District of Columbia Medicaid automatically covers infants born to pregnant women who were receiving Medicaid in DC on the date of delivery. This eligibility group is called “deemed newborns.” Medicaid eligibility continues for deemed newborns until the child’s first birthday, and citizenship documentation is not required.
Deemed Newborns are automatically eligible for Medicaid for twelve (12) months unless the child is no longer a DC resident. Medicaid eligibility for a deemed newborn must be renewed when the child reaches the age of one (1). The infant continues to be eligible as long as they meet the eligibility requirements for the children category. However, children who are determined eligible for Medicaid as deemed newborns are considered to have provided satisfactory documentation of citizenship and identity (by virtue of being born in the United States) and will not be required to further document citizenship or identity at any future Medicaid renewal.
Who is Eligible?
Deemed Newborns are eligible for Medicaid in the District, if:
- They are born to a woman determined eligible for Medicaid benefits on the date the child is born. (This includes a child who is born to a mother who is determined retroactively eligible for the date the child was born or to a non-citizen mother eligible for emergency services only); and
- They live in the District of Columbia
Other Newborns
Newborns are only eligible under the Deemed Newborn category if the pregnant woman was eligible for Medicaid on the date of delivery. Other newborns are not automatically eligible for Medicaid and cannot qualify for Medicaid under the Deemed Newborn category. They may be eligible under the Infant and Children eligibility category. The parent/caretaker relative would have to submit an application for health coverage to determine eligibility.
District of Columbia Medicaid provides medical coverage for newborns with family income of up to 319% of the Federal Poverty Level (FPL).
To find out more information about how your child may qualify for the DC Medicaid program under the children category, please select here.
The District covers this population with household income up to 319 % of the Federal Poverty Level
|
Category |
Newborns |
|
Threshold in FPL |
319% |
|
1 person household, monthly |
$4,003 |
|
2 person household, monthly |
$5,434 |
|
3 person household, monthly |
$6,864 |
|
4 person household, monthly |
$8,294 |
|
5 person household, monthly |
$9,724 |
|
6 person household, monthly |
$11,154 |
|
7 person household, monthly |
$12,585 |
|
8 person household, monthly |
$14,015 |
Figures compiled using 2024 FPL numbers distributed by the U.S. Department of Health and Human Services
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