If you are helping a DC parent qualify for long-term care, District of Columbia Medicaid limits countable assets to $4,000 and monthly income to $2,982 in 2026.

District of Columbia Medicaid is administered by the Department of Health Care Finance (DHCF), the District's state Medicaid agency. Financial eligibility is determined by the DC Department of Human Services, Economic Security Administration (ESA), while the Department of Aging and Community Living (DACL) runs aging and long-term care enrollment. DC is a Medicaid expansion jurisdiction, so coverage reaches childless adults up to 138% of the Federal Poverty Level with no asset test.

In This Guide

What District of Columbia Medicaid Covers

DC Medicaid covers the mandatory federal benefit categories along with a set of state-elected optional services. For seniors and people with disabilities, the coverage falls into three broad tracks:

  • Full-scope Medicaid for people who qualify on income, and for the aged, blind, and disabled (ABD) category
  • Long-term care, both nursing facility care and home and community-based services through the EPD Waiver
  • Medicare cost-sharing through the Qualified Medicare Beneficiary (QMB) program for people who also have Medicare

DHCF also administers the DC Alliance and the Immigrant Children's Program for residents who do not qualify for federally funded Medicaid.

For older adults, long-term care is the most financially significant benefit, and it carries its own asset and income rules covered below.

Who Runs DC Medicaid

Unlike a state, the District combines several agency roles under one government, but the Medicaid program is split across three offices:

  • DHCF is the District's state Medicaid agency. It sets policy, oversees the two Section 1915(c) waivers, and pays claims. Its Division of Long-Term Care (also called the Department of Long-Term Care, DLTC) operates the EPD Waiver day to day.
  • DHS Economic Security Administration (ESA) takes applications and determines financial eligibility. Applications, renewals, changes, and verifications all route through ESA's channels.
  • DACL connects older residents to long-term care. Its Medicaid Services Enrollment Unit coordinates and submits EPD Waiver applications and links enrollees to case management.

Appeals of an adverse decision go to a fourth, independent body: the DC Office of Administrative Hearings (OAH), which is separate from DHCF.

Who Qualifies for District of Columbia Medicaid

DC runs two distinct eligibility paths, and which one applies depends on why you are seeking coverage.

Modified Adjusted Gross Income (MAGI) adults (the Affordable Care Act (ACA) expansion group). Childless adults age 21 to 64 qualify with household income up to 138% of the Federal Poverty Level, a 133% threshold plus an across-the-board 5% income disregard, using 2026 FPL figures. This group has no asset or resource test. DC is a full expansion jurisdiction, so this is the standard 138% level rather than a higher local ceiling.

Aged, blind, and disabled (ABD) and long-term care. People seeking nursing facility care or waiver services are tested on both income and assets. In 2026, the countable resource limit is $4,000 for one person and $6,000 for a married couple; the home, one vehicle, and ordinary household and personal goods are excluded. On income, DC uses a Special Income Standard equal to 300% of the SSI federal benefit rate, which is $2,982 a month in 2026. Applicants whose income exceeds that limit but who have high medical expenses can still qualify through a Medically Needy spend-down, set at a Medically Needy income level of $856.90 a month for one person over a six-month budget period.

For the full income tables and the spend-down calculation, see DC Medicaid Eligibility & Income Limits.

Long-Term Care and the EPD Waiver

DC covers long-term care in two settings: nursing facilities and the community. The community option is the Elderly and Persons with Physical Disabilities (EPD) Waiver, a Section 1915(c) waiver overseen by DHCF and operated by its Division of Long-Term Care.

The EPD Waiver lets residents who would otherwise need nursing-home care receive services while living in their own home or in an assisted living community. It serves people who are a District resident and either 65 or older, or 18 to 64 with a physical disability, and who meet a nursing-facility level of need established through a provider order form and a face-to-face assessment by Liberty Healthcare. Covered services include case management, personal care aide services, personal emergency response systems, self-directed "Services MyWay," and assisted living. The waiver serves about 3,000 people.

Financially, an EPD applicant must have countable assets at or below $4,000 for an individual, and income at or below the 300%-of-SSI standard ($2,982 a month in 2026) or be able to meet a spend-down. DACL's published page still lists the older 2023 figure of $2,743 a month, which was 300% of that year's SSI rate; the standard rises each year with the SSI cost-of-living adjustment.,

A nursing facility resident keeps a Personal Needs Allowance of $109 a month, effective January 1, 2026, and contributes remaining income toward the cost of care.

See DC Medicaid Long-Term Care and the DC Medicaid HCBS Waivers guide for the full service lists and enrollment steps.

Medicare Savings Programs

For residents who have Medicare, DC administers a Medicare Savings Program as a single Qualified Medicare Beneficiary (QMB) program, and it sets that program's income ceiling far above the federal QMB standard. QMB in DC covers Medicare Part A and Part B premiums, deductibles, and coinsurance for Medicare-covered services, and it confers automatic Part D Extra Help.

DC sets QMB eligibility at income up to 300% of the Federal Poverty Level. With a $20 income disregard applied, the 2026 monthly income limits are $4,010 for a one-person household and $5,430 for a two-person household. DHCF's published QMB criteria list income as the financial test, not a resource limit. Because the 300%-FPL ceiling sits far above the federal thresholds for the Specified Low-Income Medicare Beneficiary (SLMB) and Qualifying Individual (QI) programs, DC's QMB captures the population those lower-benefit programs serve elsewhere.

Full details are in the DC Medicare Savings Programs guide.

Estate Recovery

After a beneficiary's death, DHCF must recover Medicaid long-term care costs from the estate of a person who received coverage at age 55 or older. The estate includes real and personal property, including a home, that does not pass to another person at death.

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 for undue hardship. The details, including how the homestead lien and hardship waiver work, are in the DC Medicaid Estate Recovery guide.

How to Apply for District of Columbia Medicaid

DC does not require an in-person interview for Medicaid. You can apply through any of the ESA channels below.

1
Step 1

Gather your documents

Collect proof of identity, District residency, income, and, for long-term care, asset statements and a record of any assets you have transferred or given away, which the agency reviews when you apply for long-term care.

2
Step 2

Choose a channel

Apply online at districtdirect.dc.gov, where you can also file renewals, changes, and verifications; by phone through the ESA Public Benefits Call Center at (202) 727-5355; by mail to the Department of Human Services, Economic Security Administration, Case Record Management Unit, P.O. Box 91560, Washington, DC 20090; or in person at any ESA Service Center.

3
Step 3

Complete the eligibility determination

ESA reviews your financial eligibility. For long-term care, DACL arranges the clinical level-of-need assessment.

4
Step 4

Await the decision

Respond promptly to any request for additional verification, then watch for the written eligibility notice.

If you disagree with a denial, reduction, or termination, you can request a fair hearing from OAH within 90 days of the postmark on the agency's notice, and you may keep your benefit during the review if you request the hearing before the notice period ends. See DC Medicaid Appeals & Fair Hearings.

Keeping the District of Columbia Medicaid Once You Have It

Coverage is not permanent once approved. Eligibility is re-checked on a recurring cycle, and missing that step is one of the most common ways people lose coverage they still qualify for.

DC Medicaid must first try to renew your coverage automatically from information it already holds, and may only request documents if it cannot. If it does need paperwork, it must send a renewal form and give you at least 30 days from the date of the form to return it. That duty, and the 90-day reconsideration window below, cover eligibility based on modified adjusted gross income (MAGI). If you qualify through age, disability, long-term care, a Medicare Savings Program, or the medically needy pathway, DC may offer the same windows but is not required to, so ask DC Medicaid what applies to you.

If coverage does close because a form went unreturned, that is not the end of it. Federal rules require the agency to reconsider your eligibility without a new application if you return the renewal form within 90 days of the termination (required for MAGI-based coverage; a state option otherwise).

Keep your mailing address current, open anything from DC Medicaid, and return the form by the deadline printed on it. See the District of Columbia Medicaid Recertification and Renewal for the full cycle.

Where to Get Help

Department of Health Care Finance (DHCF) The District's state Medicaid agency. Sets policy, oversees the EPD Waiver, and administers the QMB Medicare Savings Program. dhcf.dc.gov
DHS Economic Security Administration (ESA) Takes Medicaid applications and determines financial eligibility. Online applications run through districtdirect.dc.gov. (202) 727-5355 dhs.dc.gov
Department of Aging and Community Living (DACL) Connects older residents to long-term care and enrolls eligible applicants in the EPD Waiver through its Medicaid Services Enrollment Unit. dacl.dc.gov

Frequently Asked Questions

Who runs District of Columbia Medicaid?

DHCF is the District's state Medicaid agency and sets policy. DHS's Economic Security Administration takes applications and determines financial eligibility, and DACL handles long-term care enrollment for older residents.

What is the income limit for DC Medicaid?

It depends on the pathway. Childless adults 21 to 64 qualify up to 138% of the Federal Poverty Level with no asset test. Long-term care applicants use a Special Income Standard of 300% of the SSI federal benefit rate, $2,982 a month in 2026, with a Medically Needy spend-down at $856.90 a month for those over the limit.,

What is the asset limit for DC Medicaid long-term care?

$4,000 for one person and $6,000 for a married couple. The home, one vehicle, and ordinary household and personal goods are excluded.

Does DC Medicaid pay for home care instead of a nursing home?

Yes. The EPD Waiver covers home and community-based services, including personal care aide services and assisted living, for people who meet a nursing-facility level of need. It serves about 3,000 people and is run by DHCF's Division of Long-Term Care with enrollment through DACL.

How does DC help with Medicare costs?

Through the QMB program, which covers Medicare Part A and Part B premiums, deductibles, and coinsurance. DC sets the income ceiling at 300% of the Federal Poverty Level, with 2026 monthly limits of $4,010 for one person and $5,430 for a couple after a $20 disregard.

Learn More

MedicaidMedicaid by State: Eligibility, Coverage, and How to ApplyMedicaid works differently in every state, from who qualifies to what's covered and how to apply. See what varies and jump to your state's full guide. MedicaidDC Medicaid Long-Term CareDC Medicaid pays for long-term care in a nursing home or at home through the EPD Waiver. See the 2026 income standard and how to qualify in the District. MedicaidDC Medicaid HCBS Waivers: The EPD WaiverHow District of Columbia Medicaid HCBS waivers work in 2026: the EPD Waiver, who qualifies, what it covers, income and asset limits, and how to apply. MedicaidDC Medicaid Eligibility & Income LimitsDC Medicaid income limits for 2026: the 138% FPL adult cap with no asset test, the $4,000 asset limit, the $2,982 income standard, and spousal rules. MedicaidHow to Apply for DC MedicaidHow to apply for DC Medicaid: the four channels (District Direct, ESA, phone, mail), the documents to gather, timelines, and how to appeal a denial. MedicaidDC Medicare Savings ProgramsDC Medicare Savings Programs pay Medicare premiums, deductibles, and coinsurance. See the District's 2026 QMB income limits ($4,010 single) and how to apply. MedicaidDC Medicaid Estate RecoveryDC Medicaid estate recovery in 2026: what DHCF recovers, the age-55 trigger, the home lien, the spouse and disabled-child exemptions, and hardship waivers. MedicaidDC Medicaid Spousal Impoverishment ProtectionsDC Medicaid spousal impoverishment rules let the at-home spouse keep up to $162,660 in assets and $4,066.50 a month in income in 2026. Here is how it works. MedicaidDC Medicaid Personal Needs AllowanceDistrict of Columbia Medicaid lets a nursing-facility resident keep a $109 Personal Needs Allowance in 2026. Here's how it works and how it's protected.

Find personalized help understanding District of Columbia Medicaid eligibility and how to apply 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.

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