What is the DC Healthcare Alliance?
The DC Healthcare Alliance Program (“the Alliance”) is a locally-funded program designed to provide medical assistance to District residents who are not eligible for Medicaid. The Alliance program serves low-income District residents who have no other health insurance and are not eligible for either Medicaid or Medicare.
To be eligible for the DC Healthcare Alliance, you must be a resident of the District of Columbia, meet financial eligibility requirements, not have any other health or medical health coverage and complete a face- to-face interview.
Who is eligible for DC Healthcare Alliance?
You may be eligible for DC Healthcare Alliance, if you:
- Are twenty-one (21) and older;
- Are a District resident;
- Have income at or below 200% of the federal poverty level (“FPL”) ( see chart below);
- Have resources (for example, a bank account) at or below $4,000 for one person and $6,000 for couple or families; and
- Have no health insurance, including Medicare and Medicaid.
What are some of the services that DC Healthcare Alliance covers?
- Doctor visits
- Preventive care (checkups, diet and nutrition)
- Prenatal care (pregnancy)
- Prescription drugs
- Laboratory services
- Medical supplies
- Dental Services up to $1000
What are some of the services that DC Health Care Alliance does not cover?
- Any service provided by a healthcare professional outside of the MCOs provider network
- Vision care
- Mental/Behavioral health and substance abuse services
- Non-emergency transportation services
- Long term care services that extend more than 30 days
- Cosmetic Surgery
- Open Heart Surgery
- Organ transplantation
The District covers this population with household incomes up to 200% of the Federal Poverty Level (FPL):
|Category||DC Health Care Alliance Program|
|Threshold in FPL||200|
|1 person household, monthly||$1,945|
|2 person household, monthly||$2,622|
|3 person household, monthly||$3,298|
|4 person household, monthly||$3,975|
|5 person household, monthly||$4,652|
|6 person household, monthly||$5,328|
|7 person household, monthly||$6,005|
|8 person household, monthly||$6,682|
How are services received?
Once you have been determined eligible for DC Healthcare Alliance, you will be automatically assigned to a managed care health plan. You have 90 days to request a change in your managed care providers. The Alliance does not allow providers (doctors, hospitals and managed care organizations) to charge co-payments or fees for health services.
DC Healthcare Alliance program enrollees are not eligible for retroactive coverage.