How to get Medicaid or low-cost care in Washington, DC

DC Medicaid in plain words

Medicaid is a program that pays for health care for people with low incomes. In the District the program is called DC Medicaid, and the Department of Health Care Finance, or DHCF, runs it. KFF, a health research group, lists DC among the places that have expanded Medicaid.

The income limit for adults changed on January 1, 2026. DHCF says the limit is now 138 percent of the federal poverty level for parents, caretakers and adults without children. That figure already includes a 5 percent allowance. The federal poverty level is a yearly dollar amount the government uses to measure poverty. For one person the monthly limit is $1,800, and for a household of four it is $3,697.

Before that date, the District allowed higher incomes for these adults. DHCF told people above the new limit that their Medicaid would end on December 31, 2025. It said it would send their files to DC's health insurance exchange, which is described below. If that happened to you, our guide on who qualifies for Medicaid can help you check the other groups.

Where to apply

DHCF lists District Direct as the place for applications and for updates to your account. It has a website and an app for phones. You can also apply in person at an Income Maintenance Administration service center, which is a District office that handles public benefits. For phone help, call the Public Benefits Call Center at 202-727-5355. The center is open from 7:30 a.m. to 4:45 p.m., and callers who use a relay service can dial 711.

A third route is DC Health Link, the District's health insurance marketplace. People can check there whether they qualify for a tax credit or for Medicaid. If you earn too much for Medicaid, you can buy a private plan there. Its customer service line is 855-532-5465. It is open from 8 a.m. to 6 p.m., Monday through Friday.

Medicaid has no sign-up season, so you can apply in any month. The guide to how to apply for Medicaid lists the papers to gather. If a problem comes up along the way, you can reach the DC Health Care Ombudsman at 202-724-7491.

How the DC Health Care Alliance works

The DC Health Care Alliance is a separate program for DC residents who have no health insurance, including no Medicare or Medicaid. Your income must be below a limit that the District sets. DHCF says you can submit an application at any enrollment location on its list, and the answer usually takes about 45 days. Members get a card, and they fill out a form every 12 months to show they still qualify.

To learn the current income limit, call the Income Maintenance Administration at 202-727-5355. Being enrolled in the Alliance also counts toward the District's coverage rule, which is explained next.

DC has its own health coverage rule

The District has a coverage rule of its own. DC Health Link says all DC residents must have health coverage or pay a tax penalty for the months they go without it. The federal penalty is zero, but the District's penalty is not zero, and you pay it through your DC taxes. For the national picture, read whether it is illegal to go without insurance.

For 2026, going without coverage for the full year costs the greater of two amounts. One is $845 per adult and $422.50 per child, up to $2,535 per family. The other is 2.5 percent of family income above the filing threshold. You do not owe the penalty if you are uninsured for fewer than three months in a row. Exemptions also exist for low income and for Alliance members, and hardship exemptions need approval from DC Health Link.

The 2027 work rule

DHCF says work requirements begin on January 1, 2027. The federal rule asks adults ages 19 to 64 in the expansion group for 80 hours a month of work, training, volunteering or similar activity. The federal wording lists exceptions, and those include pregnant people and people with serious health problems, as well as parents and caregivers of a child 13 or younger.

DHCF says it will share more details later. You can call it at 202-442-5988 on weekdays, and you should keep your District Direct contact information up to date so notices reach you. The Medicaid work requirement guide explains how proof usually works.

Health centers and checking a doctor

Community health centers get federal money and serve everyone, and they set your price by your income and family size. Use the free Find a Health Center tool from the Health Resources and Services Administration and enter your zip code. Then ask each center about its sliding fee and what to bring to a first visit. Our guide to sliding-scale clinics can help you compare prices.

DC Health runs a Licensure Lookup System, also labeled Search for a Health Professional, on its Board of Medicine page. You can use it to check a doctor's license, and the licensing help line is 877-672-2174.

Direct primary care and emergency care in the District

Some doctors in the District charge a flat monthly fee for primary care, which is called direct primary care. The doctor does not bill insurance for those visits, and the fee does not cover the emergency room or a hospital stay. You can search our directory of cash-pay doctors.

In an emergency, call 911 or go to the nearest emergency room. Hospitals in the District that have an emergency room must examine you by federal law, insured or not. If a bill arrives later, our guide to hospital financial assistance shows how to ask for help.