Washington, D.C. Medicaid for Senior Care
Complete guide to Medicaid eligibility, coverage, and application process for nursing homes, assisted living, and home care in Washington, D.C..
7.6 million Medicaid long-term care recipients nationwide
DC Department of Health Care Finance
Processing Time
30-45 days for standard Medicaid; EPD Waiver enrollment typically occurs within 45-60 days of Medicaid approval
Washington, D.C. Medicaid Eligibility Requirements (2026)
To qualify for Medicaid long-term care in Washington, D.C., applicants must meet both financial eligibility criteria (income and assets) and medical criteria (level of care needs). Washington, D.C. follows federal Medicaid guidelines with some state-specific variations.
Income Limits
Individual Applicant
$2,982/month
Married Couple (One Applying)
$5,964/month
Income includes Social Security, pensions, annuities, interest, dividends, and rental income.
Asset Limits
Individual Applicant
$4,000
Community Spouse (At-Home Spouse)
$6,000
Primary residence, one vehicle, personal belongings, and prepaid burial arrangements are exempt from asset limits.
5-Year Look-Back Period
Washington, D.C. Medicaid reviews all financial transactions for the 60 months prior to application. Asset transfers or gifts during this period can result in a penalty period of Medicaid ineligibility. The penalty is calculated by dividing the transferred amount by $13,422/month average (semi-private), $14,733/month (private) (the average monthly nursing home cost in Washington, D.C.).
Medical Eligibility
Applicants must demonstrate need for nursing facility level of care through a state assessment. This typically requires assistance with 2-3 Activities of Daily Living (bathing, dressing, toileting, transferring, eating) or cognitive impairment requiring supervision.
Assessments are performed by state-designated evaluators (nurses or social workers) and typically take 45-90 minutes. The assessment can occur at home, in a hospital, or at the care facility.
What Medicaid Covers in Washington, D.C.
Nursing Home Care
Medicaid pays 100% of nursing home costs in Washington, D.C. once eligibility is established. The average monthly cost is $13,422/month average (semi-private), $14,733/month (private). Recipients contribute most of their monthly income toward care costs, keeping only $50-75 for personal needs.
Coverage includes room, board, 24-hour nursing care, meals, medications, therapy services, and all medical care provided at the facility.
Assisted Living Coverage
EPD Waiver - Assisted Living Services: DC's EPD Waiver explicitly includes "assisted living services" as a covered benefit. Participants residing in licensed assisted living residences can receive Medicaid-covered personal care, medication management, care coordination, and supportive services. Room and board costs are not covered by Medicaid—residents must pay housing costs from their monthly income or private resources.
Note: This program covers personal care services but does not cover room and board costs. Residents need approximately $1,500-$2,500/month from Social Security or other income to cover housing expenses.
Home and Community-Based Services (HCBS) Waivers
Washington, D.C. offers 2 HCBS waiver programs that provide in-home care and community services as an alternative to nursing facility placement.
Elderly and Persons with Physical Disabilities (EPD) Waiver
Serves District residents age 65+ or adults with physical disabilities who meet nursing facility level of care. Provides care coordination, personal care aide services, respite care, adult day health, assisted living services, chore aide, home-delivered meals, medical alert systems, home modifications, and specialized medical equipment. Approximately 4,500 participants.
Program Details →Individual and Family Supports (IFS) Waiver
Serves individuals with intellectual and developmental disabilities. Some elderly individuals with lifelong disabilities qualify.
Program Details →How to Apply for Medicaid in Washington, D.C.
Washington, D.C. Medicaid applications typically take 30-45 days for standard Medicaid; EPD Waiver enrollment typically occurs within 45-60 days of Medicaid approval. Starting the process early and submitting complete documentation helps avoid delays.
Application Methods
You can apply for Medicaid in Washington, D.C. through:
- Online at DCHealthLink.com (DC Health Benefit Exchange)
- Phone: 1-855-532-3751 (DC Medicaid hotline)
- Download application at dhcf.dc.gov and mail to: DC Dept of Health Care Finance, P.O. Box 90224, Washington, DC 20090
- In-person at DC Service Center: 64 New York Avenue NE, 3rd Floor, Washington, DC 20002
Step 1: Gather Required Documents
Before starting your application, collect:
- •Birth certificate and Social Security card
- •Proof of citizenship (passport, naturalization)
- •5 years of bank statements
- •Investment and retirement account statements
- •Property deeds and mortgage statements
- •Life insurance policies
- •Social Security award letter
- •Pension benefit statements
- •Medicare card
- •Doctor's statement of care needs
Step 2: Submit Your Application
Complete and submit your application through one of the methods listed above. If applying online or by mail, keep copies of all submitted documents.
Step 3: Medical Assessment
A state assessor will evaluate level of care needs. This assessment typically takes 45-90 minutes and covers functional abilities, medical needs, cognitive status, and safety concerns.
Step 4: Financial Review
Medicaid staff review all financial documents and investigate any transfers or gifts made in the past 60 months. They may request additional documentation during this process.
Step 5: Receive Determination
You'll receive written notification of approval or denial. Approved applications include the effective date of coverage (often retroactive up to 3 months), patient responsibility amount, and covered services.
Get Free Application Help
Free Medicaid application assistance is available in Washington, D.C. from:
- •Area Agency on Aging: Call 1-800-677-1116 (Eldercare Locator) to find your local office
- •SHIP counselors: Free Medicare/Medicaid counseling
- •Nursing facility social workers: In-facility application support
- •Elder law attorneys: Paid help for complex financial situations ($2,000-$5,000)
Washington, D.C.-Specific Programs and Resources
Medicare Savings Programs (QMB/SLMB/QI)
QMB pays Medicare premiums, deductibles, and coinsurance. SLMB pays Part B premiums. QI pays Part B premiums (limited funding).
Learn MoreDC Healthcare Alliance
District-funded health insurance program for low-income DC residents who don't qualify for Medicaid. Provides comprehensive coverage similar to Medicaid.
Learn MoreOffice on Aging Services
District aging agency providing case management, senior centers, nutrition programs, and caregiver support.
Learn MoreNeed Help with Washington, D.C. Medicaid?
Contact DC Department of Health Care Finance for specific questions about eligibility, application status, or covered services.