This site is privately owned and is not affiliated with any government agency. Learn more here.

Learn About Medicaid Costs and Coverage in Washington DC

Washington DC Medicaid coverage, known as DC Medicaid, creates a path for citizens struggling with income to receive assistance that provides a variety of medical care. The types of Medicaid insurance provided by the program covers a broad range of medical services for a lot of different city residents. For instance, Medicaid for the Aged, Blind and Disabled (MABD) covers a specific group of residents. Medicaid receives millions in funds from both the local and federal governments to cover the cost of services. The structure for the program is established federally, but is managed by local officials. Medicaid benefits are well-funded by officials who work to keep costs low or to remove expenses, altogether for recipients. How much is Medicaid in DC? Expenses such as copays may still apply to specific medical services for beneficiaries of the program. Learn what services are covered by Medicaid in DC, the costs related to Medicaid and what Medicaid coverage includes by reading through the sections below.

What services are covered by Medicaid in Washington DC?

The federal government outlines the DC Medicaid coverage regulations, including the services that are available to those who meet eligibility requirements. The city may alter certain Medicaid benefits depending on several factors. However, the coordination between local and federal officials and essential funding helps create a system which is flexible, allowing each state (and Washington, D.C.) to adjust accordingly.

The benefits of Medicaid coverage are numerous, especially for low-income families who cannot otherwise get affordable health care. Services covered by Medicaid in Washington, D.C. fall under the management of local health officials who provide detailed information about Medicaid cost estimates and services included. Furthermore, the flexibility of Medicaid coverage in DC means that certain guidelines are mandatory, while others are optional. For example, the 2010 Affordable Care Act allowed states to expand Medicaid to a broader group of residents. Washington, D.C. accepted the expansion, and therefore, does cover additional petitioners. The types of services covered by Medicaid include:

  • X-rays.
  • Primary care physician visits.
  • Testing and treatment for specific diseases.
  • Home health care services.
  • Emergency ambulance services.
  • Hospice services.
  • Laboratory services.
  • Radiology.
  • Medical supplies.
  • Mental health services.

Download our free guide to review the services covered by Medicaid.

DC Medicaid coverage includes a lot of potential recipients throughout the city. All eligible applicants will benefit from the aid provided by the program. Furthermore, in addition to Medicaid coverage, certain providers add other resources aimed at helping anyone under a certain age. Some of the coverage provided to minors includes:

  • Psychology and counseling.
  • Chiropractic services, such as spine adjustment and more.
  • Braces for teeth.
  • Private duty nurses in the home.
  • Vision, hearing and dental screenings.
What services are not covered by Medicaid in Washington DC?

For petitioners, it is important to learn the answer to, “What does Medicaid not cover?” as it may not help in particular cases. Becoming familiar with the services not covered by Medicaid removes any expectation applicants may have regarding potential assistance from the program. Resources are limited, so officials who manage the program prioritize necessary services and ignore other services (known as “elective” services). Some Medicaid coverage does not extend to such things as:

  • Cosmetic procedures.
  • Hearing and dental services for beneficiaries.
  • Occupational, speech or respiratory therapies.
  • Any rentals through on-demand services in hospital rooms.
How much does Medicaid cost in Washington DC?

Medicaid cost estimates will be as low as possible to help petitioners struggling with income. However, it is essential to understand that additional costs may be required of beneficiaries. Before learning how to apply for Medicaid coverage in DC, potential recipients benefit from knowing what expenses may be associated with Medicaid. For example, individuals and families who need certain services, such as preventative care, may face some out-of-pocket expenses. Additionally, some Medicaid recipients may be exempt from extra costs.

Medicaid cost estimates in Washington DC for recipients remain low because the program receives adequate funding. However, there are circumstances in which costs are required from recipients. Also, in cases where copayments are due, Medicaid coverage limits how much providers may charge for specific procedures. The limits set for Medicaid benefit costs are based on a range of factors. Officials notify eligible petitioners and provide details, such as the limits on costs, via mail. Keep in mind that providers are free to choose to charge the maximum amount.

In some situations the answer to, “How much does Medicaid cost?” is sometimes nothing at all.

Some beneficiaries receive exemptions from copayments or other expenses associated with coverage. The benefits of Medicaid are numerous, and some petitioners, such as minors, those living in nursing homes, pregnant women or those suffering from disabilities typically do not have to pay any costs. To learn more about Medicaid coverage benefits and cost estimates, download our free guide.