Healthy DC Plan for Providers
(Doctors, Hospitals, Community Health Centers, Pharmacists, Dentists, and others that provide patient care)
The Healthy DC Plan is quality health coverage for DC residents who qualify. Healthy DC Plan started on January 1, 2026. There are no monthly payments and no costs when you get care. All plans cover doctor visits, urgent care visits, hospital stays, prescription drugs, mental health care, and more. NEW for 2027: Healthy DC Plan now covers dental and vision!
Which insurance companies are offering Healthy DC Plan?
There are three insurance companies offering Healthy DC Plan:
- AmeriHealth Caritas District of Columbia Healthy DC Plan
- CareFirst BlueCross BlueShield Healthy DC Plan
- MedStar Family Choice Healthy DC Plan
Where can I check enrollment for Healthy DC Plan members?
You can access the provider portals for the three insurance companies offering Healthy DC Plan below.
AmeriHealth Caritas District of Columbia Provider Portal (login required)
CareFirst BlueCross BlueShield Provider Portal (login required)
MedStar Family Choice Provider Portal (login required)
Where can I check benefits, provider networks, and prescription drug coverage for Healthy DC Plan members?
All three insurance plans cover the same services. The major differences are provider networks and prescription drug coverage. Use our 2027 Healthy DC Plan Match Tool for more information on coverage and prescription medication. You can also visit the insurance company provider websites:
Looking for a 2026 Healthy DC Plan? Browse 2026 Healthy DC Plans now.
Will patients enrolled for 2026 be automatically renewed for 2027?
Yes. Patients will be automatically re-enrolled into the same Healthy DC Plan for 2027 if they still qualify.
Will patients get a Healthy DC Plan insurance card?
Current Healthy DC Plan enrollees have a Healthy DC Plan insurance card. Their insurance card and member ID will remain the same for 2027.
New Healthy DC Plan enrollees will receive a card. Each enrollee will have their own Healthy DC Plan insurance card and Healthy DC Plan member ID number, even if they are members of the same family.
If a patient lost or did not receive their Healthy DC Plan insurance card, they can log into the health insurance company’s enrollee portal for an electronic insurance card.
Are there out-of-pocket costs for Healthy DC Plan?
No. Healthy DC Plan does not have monthly payments (also called premiums) or out-of-pocket costs for covered services. When residents get care from participating doctors and hospitals, and community health centers, there is no out-of-pocket cost.
What does Healthy DC Plan cover?
The Healthy DC Plan covers essential health care services including:
- Primary care doctor visits
- Specialist doctor visits
- Urgent care visits
- Hospitalizations and emergency care
- Laboratory services
- Prescription drugs
- Mental health, behavioral health, and substance use disorder services
- Preventive care
- Dental services NEW
- Vision services NEW
Are there services patients get with Medicaid that are not covered by Healthy DC Plan?
Yes. Healthy DC Plan does NOT cover:
- Non-emergency transportation
- Community behavioral supports, such as housing support
There are other differences between Healthy DC Plan and Medicaid. For more information about covered services and non-covered services, review the plan’s summary of coverage (SOC).
Coverage Details
For more information on covered services, download and review each plan's Summary of Coverage (SOC) and Evidence of Coverage (EOC).
AmeriHealth Caritas District of Columbia Healthy DC Plan Plan Year 2027: Plan Year 2026: CareFirst BlueCross BlueShield Healthy DC Plan Plan Year 2027: Plan Year 2026: MedStar Family Choice Healthy DC Plan Plan Year 2027: Plan Year 2026:Who is eligible for Healthy DC Plan?
DC residents are eligible for Healthy DC Plan if they are:
- 21–64 years old;
- US Citizen or lawfully present;
- Not eligible for Medicaid;
- Not eligible for employer or other coverage; and
- Have an annual income between 138% and 200% of the Federal Poverty Level. For more information, see the Income Eligibility for Healthy DC Plan table below.
Income Eligibility for Healthy DC Plan
| Household Size* | You qualify if your annual income is:** |
|---|---|
| 1-person household, annual income | $22,025 – $31,920 |
| 2-person household, annual income | $29,863 – $43,280 |
| 3-person household, annual income | $37,702 – $54,640 |
| 4-person household, annual income | $45,540 – $66,000 |
*Contact us about eligibility for larger households.
**Special Eligibility for Lawfully Present Residents: If a lawfully present resident with an annual income below 138% of the federal poverty level is not eligible for Medicaid due to immigration status, the resident is eligible for Healthy DC Plan in 2026.
Need help?
HEALTHY DC PLAN CONTACT CENTER
(833) 432-7526 / TTY: 711
Mon-Fri 8am-6pm
CONTACT FORM
If you don’t find what you’re looking for, please fill out this contact form for more assistance from our team.
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