Washington, DC Medicaid
Medicaid, funded by both the federal and state governments, is an important health program for people with lower incomes, elderly people, some families with children, and people with disabilities.
The District of Columbia Department of Health administers Washington, DC Medicaid programs, and recipients must be American citizens or legal permanent residents living in Washington, DC, who fall into certain qualifying categories.
Qualifying categories for Medicaid eligibility include:
- the elderly
- the physically disabled
- the mentally disabled
- severely disabled children
- pregnant women
- low income adults
- low income children
Although income limits for various District of Columbia Medicaid programs vary substantially, all limits are tied to the Federal Poverty Level (FPL). For recipients who are aged or disabled, the income limit is currently set at 100% of the FPL for both single people and couples.
Medicaid in Washington, DC covers a wide range of medical services including:
- Laboratory and X-ray services
- Inpatient and outpatient hospital services
- Health screenings for children and treatment of detected medical problems
- Comprehensive dental services for children
- Adult medical and surgical dental services
- Nursing facility services for adults
- Health clinic services
- Prescription drugs
- Physical, occupational, or speech therapy for children
- Eye doctor visits and eyeglasses for children
- Medically-necessary transportation services
The DC Medicaid Fee-for-Service Member Handbook is a great resource for further information about services covered or not covered by DC Medicaid, copayments, income and asset limits, and any other aspects of Washington, DC Medicaid that you may wish to know more about.
Some people are eligible for both Medicare and Medicaid. In such cases, Medicare is the primary payer.
DC Medicaid offers assistance to Qualified Medicare Beneficiaries (QBM). Medicare recipients with incomes up to $32,490 for a single-person household qualify for payment of Medicare Part B premiums and Medicare copayments and deductibles. QMB status also ensures that you will receive extra help with Medicare Part D prescription drug costs. See pages 43 and 44 of the Member Handbook for more information about QBM benefits.
If you are eligible for both Medicare and Washington, DC Medicaid, looking into Medicare Advantage plans may be a wise move. Medicare Advantage can offer increased coverage and security to dual eligible individuals, and some Medicare Advantage plans are available premium-free. Most Medicare Advantage plans include prescription drug benefits.
Call MedicareMall toll-free at 1-877-413-1556 for help determining whether Medicare Advantage is right for you.
For more information about Medicaid in Washington, DC, contact the DC Department of Health at 1-202-442-5999. If you have any further questions about senior healthcare including Original Medicare Part A and Part B, Medicare Advantage, or Medicare supplement plans, contact a licensed, bonded MedicareMall representative and let us lead you with confidence through the Medicare maze!
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