DC HEALTHY FAMILIES

DC Healthy Families is Washington, DC’s health insurance program for low income families. It is also called Medicaid.

To get DC Healthy Families for your child:

• Your child must live in Washington, DC
• You must have a low income. For example:

Number of people in your family	Your income each month must be less than:*
1	$2,873
2	$3,878
3	$4,883
4 or more	For each additional person, add $1,005 to the number just above

Attention: If your income is a little higher than the numbers below, you should still apply. Some of your income may not count.

* These are the numbers for 2013. They will go up a small amount each year.

• Your income can be higher if:
  • you have high medical bills,
  • you have work income, or
  • you pay for childcare.
  • Your income must be lower if your child is age 19 or 20.

Your child must be a U.S. citizen or meet certain immigration requirements to get DC Healthy Families.

Most people with DC Healthy Families get their medical care through a managed care plan.

The plans are: Chartered Health, Unison, and Health Care Services for Children with Special Needs. DC Healthy Families pays for all your child’s health care needs:

• You should not have to pay for any care. This includes doctor and hospital care, dental care, eye care, and mental health care.
• You will have to pay $1 for each prescription if your child is not in a managed care plan.
• DC Healthy Families may also pay for medical care that your child got in the three months before you apply.

How to apply for DC Healthy Families:

• Call the Department of Human Services at 202-727-5355.
• Ask them for the address of the office or clinic nearest you where you can apply. Ask what information you will need.

Once your child has been approved, you should get one insurance card from Medicaid and another one from the managed care plan, if your child has one.

To keep getting Medicaid or Alliance:

The Department of Human Services will send you a form. Fill out the form and return it right away so your child’s health insurance does not get cut off.

If your child needs a kidney transplant or needs dialysis, or has Lou Gehrig’s disease (ALS):

• Call the Social Security Administration at 800-772-1213 to apply for Medicare.
• Medicaid can help you pay your child’s Medicare costs. This part of Medicaid is called QMB. Call 202-727-5355 and ask how to apply.

If your child or a family member has HIV or AIDS:

• The DC AIDS Drug Assistance Program can pay your child’s premiums and copayments. The program also pays for medicines. Call 202-671-4900 or visit http://budget.dc.gov/node/137072

Consider buying private health insurance for your child:

• This can cost a lot.
• When you apply, you will have to answer questions about your child’s health. Your child may need a physical exam.
• If your child is under 19, the insurance company cannot turn your child down because of a health problem your child had before you applied. This is called a pre-existing condition.
• If your child is over 19, the insurance company may turn your child down because of a pre-existing condition. Even if your child is accepted, the insurance may not cover your child’s pre-existing condition. Make sure to ask whether the insurance will pay for all the services your child needs.
• If your child has a pre-existing condition and has not had insurance for 6 months or longer, he or she may qualify for the Pre-Existing Condition Insurance Plan. Call 866-717-5826 or visitwww.pcip.gov.
• CareFirst Blue Shield must offer your child the Blue Preferred Open Enrollment plan. Your child’s health and immigration status do not matter. Call CareFirst Blue Shield at 800-544-8703.
• For health insurance companies and plans for DC residents, visit www.healthreform.dc.gov and click on “Insurance Coverage Options.”

Children who are not U.S. citizens can get health care and health insurance in Washington, DC. Applying will not hurt your immigration status or your child’s. Parents’ immigration status does not matter when applying for insurance for your child.

• The Immigrant Children’s Program is for children who cannot get DC Healthy Families because of their immigration status. Your child gets the same health care as children in D.C. Healthy Families.
• Your child must live in Washington, DC, and you must have a low family income.
• Families (see the information under “DC Healthy Families” on the first page of this brochure).

For problems with DC Healthy Families, DC Healthcare Alliance, or Medicare:

• Call the Legal Aid Society of the District of Columbia at 202-628-1161.
• If you do not qualify for legal aid help, call the Bar Association of the District of Columbia Lawyer Referral Line at 202-296-7845. The lawyers they refer you to may charge a fee. Tell them that you have a low income or ask for a reduced fee.

If you have a problem with a bill or renewing DC Healthy Families:

• Call Terris, Pravlik & Millian at 202-682-0578.

For any problems with your child’s health care:

• Call the Office of Ombudsman & Health Care Bill of Rights at 877-685-6391.

If you need to call your managed care plan:

• Call the DC Healthy Families/Alliance Managed Care Line at 202-639-4030. They can connect you to your plan.

If your child has a disability:

• Call the University Legal Services/Protection and Advocacy Program at 202-547-4747.

If your child has a developmental disability and you need referrals for health care or other support:

• Call DC Quality Trust at 202-448-1450.