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Health Care Alliance

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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:

  1. Are twenty-one (21) and older;
  2. Are a District resident;
  3. Have income at or below 200% of the federal poverty level (“FPL”) ( see chart below);
  4. Have resources (for example, a bank account) at or below $4,000 for one person and $6,000 for couple or families; and
  5. 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 

Income Threshold

 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. 

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