DC Medicaid Income Limits 2026: Adults, Kids, Alliance

Medicaid in the District is health coverage, not a payment to you, and applying is free. To compare the District with the states, see our national Medicaid income limits guide.

DC Medicaid Income Limits by Household Size (2026)

The District now publishes 3 MAGI income lines: 324% for children and pregnancy, 221% for young adults 19 and 20, and 138% for every other adult. According to DHCF's 2026 eligibility charts, a household of four can have $3,795 a month for the adults, $6,078 for a 19- or 20-year-old and $8,910 for children or a pregnant member.

Sources: DHCF pages for childless adults (opens in a new tab), parents and caretaker relatives (opens in a new tab), infants and children (opens in a new tab) and pregnant individuals (opens in a new tab). Each says its figures were "compiled using 2026 FPL numbers as of January 16, 2026" with the 5% disregard included. DHCF's charts stop at eight people and give no per-person increment. The pregnancy chart starts at a household of two because the baby counts. For a 19- or 20-year-old in a household of six, the Medicaid children's page shows $8,179 and the Alliance for Children page shows $8,170; Grantsights used $8,170, which matches 221% of the 2026 guideline.

One figure you may see elsewhere is out of date. Medicaid Director Letter 25-02 (October 16, 2025) and DHCF's income limits announcement (opens in a new tab) show the new adult limit as $1,800 for one person. Those were calculated with 2025 poverty figures. The program pages above carry the 2026 amounts.

Seniors, disability and long-term care limits

Sources: DHCF aged, blind and disabled page (opens in a new tab) and long-term care page (opens in a new tab).

How DC Counts Your Income

The District uses 2 sets of rules, and the group you qualify through decides which one applies.

MAGI rules cover children, young adults 19 and 20, pregnant people, parents and caretakers, and adults without dependent children. Income is figured the way the IRS does it: wages, net self-employment income, unemployment pay and taxable Social Security count, while child support received and SSI don't. Your household follows your tax return. DHCF's childless adult page states there's no resource limit for that group, and MAGI groups generally don't have an asset test.

The 5% disregard is already baked into every MAGI figure DHCF publishes, which is why the adult chart is labeled "133% + 5% disregard" while the program pages call it 138%. Compare your gross monthly income directly to the table.

Non-MAGI rules apply to aged, blind and disabled residents, long-term care and Medicare-related coverage. These look at resources as well as income. DHCF says the value of your primary home, a car, home furnishings, clothing and jewelry don't count toward the $4,000 limit.

For example, a family of three in DC earning $3,500 a month gross, a mother with a 2-year-old and a 9-year-old, splits across two programs. The mother is specifically $358 over the $3,142 adult limit for three, so she no longer qualifies for Medicaid after the January 2026 cut. Both children qualify, since the limit for kids in a household of three is $7,377. If the mother is 21 to 64, lawfully present and has no job-based coverage, her income sits between 138% and 200% of poverty, so she'd qualify for the Healthy DC Plan with no premium.

DC Medicaid Asset Limits

$4,000 is the resource limit for one person in the aged, blind and disabled group and in long-term care, according to DHCF's eligibility pages, and $6,000 applies to a married couple in long-term care. Adults, parents, children and pregnant people on MAGI coverage don't face an asset test.

Resources DHCF counts include cash, bank and retirement accounts, stocks and bonds, and the cash value of life insurance. For long-term care, DHCF adds trusts, annuities and property other than your home.

Two long-term care rules are worth planning around:

• The spend-down route. If your income is over the $2,982 Special Income Standard, you can still qualify by subtracting medical expenses from your income until you reach the $856.90 medically needy level. DHCF approves spend-down cases for six months at a time, and you reapply after each period.
• Home equity starting in 2028. DHCF's federal changes page says that from January 1, 2028, a long-term care applicant's home equity must be $1 million or less.

Expansion vs Non-Expansion: DC's Position in 2026

The District expanded Medicaid and for years covered adults well above the federal floor. The Medicaid.gov eligibility levels table (opens in a new tab) (as of December 1, 2023) still lists DC at 210% for expansion adults and 216% for parents, with 319% for children and pregnant women. That table predates the 2026 cut, so its adult figures no longer apply.

What changed on January 1, 2026. According to Medicaid Director Letter 25-02 and DHCF's resource document on the change (opens in a new tab), which ties it to the Fiscal Year 2026 Budget Support Act of 2025, parent and caretaker limits fell from 221% to 138% and childless adult limits from 215% to 138%. Adults over the new line lost Medicaid on December 31, 2025. DHCF's February 2026 stakeholder briefing says about 15,000 residents who lost Medicaid were automatically enrolled in the Healthy DC Plan, and adults with Medicare above 138% were moved to QMB-only coverage, which pays Medicare premiums and cost sharing but isn't full Medicaid.

The District's limits for adults now line up with expansion states such as Maryland and Virginia. For a non-expansion comparison, our Texas Medicaid income limits guide shows the adult coverage gap.

What changes on January 1, 2027. According to DHCF's federal changes page and its February 25, 2026 eligibility briefing (opens in a new tab):

• Work requirements for most adults 19 to 64 without dependent children: at least 80 hours a month of work, training, volunteering or similar activities, or monthly income of at least 80 times the federal minimum wage. DHCF's briefing says new applicants will be checked for one month before the month they apply, and members who can't show compliance get 30 days to respond before coverage ends.
• Parents are exempt in DC. The briefing explains that because the District covered parents to 138% before the ACA, none of its parents or caretaker relatives count as expansion adults, so the work rule doesn't reach them.
• Renewals every 6 months for most adults without children.
• Shorter retroactive coverage: 1 month before application for adults without children, 2 months for everyone else.

Already in effect: DHCF's adult noncitizen eligibility page (opens in a new tab) says that starting October 1, 2026, full federal Medicaid for adults 21 and older is limited to green card holders, Cuban and Haitian entrants and COFA migrants. Refugees and asylees without a green card generally lost eligibility on that date. Children under 21 and pregnant people who are lawfully residing keep coverage, and Emergency Medicaid remains for emergencies, including labor and delivery.

What DHCF Doesn't Tell You About DC's Income Limits

Grantsights found 5 gaps between how DHCF publishes the limits and what they mean for a household:

1. The cut was steep. Grantsights analysis of DHCF's before-and-after table shows the one-person adult limit fell from $2,806 to $1,800 a month under the same 2025 guideline, a 36% drop, and the four-person parent limit fell by $2,226 a month ($5,923 to $3,697). Anyone denied for income before 2026 and anyone who lost coverage in December should recheck against the current chart, not their memory of the old one.
2. Kids barely changed. Grantsights analysis of the 2026 charts found children in a family of four qualify up to $5,115 a month more than their parents ($8,910 vs $3,795). A common mistake is assuming the January cut reached children. It didn't.
3. Two programs replaced one. Adults between 138% and 200% now land in the Healthy DC Plan, run by the DC Health Benefit Exchange, not DHCF. It doesn't cover dental, vision, non-emergency transportation or long-term services, according to DHCF's February briefing.
4. The Alliance is mostly closed to new adults. DHCF's briefing says that since October 1, 2025, adults who are 26 or older at application can't newly enroll in the Health Care Alliance, and the adult benefit was narrowed to primary care, generic drugs, hospital care, lab work and medical equipment.
5. Old charts are still online. The $1,800 figure in MDL 25-02 and the 210% adult level on Medicaid.gov are both easy to find and both wrong for a 2026 application.

Health Care Alliance and Alliance for Children

2 locally funded programs cover District residents who can't get Medicaid, usually because of immigration status. According to the Alliance for Children program page, the Alliance and the Immigrant Children's Program combined into the Health Care Alliance for Adults and Children on October 1, 2026.

Sources: DHCF Alliance for Adults (opens in a new tab) and Alliance for Children (opens in a new tab) pages; enrollment moratorium and benefit changes from DHCF's February 25, 2026 briefing.

Common Mistakes and Red Flags

These errors cause most wrong answers in the District:

• Comparing take-home pay. DHCF's limits are gross monthly income before taxes.
• Using the 2025 chart. The $1,800 single-adult figure was based on 2025 guidelines; the 2026 figure is $1,836.
• Assuming parents face work rules. DHCF's own briefing says District parents and caretakers aren't subject to them.
• Skipping the children after a parent is denied. Each person in the household is checked against their own line.
• Paying for an application. Applying through District Direct or a service center is free. A red flag is any person or website charging a fee, asking for gift cards, or asking for your District Direct password to "handle" your case.
• Missing a renewal. DHCF's FAQ says you get a 90-day grace period after your certification ends, but after that you have to start a new application. With six-month renewals coming for many adults in 2027, many people underestimate how quickly that window passes.

How to Apply for DC Medicaid and How Long It Takes

According to the DHCF Medicaid changes guide for community partners, a November 2025 resource document (opens in a new tab), eligibility takes 45 business days to determine, or 60 business days if you attest to a disability. If you're approved, coverage starts on the first day of the month you applied.

1. Online: through District Direct (opens in a new tab) or its mobile app.
2. By phone: the District Direct and Public Benefits Call Center at (202) 727-5355 (TTY 711).
3. In person or by fax: at a Department of Human Services service center (Anacostia, Congress Heights, Fort Davis, H Street or Taylor Street), or by fax to 202-671-4400.

DHCF says you'll need proof that you live in the District, your Social Security card or green card number, and income documents; seniors and long-term care applicants also need resource records. No face-to-face interview is required. If you also need help with groceries, our DC food stamps guide covers SNAP.

What to Do If You're Denied

You have 90 days from the postmark on your notice to request a fair hearing, according to the DC Office of Administrative Hearings Medicaid page (opens in a new tab) and DHCF's fair hearing page (opens in a new tab). To keep your benefit while the hearing is pending, DHCF says you must ask before the 30-day notice period ends.

Call OAH at (202) 442-9094 to file by phone, or file in writing or in person at One Judiciary Square, 441 4th Street NW, Suite 450 North. Check the notice's reason first: income denials often come down to household size or an old pay stub, and both can be corrected. A District legal aid organization may be able to help with the hearing at no cost.

If You're Over the DC Medicaid Limit

An adult who's a few hundred dollars over 138% has at least 5 good options, and the Healthy DC Plan is the best bet for most of them.

• Healthy DC Plan: according to the Healthy DC Plan program criteria in MDL 25-02, residents 21 to 64 between 138% and 200% of poverty get coverage with no premium. Grantsights calculated 200% of the 2026 HHS guideline as $2,660 a month for one person and $5,500 for four.
• DC Health Link private plans: above 200%, you can buy coverage and may qualify for lower premiums; HealthCare.gov's savings page (opens in a new tab) explains how the federal tax credits work.
• Medicaid for the children: kids stay eligible up to 324% of poverty.
• QMB: adults with Medicare over the new adult limit can keep help with Medicare premiums and cost sharing.
• WIC for pregnant women and children under 5 up to 185% of poverty: see our WIC income limits guide.

Older residents and people with disabilities can compare cash help in our SSI income limits guide and local services in the help for seniors programs guide. The federal poverty guidelines guide turns DHCF's percentages into dollars for any family size, and our LIHEAP income limits guide covers utility help. Grantsights' free eligibility checker can point you to official programs for rent, utilities and other needs; it doesn't make Medicaid decisions or file for you, it shows where to apply.

FAQ: DC Medicaid Income Limits

What is the income limit for DC Medicaid in 2026?

$1,836 a month for one adult and $3,795 for four, at 138% of poverty.

Did DC Medicaid income limits change in 2026?

Yes; adult limits fell to 138% of poverty on January 1, 2026.

What is the DC Medicaid income limit for children and pregnant women?

$7,377 a month for three and $8,910 for four, at 319% plus the disregard.

What is the DC Healthcare Alliance income limit?

138% for adults ($1,836 for one person); 319% for children 18 and under.

What is the Healthy DC Plan income limit?

Between 138% and 200% of poverty, for residents 21 to 64.

What is the income limit for nursing home Medicaid in DC?

$2,982 a month in 2026, with a spend-down route above it.

When do DC Medicaid work requirements start?

January 1, 2027, for most adults without dependent children.

How long do I have to appeal a DC Medicaid decision?

90 days from the notice postmark; before the 30-day notice ends to keep benefits.

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Sources

1. DHCF: Adults Without Dependent Children (opens in a new tab) - 2026 chart, as of January 16, 2026
2. DHCF: Parents and Caretaker Relatives (opens in a new tab) - 2026 chart
3. DHCF: Infants and Children (0-20) (opens in a new tab) - 2026 chart
4. DHCF: Pregnant Individuals (opens in a new tab) - 2026 chart
5. DHCF: Aged, Blind and Disabled Individuals (opens in a new tab)
6. DHCF: Long-term Care (opens in a new tab), updated January 2026
7. DHCF: Health Care Alliance for Adults (opens in a new tab) and Alliance for Children (opens in a new tab)
8. DHCF: Medicaid Director Letter 25-02 (opens in a new tab), October 16, 2025 - adult income cut effective January 1, 2026; Healthy DC Plan criteria
9. DHCF: Medicaid Income Limits announcement (opens in a new tab)
10. DHCF: Eligibility Changes to the Medicaid Program, resource document (opens in a new tab), version 1.0, November 11, 2025
11. DHCF: Biweekly Eligibility Meeting slides (opens in a new tab), February 25, 2026
12. DHCF: Federal Changes to Medicaid (opens in a new tab)
13. DHCF: Adult Noncitizen Eligibility Changes (opens in a new tab)
14. DC Office of Administrative Hearings: Medicaid (opens in a new tab) and DHCF: Fair Hearing (opens in a new tab)
15. Medicaid.gov eligibility levels table (December 2023 data), used here for DC (opens in a new tab), as of December 1, 2023
16. HHS ASPE: 2026 Poverty Guidelines (opens in a new tab)