families with low incomes
- Pregnant women
- Children under the age of 19
- Disabled individuals
- Elderly adults
- Individuals receiving Supplemental Security Income (SSI)
What Documents Are Required to Apply for Medicaid in the District of Columbia?
- Proof of identity (e.g., driver’s license, Social Security card)
- Proof of income (e.g., pay stubs, tax returns)
- Proof of assets (e.g., bank statements, investment account statements)
- Proof of citizenship or lawful immigration status (e.g., birth certificate, passport, naturalization certificate)
- Proof of residency in the District of Columbia (e.g., utility bill, rental agreement)
How to Apply for Medicaid in the District of Columbia
Online Application
- Visit the DHS website and click on the “Apply for Benefits” link.
- Select the “Medicaid” program and click on the “Apply Now” button.
- Create an account and provide your personal information, including your name, address, and contact information.
- Answer the questions about your income, assets, and household members.
- Upload any required documents.
- Review your application and submit it.
Mail Application
- Download and print the Medicaid application form from the DHS website.
- Fill out the application completely and sign it.
- Attach copies of the required documents.
- Mail the completed application and documents to the DHS office.
In-Person Application
- Visit a local DHS office.
- Ask for a Medicaid application form.
- Fill out the application completely and sign it.
- Provide copies of the required documents.
- Submit the completed application and documents to a DHS staff member.
Note: The application process may take several weeks to complete. Applicants will be notified by mail or email when their application has been processed and a decision has been made.
What Happens After I Apply for Medicaid in the District of Columbia?
- DHS will review your application and determine if you are eligible for Medicaid.
- If you are eligible, you will receive a Medicaid card in the mail.
- Your Medicaid coverage will start on the first day of the month following the date your application is approved.
What Can I Do if My Medicaid Application is Denied?
- You can appeal the denial of your Medicaid application.
- To appeal, you must file a written request for a hearing with DHS within 30 days of receiving the denial notice.
- At the hearing, you will have the opportunity to present evidence and argue your case.
- The hearing officer will make a decision on your appeal within 90 days.
Additional Resources
- DHS website
- Medicaid application form
- Medicaid appeal form
Steps After Applying for Medicaid in District of Columbia
Once you have applied for Medicaid in District of Columbia, there are a few things you should do to follow up and make sure your application is processed successfully.
- Keep track of your application. Make sure you have a copy of your completed application and any supporting documents you submitted. You should also keep track of the date you applied and the Medicaid case number that was assigned to you.
- Follow up with the Medicaid office. If you have not heard back from the Medicaid office within 45 days of applying, you should call or visit the office to check on the status of your application. You can also check the status of your application online at the District of Columbia Medicaid website.
- Attend any required interviews or hearings. If the Medicaid office needs more information from you, they may schedule an interview or hearing. Be sure to attend all scheduled appointments and bring any requested documentation with you.
- Be prepared to pay for medical expenses. If you are approved for Medicaid, you may be responsible for paying a small copayment for some medical services. You should also be prepared to pay for any medical expenses that are not covered by Medicaid, such as dental care or vision care.
| Income Level | Medicaid Coverage |
|---|---|
| Up to 138% of the Federal Poverty Level (FPL) | Full Medicaid coverage |
| 139% to 400% of the FPL | Partial Medicaid coverage (also known as CHIP) |
| Over 400% of the FPL | Not eligible for Medicaid |