DC Medicaid Income Limits 2026: Eligibility and Asset Rules

DC Medicaid income limits split by age: a working-age adult is measured on income with no asset test, while a senior needing long-term care faces a $4,000 asset limit. That senior also meets a separate income standard, and the two tracks otherwise work very differently depending on your age and why you need coverage.1,2

In This Guide

• DC Medicaid income and asset limits in 2026: the numbers that matter
• DC Medicaid Income Limits for Working-Age Adults
• Which Income Test Applies to a Senior
• The DC Medicaid Asset Limit for Long-Term Care, and What Does Not Count
• How DC Medicaid Income Limits and Spend-Down Work for Long-Term Care
• What a Nursing-Home Resident Keeps
• Protecting the Spouse Who Stays Home
• If You Also Have Medicare
• After Death: Estate Recovery
• How to Apply in the District
• Frequently Asked Questions
• Learn More

DC Medicaid Income Limits for Working-Age Adults

Most people searching "DC Medicaid income limits" are not pricing a nursing home. They are a working-age adult, often uninsured and asking a simple question: does my paycheck qualify me? For them the rule is short.

The District adopted the Affordable Care Act Medicaid expansion, so an adult age 21 to 64 without dependent children is covered up to 138% of the federal poverty level (a 133% threshold plus a 5-percentage-point income disregard).1,4 For 2026, the poverty guideline is $15,960 a year for one person, so 138% works out to roughly $22,000 a year, about $1,835 a month.5 The ceiling rises with household size.

Two features set this pathway apart from the long-term-care rules further down:

• There is no asset test. This track uses Modified Adjusted Gross Income (MAGI), and federal law bars states from applying any resource or asset test to the MAGI groups. Your bank account, your car, and your retirement savings do not count. The District's Department of Health Care Finance (DHCF), which administers DC Medicaid, confirms on its eligibility page that there is no resource limit for this group.1,4
• Income is measured the tax way. MAGI counts income by tax rules, with only the single across-the-board 5% deduction rather than the SSI-style disregards the aged-and-disabled track allows.1,4

Turning 65 or enrolling in Medicare closes this door. The expansion adult group is written for people under 65 who are not enrolled in Medicare, so reaching either milestone ends eligibility on this pathway even if your income never changes.4 At that point the District assesses you on the Aged, Blind, and Disabled track described below, whose SSI-related rules key off the far lower SSI benefit rate of $994 a month for an individual (the long-term-care income standard itself is set at 300% of that rate, $2,982, covered below), and which does apply an asset test.2

Which Income Test Applies to a Senior

The percentage-of-poverty-level figure above is the MAGI test. It governs coverage for working-age adults, children, and pregnant applicants, not the long-term-care pathway a senior usually needs.

A senior applying for nursing-facility care or a home-and-community-based waiver is assessed on the Aged, Blind, and Disabled (ABD) pathway, which uses Supplemental Security Income-related rules. That pathway is where the $4,000 asset limit and the District's income standard and spend-down apply.2 If you are pricing long-term care for a parent, the ABD rules on this page are the ones that matter, not the MAGI poverty-level chart.

The DC Medicaid Asset Limit for Long-Term Care, and What Does Not Count

For long-term-care Medicaid in the ABD category, the District limits countable resources to $4,000 for one person and $6,000 for a married couple.2

DHCF excludes the home, one vehicle, and ordinary home and personal goods from the count, so the $4,000 applies only to the remainder: bank accounts, a second vehicle, and investments, not the roof over your head or the car in the driveway.2 The same $4,000 / $6,000 limit applies whether the care is delivered in a nursing facility or at home through the District's Home and Community-Based Services waiver.2

That resource limit is low, while the income limits on the long-term-care side, covered next, are set considerably higher.

How DC Medicaid Income Limits and Spend-Down Work for Long-Term Care

The District runs long-term-care Medicaid on two income pathways at once, and an applicant qualifies through whichever fits.

The first is a Special Income Standard set at 300% of the SSI federal benefit rate, or $2,982 per month in 2026.2 An applicant whose countable monthly income is at or below that figure meets the income test for institutional care and for the District's waiver.

The second is a Medically Needy spend-down for applicants whose income runs above the Special Income Standard but who have high medical and care expenses. The District sets its Medically Needy income level at $856.90 per month for one person, measured over a six-month budget period.2 An over-income applicant qualifies by incurring medical costs that bring countable income down toward that level, rather than being turned away.

Because the District operates both a Special Income Standard and a Medically Needy spend-down, it is neither a pure income-cap jurisdiction nor a pure medically-needy one. A high monthly income does not, by itself, shut you out of long-term-care Medicaid in the District. For a fuller walk-through of the care settings this covers, see our guide to DC Medicaid long-term care.

Care at home: the EPD Waiver

Long-term care in the District is not limited to a nursing home. The Elderly and Persons with Physical Disabilities (EPD) Waiver, operated by the Department of Long-Term Care (DLTC) within DHCF, lets a resident who would otherwise need nursing-home care receive services at home or in an assisted-living community instead.6 The District's EPD Waiver serves roughly 3,000 people, covering personal care and assisted living among other services.6 The same $2,982 income standard and $4,000 asset limit that govern nursing-facility eligibility apply to the waiver.7,2 Our DC Medicaid HCBS waivers guide covers how the waiver works in detail.

The five-year look-back

The District reviews asset transfers made in the 60 months before a long-term-care application.8 Giving away money or property for less than fair market value during that window, such as signing a house over to a child for a dollar, can trigger a penalty period during which Medicaid will not pay for long-term-care services even though you are otherwise eligible.8

There are legitimate exceptions (transfers between spouses, transfers to a disabled child) and legitimate planning approaches, but anything done inside the five-year window deserves an elder-law attorney's review first. If long-term care is on the horizon for someone in your family, talk to a professional before moving assets.

What a Nursing-Home Resident Keeps

When DC Medicaid pays for nursing-facility care, the resident contributes almost all of their monthly income toward the cost of that care. What they keep is the Personal Needs Allowance (PNA): money reserved for small personal expenses like clothing, a haircut, or a phone card. Effective January 1, 2026, the District sets its PNA at $109 per month, well above the federal floor of $30.2,9

Everything above the $109 allowance and other recognized deductions (such as a community-spouse allowance and certain health-insurance premiums) goes toward the monthly bill, with Medicaid covering the balance.2 For the national picture on how this allowance is calculated, see our explainer on the Medicaid Personal Needs Allowance.

Protecting the Spouse Who Stays Home

When one spouse needs long-term care and the other remains in the community, federal spousal-impoverishment rules keep the at-home spouse from being left destitute. These rules govern long-term-care Medicaid in every state and the District, using the same 2026 federal figures.

For 2026, the at-home spouse can keep countable assets from a $32,532 minimum up to the $162,660 federal maximum, and monthly income up to the $4,066.50 maximum allowance.3 On the home, the federal home-equity limit for 2026 starts at a $752,000 minimum, and a state may elect a higher amount up to $1,130,000; equity above the applicable limit bars eligibility for long-term-care assistance.8

If You Also Have Medicare

Many seniors reach the District's long-term-care rules already on Medicare. If your income is too high for full Medicaid but still modest, the District's Medicare Savings Program can pay your Medicare costs. DC runs it as the Qualified Medicare Beneficiary (QMB) program, and sets the income ceiling at up to 300% of the federal poverty level, which with a $20 income disregard works out to $4,010 a month for one person and $5,430 for a couple in 2026.10 QMB pays your Medicare Part A and Part B premiums, deductibles, and coinsurance, and enrolls you automatically in Part D Extra Help.10 See our DC Medicare Savings Programs guide for the full rules.

After Death: Estate Recovery

Like every state, the District runs a Medicaid estate-recovery program. After a recipient who was 55 or older and received long-term-care services dies, DHCF must seek repayment from the estate, which includes a home that does not pass to another person at death.11 Federal law requires recovery for this age group to cover nursing-facility services, home and community-based services, and related hospital and prescription-drug costs.8

DHCF will not pursue recovery while a surviving spouse, a child under 21, or a blind or disabled child lives in the home, and the District must waive or reduce its claim in cases of undue hardship.11 For how estate recovery works nationally and where families have room to plan, see our Medicaid estate recovery explainer.

How to Apply in the District

DC Medicaid is administered by DHCF, but eligibility for the long-term-care and ABD pathways is determined by the Department of Human Services Economic Security Administration (ESA). The District does not require an in-person interview.12

If your application is denied or your coverage is reduced, you have the right to a fair hearing, and you have 90 days from the postmark on the notice to request one from the DC Office of Administrative Hearings.13 That is the full federal maximum: 42 CFR 431.221 caps the request window at 90 days from the date the notice is mailed and lets a state set a shorter one, and the District allows the full 90.13 Count from the postmark, not the day it reached your mailbox. One caution if you are already covered: keeping the benefit while the hearing is reviewed means requesting it before the notice's 30-day period ends, well short of 90 days.13 Our guide to DC Medicaid appeals and fair hearings covers the process in full.

Where to Get Help

Learn More

Find personalized help working through DC Medicaid income and asset limits for your family at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.