PDF download: What You Need to Know: DC Medicaid and Alliance – dhcf – DC.gov. 0000007272 00000 n The table below shows Medicaid’s monthly income limits by state for seniors. It allows children to be served at home by the family with additional supports, instead of in an institution. 0000006613 00000 n Because Medicaid is administered through the state and states determine eligibility, you will need to visit your state's Medicaid office or website to apply. The TEFRA/Katie Beckett is an eligibility pathway for the DC Medicaid Program for certain children with long-term disabilities or complex medical needs who live at home. Complete the DC Combined Application for Medical Assistance; Show proof that you live in DC; Show proof of any income or assets; If you have your Social Security Card, you must provide it during the interview; If you have a green card, you must provide your Alien Number or your Social Security Card; 0000036329 00000 n Informational Bulletins for LTC Providers, Important Notice for Primary Care Providers, DC HIE Onboarding Requirements for the Behavioral Health Transformation Rule, Medicaid Electronic Health Record Incentive Program, Americans with Disabilities Act Information, DHCF Notice of Non-Discrimination and Accessibility Requirements Statement, Individuals who are Aged, Blind, Disabled (ABD), Breast and Cervical Cancer Patients (Project Wish), Adults without Dependent Children (Childless Adults), Individuals who qualify for Emergency Medicaid, Children who qualify for TEFRA/Katie Beckett, Optional State Supplement Payment Program, Supplemental Security Income (SSI) Program, Individuals with high medical bills (Medically Needy Spend-Down), Qualified Medicaid Beneficiaries (QMB and QMB Plus), Individuals who need Long-Term Care Services: Intermediate Care Facility, Home and Community based Wavier Services, Nursing Home. 0000005341 00000 n If you have low income and are unable to pay your medical bills, it may be worth applying to find out if you are eligible. If an individual child is eligible for Medicaid … 0000006828 00000 n Social Services. However, if Public Works, Sanitation and Utilities. Medicaid eligibility is exceedingly complex and to provide the minute details is beyond the mission of this website. CareFirst CHPDC is the Washington DC provider of Medicaid and Alliance Benefits. %PDF-1.3 %���� 0000015599 00000 n 0000015520 00000 n Even if you were told you didn't qualify for Medicaid in the … 0000078987 00000 n Medicaid pays the medical bills of certain people who have low incomes. Applying is the only way to know for sure. Read Mayor Bowser’s Presentation on DC’s COVID-19 Situational Update: March 11 Medicaid is a wide-ranging health insurance program for low-income individuals of all ages. Washington, DC 20043-4768 ADA and Pharmacy Claim Forms P.O. First, find out if your state is expanding Medicaid and learn what that means for you. HBPE will provide individuals with temporary District Medicaid benefits. 0000001816 00000 n Box 34770 Washington, DC 20043-4770 837 Claim Transaction Attachments P.O. 0000001051 00000 n Department of Health Care Finance - User Logon. For the eligibility groups reflected in the table, an individual’s income, computed using the Modified Adjusted Gross Income (MAGI)-based income rules described in 42 CFR 435.603, is compared to the income standards identified in this table to determine if they are income eligible for Medicaid or CHIP. Providers are doctors, hospitals, and pharmacies who are enrolled with DC Medicaid. What Medicaid coverage is available for Breast and Cervical Cancer Patients? 0000002311 00000 n MAGI is used to determine financial eligibility for Medicaid, CHIP, and premium tax credits and cost sharing reductions available through the health insurance marketplace. However, income is not the only eligibility factor for Medicaid long term care, there are asset limits and level of care requirements. DC Medicaid Eligibility. 0000075747 00000 n If your state is expanding Medicaid, use this chart to see what you may qualify for based on your income and family size. Last updated: February 18, 2021. �� ?`KFy����x�8����1�l$�R�SLTH�H�@�7���a���z��&����23�Q�4e��J�V�Ջ���9y�1rJb����+8-�d��1%!�Y���e��^�"�[m x��>1Y=���Ծn┆$�8圬���wu�T�|�tmT�չ"�J3-Pnj����ŧ�*���?H&�G 4�R�U��5�� i6��}���^��:W��{�SD������,�oͣj��l�����U�W�t��=�c� ĸ�'��78����c��l1�>1p Pm�s��Ϫ�y����ߩ���m�j����.�y�P���t6�7�/D5�QD�2y�W"=��B�Ѕ�����x��}��V��p/�IyD$f) �I�eϝUAeS�`١r�h �SͮT�iېm��H�m[��d�$w���-��3y�L�i���f��l��%MY� �G�9�����M�ڐ;�U����l�\��-��-+��ɨi��S���� j�Xݕ��f*eg@'�^m��7���D1Y�Xc6֘�����2Zs.&��c@ yPf For those eligible for full Medicaid services, Medicaid pays healthcare providers. 2. Please join Medicaid Director Melisa Byrd for a virtual Medicaid Town Hall to learn more about upcoming changes to DC's Medicaid, Alliance, and Immigrant Children's Program. 0000002658 00000 n While there are differing eligibility groups, this page is focused strictly on Medicaid eligibility for Washington DC elders, aged 65 and over, and specifically fo… Coverage and care will not be interrupted. 0000002434 00000 n To be eligible for DC Medicaid, you must be a resident of the District of Columbia and must meet non-financial and financial eligibility requirements. 0000046178 00000 n �e�JU|����|SD� There is no age requirement for an individual who is statutorily blind or permanently and totally disabled. What if I am over-income for Medicaid? In DC, Medicaid Covers: DC Eligibility Levels 100% of FPL: $21,330 for a family of three; $12,490 for an individual of adult Medicaid enrollees are working in DC of children with special health care needs are covered by Medicaid in DC 62% 62% 26% 28% (as a % of FPL) of DC population is low-income (<200% FPL) of DC When applying you will need proof of income, residency, age, citizenship and/or immigration status for every member of … D.C. Medicaid Provider Inquiry Unit is available to assist you with information regarding billing, recipient eligibility or claims status. View the Guidance. Hospital Services Billing Codes and Reimbursement Rates for COVID-19 Vaccine Administration. The average cost of Skilled Nursing Care in District of Columbia is $121,368, so securing Medicaid coverage is essential. You must contact MTM (1-866-796-0601) or (202) 263-4640 (DC Office) 72 hours in advance of your scheduled appointment to arrange transportation to your medical appointment. View available state's eligibility verifications plans in the table below: Jointly funded by the state and federal government, health coverage is provided for varying groups of Washington DC residents, including pregnant women, parents and caretaker relatives, adults with no dependent children, disabled individuals, and seniors. Medicaid Eligibility Program Overview. Providers are doctors, hospitals and pharmacies who are enrolled with DC Medicaid. To contact them, call 1.202.906.8319 (inside of DC Metro) or 866.752.9233 (Outside DC Metro). It allows children to be served at home by the family with additional supports, instead of residing in an institution. 0000006423 00000 n Transportation and Motor Vehicles. Residency and Citizenship – the applicant must be a resident of Washington D.C. and a U.S. citizen or a lawful permanent resident who has lived in the U.S. for at least five years. Individuals who are Aged, Blind, Disabled (ABD) Breast and Cervical Cancer Patients (Project Wish) Adults without Dependent Children (Childless Adults) Medicaid benefits will stay the same, in fact beneficiaries may receive more services. All Late Breaking News>>. For those eligible for full Medicaid services, Medicaid pays healthcare providers. To be eligible for DC Medicaid, you must be a resident of the District of Columbia and must meet non-financial and financial eligibility requirements. Medicaid eligibility levels in DC are among the most generous in the nation, and about one in three DC residents is covered by Medicaid. endstream endobj 181 0 obj 190 endobj 150 0 obj << /Type /Page /Parent 146 0 R /Resources << /ColorSpace << /CS3 153 0 R /CS4 151 0 R /CS5 152 0 R >> /XObject << /Im5 175 0 R /Im6 176 0 R /Im7 177 0 R /Im8 178 0 R /Im9 179 0 R >> /ExtGState << /GS2 168 0 R /GS3 169 0 R >> /Font << /TT5 155 0 R /TT6 161 0 R /TT7 159 0 R /TT8 160 0 R /TT9 165 0 R >> /ProcSet [ /PDF /Text /ImageC /ImageI ] >> /Contents 156 0 R /MediaBox [ 0 0 612 792 ] /CropBox [ 0 0 612 792 ] /Rotate 0 /StructParents 0 >> endobj 151 0 obj [ /Indexed 153 0 R 255 167 0 R ] endobj 152 0 obj /DeviceGray endobj 153 0 obj [ /ICCBased 171 0 R ] endobj 154 0 obj << /Type /FontDescriptor /Ascent 905 /CapHeight 718 /Descent -211 /Flags 32 /FontBBox [ -665 -325 2028 1037 ] /FontName /DBOFBJ+Arial /ItalicAngle 0 /StemV 94 /XHeight 515 /FontFile2 170 0 R >> endobj 155 0 obj << /Type /Font /Subtype /TrueType /FirstChar 32 /LastChar 148 /Widths [ 278 0 0 0 556 0 0 0 333 333 0 0 278 333 278 0 556 0 556 556 556 556 556 0 556 556 0 0 0 0 0 0 0 667 667 722 722 667 611 778 722 278 0 0 0 833 0 0 667 0 0 667 611 722 0 944 0 667 0 0 0 0 0 0 0 556 556 500 556 556 278 556 556 222 0 500 222 833 556 556 556 556 333 500 278 556 500 722 500 500 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 333 333 ] /Encoding /WinAnsiEncoding /BaseFont /DBOFBJ+Arial /FontDescriptor 154 0 R >> endobj 156 0 obj << /Filter /FlateDecode /Length 157 0 R >> stream
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