District of Columbia program
Free adult coverage just above the Medicaid line (Healthy DC Plan)
Free health coverage for eligible adults under 65 just above the Medicaid line [Healthy DC Plan].
What it is
Free health coverage for eligible adults under 65 just above the Medicaid line [Healthy DC Plan].
Healthy DC Plan covers eligible adults who cannot get Medicaid. It started in January 2026 and has no premium or charges when you receive care. Access to affordable work coverage can change eligibility.
Eligibility rules
- For adults under 65.
- Above 133% and not above 200% of the poverty level per the certified blueprint.
- Not eligible for other minimum essential coverage or affordable employer coverage.
- District of Columbia.
What you get
- No monthly premium and no charge when you receive covered care.
- Adult hospital care, doctor visits and prescriptions.
Which income band applies
- The certified blueprint describes income above 133% and no more than 200% of poverty. Medicaid eligibility and access to affordable employer coverage must also be checked.
- The blueprint says above 133% through 200% of poverty, but an adult who qualifies for Medicaid is not routed into Healthy DC Plan. Medicaid’s income allowance can affect the boundary. Ask DC Health Link to check the adult’s income, other coverage and immigration-related rules and to confirm the current dollar limit, start date and decision time.
If you decide to apply
- Ask a DC Health Link assister to check Healthy DC Plan alongside Medicaid.
- Have income details and information about any available employer coverage ready.
DC Health Benefit Exchange Authority: 855-532-5465 · Official page ↗
Good to know
This is adult coverage. Your child's Medicaid eligibility is checked separately.
Official sources
“If my income is too high for Medicaid, could the Healthy DC Plan cover me? Could you help me compare its doctors and costs before I choose?”
Why I’m asking: I want to understand whether there is free coverage between Medicaid and a marketplace plan.
More background and detailed requirements
Additional program information and published rules
Who does what
The three parts, side by side. The agency decides; nobody on this page does.
You
Apply at dchealthlink.com and answer the income questions for this month.
Your social worker
A DC Health Link assister can walk you through it on 855-532-5465.
The care team
Records and letters when the application asks for them.
- Who decides
- The DC Health Benefit Exchange Authority, through DC Health Link.
- Ask the agency
- “I was turned down for Medicaid on income. Can you check me for the Healthy DC Plan?”
How to apply
First step: Apply at dchealthlink.com or call 855-532-5465.
- Apply at dchealthlink.com and say you have been turned down for Medicaid.
- Check the plan covers the oncology team before you pick.
Official application / program page ↗
Where it starts: Apply at dchealthlink.com or call 855-532-5465.
What to gather
The diagnosis letter, the child’s insurance card, and the last two pay stubs cover most applications. The official page lists the rest.
How long: No decision clock was published.
What a yes looks like
A District plan with no premium and no cost when you get care.
What a no looks like, and the next move
Ask DC Health Link to check you for marketplace help instead.
Watch out
- It is new, from January 2026. DC has published the income band as a percentage but no dollar table.
Dates that change this
2026-01-01: The Healthy DC Plan started on January 1, 2026. DC has published the income band as a percentage but no dollar table, so the figure shown here is poverty-line arithmetic on the published percentage.
The numbers and the rules
The arcane layer, kept on purpose. Checked September 11, 2026.
What it is worth
No monthly payments and no costs at the point of care, for an adult under 65 up to twice the poverty level.
- $200 — Upper income limit, as a share of the poverty level
Covers: The health cover an adult needs: doctor, hospital, prescriptions
Legal protection: No monthly payments and no costs when you get care
What it costs the family: DC Health Link: "There are no monthly payments and no costs when you get care."
The eligibility facts, as published
- Age
- under 65
- Income
- Above 133% and not above 200% of the poverty level per the certified blueprint
- Other
- Not eligible for other minimum essential coverage or affordable employer coverage
- Residency
- District of Columbia
The trap: It is new. Apply through DC Health Link and say plainly that you have been turned down for Medicaid.
Where I read this
- DC HBX — Basic Health Plan — DC Health Benefit Exchange Authority, read September 10, 2026
- DC HBX — CMS-Certified Basic Health Program Blueprint — DC Health Benefit Exchange Authority, read September 10, 2026
- DC Health Link — DC Health Benefit Exchange Authority, read September 10, 2026