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||$2,082|
|2 person household, monthly||$2,818|
|3 person household, monthly||$3,555|
|4 person household, monthly||$4,292|
|5 person household, monthly||$5,028|
|6 person household, monthly||$5,765|
|7 person household, monthly||$6,502|
|8 person household, monthly||$7,238|
*figures compiled using 2019 FPL numbers distributed by the U.S. Department of Health and Human Services
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.