What health care services does DC Healthy Families cover?
You get doctor visits, preventive care (checkups and screenings), and medicines. You can also ask your doctor what services are covered. The program offers these services:
- Physician visits and checkups (physicals, mammograms, etc.)
- After-hours care 24 hours a day, 7 days a week
- In-patient care
- Dental services: full routine care for children, emergency care for adults
- Emergency care
- Well-child services through HealthCheck
- Health care for pregnant women
- Birth control and family planning services
- Lab and x-ray services
- Low-cost or free prescription drugs (not for Medicare Dual Eligibles with the exception of certain drugs)
- Home health care (including durable medical equipment)
- Vision care
- Transportation for appointments
Some of the people listed in My Account are not members of my household. What should I do?
Call the ESA Change Center at (202) 727-5355.
How do I choose a doctor (primary care physician)?
Look at the Provider Directory in your Welcome Packet. It lists all the primary care physicians (PCPs) participating in the DC Healthy Families or DC HealthCare Alliance programs. It also shows the languages each doctor speaks. Check the list to make sure that the doctor you want as your PCP works with your health plan.
If you need help choosing a PCP, call your health plan or call the Customer Service Center at (800) 620-7802.
What is the DC HealthCare Alliance?
The DC HealthCare Alliance program offers medical assistance to District residents who do not qualify for Medicaid or Medicare, or do not have any other health insurance. If you have low income, you may qualify to become a member of Alliance.
How do I apply for DC Healthy Families?
To get an application, call (888) 557-1116. If you have hearing loss, call the TTY/TDD line at (877) 672-7368.
You can pick up a DC Healthy Families application at all CVS, Safeway, Rite Aid, and Giant stores. You can also get one at the District’s public libraries, the Department of Motor Vehicles, and the Department of Employment Services.
Return your application in the envelope provided . No stamp is needed if you use that envelope.
Be sure to include:
- Proof of DC residency
- Copies of Social Security cards for children and parents who are applying
- Copies of birth certificates
- Proof of one month's income
Mail your application to:
DC Healthy Families
Attn: DC Healthy Families Unit
645 H Street NE
Washington, DC 20002
If you need help with your application, call the Customer Service Center at (202) 639-4030 or (800) 620-7802.
Who is eligible for DC HealthCare Alliance?
You do not have to be a U.S. citizen to join DC HealthCare Alliance. You can get Alliance health coverage if you:
- Live in the District of Columbia
- Have no health insurance, including Medicare and Medicaid
- Have income at or below 200% of the federal poverty level
Who is eligible for DC Healthy Families?
DC Healthy Families is for families with children under age 19 and for pregnant women who live in the District of Columbia. Here are the limits on family income:
New Income Levels for Children Only
|Number of people in household||Monthly Income||Yearly income|
|1||$2,943 ||$35,310 |
|2||$3,983 ||$47,790 |
|3||$5,023 ||$60,270 |
|4||$6,063 ||$72,750 |
|5||$7,103 ||$85,230 |
|6||$8,143 ||$97,710 |
|7||$9,183 ||$110,190 |
|8||$10,223 ||$122,670 ||300% of FPL
For each additional person in the family, add $1,040.00 to monthly income, or $12,480.00 to annual income.
|Income Levels for Entire Family|
|Number of people in household||Yearly income|
|200% of FPL|
Do I have to pay for health care services?
You should always ask if the services your doctor says you need are covered by your health plan. To learn more about the types of services covered, look in the membership handbook in the welcome packet that your health plan sent you.
What happens to the personal details that I provide?
We use these details to update our records. We use your address to send out health plan selection materials and let you know of changes or annual renewals. Your personal information is carefully protected and completely confidential.
When will I know whether I am eligible for DC Healthy Families?
Once you send in your application, you should receive a letter from the Economic Security Administration (ESA) within approximately 45 days. The letter will tell you whether you are eligible. If you don’t get that letter, call the ESA at (202) 727-5355.
What services does DC HealthCare Alliance cover?
DC HealthCare Alliance covers:
Preventive care (checkups, diets and nutrition)
Health screenings (tests)
Prescription drugs (available only at Alliance pharmacies)
Dental services (cleanings, fillings, dentures, and extractions)
Family planning services (birth control)
Urgent and emergency care (emergency room)
Prenatal care (pregnancy)
Wellness programs (eating well and staying healthy)
Hospital care (medical, surgical, and GYN)
I logged in to My Account, but the page showed someone else, not me.
Try entering your Member ID and PIN again, checking the numbers carefully. If the website still shows the wrong person, call the Customer Service Center at (800) 620-7802.
I used to have DC health care coverage, but my coverage ended. What should I do?
If you or your family members used to be a part of the DC Healthy Families or DC Healthcare Alliance programs, but your coverage has ended, you need to contact the ESA and submit a new application to see if you are eligible again.
Do I need to tell Healthy Families when I move, change jobs, or have a child?
Yes, call the ESA Change Center at (202) 727-5355 and call your health plan to report all household changes.
How do I get medical services?
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To get medical care, call your PCP (doctor). You can find your PCP’s phone number on the front of your Member ID card and in the Provider Directory.
Your PCP will help you get all of the health services you and your family need. Even if you’re healthy, you should set up an appointment with your doctor. If you have never seen this doctor before, you should contact them as soon as possible.
When you call your PCP, have your insurance Member ID card ready. Tell the person in which plan you are enrolled, and that you’d like to make an appointment with your doctor. When you go to your doctor appointment, remember to bring your insurance Member ID card.
Will I get an insurance card?
DC Healthy Families Members: Once you have chosen your health plan and primary care physician (PCP), or one is chosen for you, you will get your insurance Member ID card from your health plan.
DC HealthCare Alliance Members: Once you have chosen a primary care physician (PCP), or one is chosen for you, you will get your insurance Member ID card from your health plan.
Make sure the card shows that you are in the right plan, with the right PCP. If any information is wrong, call your health plan.
How long does my DC Healthy Families eligibility last?
It lasts for 12 months. You will need to fill out a recertification form every year to prove that you are still eligible to receive benefits. ESA will send you that form in the mail every year.
Can I change my doctor?
Yes. You can change your primary care doctor at any time by calling your Health Plan Member Services Line . The number is on your Member ID card.
How do I apply for DC HealthCare Alliance?
1. Fill out an application form.
- Go to http://dhs.dc.gov. Click on Public Assistance Benefits and then Application for Benefits . You can print out the form.
- You can also get a form at one of the Economic Security Administration (ESA) Service Centers listed in the following table.
|ESA Service Center||Address||Phone
|Anacostia||2100 Martin Luther King Avenue, SE||(202) 645-4614
|Congress Heights||4001 South Capitol Street, SW||(202) 645-4546
|Fort Davis||3851 Alabama Avenue, SE||(202) 645-4500
|H Street||645 H Street, NE ||(202) 698-4350
|Taylor Street||1207 Taylor Street, NW||(202) 576-8000
2. Take the form and the documents you need to an ESA Service Center.
The application form lists documents you need to bring when you apply.
3. You should receive a letter from the ESA within approximately 45 days.
The letter will tell you whether you are eligible. If you don’t get that letter, call the ESA at (202) 727-5355.
4. If you are eligible, you will get a letter that tells you the date that your health care started.
Is there information available in another language?
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All health plan selection materials for the DC Healthy Families and DC HealthCare Alliance programs are available in Amharic, Chinese, French, Korean, Spanish, and Vietnamese. They are also available in alternative formats for the visually impaired.
If you need help in another language, call the Customer Service Center at (800) 620-7802. We can help you in the language that you speak.
Do I get dental care?
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Yes. Dental care coverage is part of your DC Healthy Families and DC HealthCare Alliance benefits. If you have questions or want to make a dentist appointment, call the Dental Line at (866) 758-6807. You can also call your Health Plan Member Services to make a dentist appointment. The number is on your Member ID card.
What is a primary care physician?
A primary care physician (PCP) is your main doctor. This doctor will provide most of your medical and health care, and will help you stay healthy. Your PCP can refer you to specialists if you need them.
How long does my DC HealthCare Alliance eligibility last?
It lasts for 6 months. You will need to fill out a recertification form every 6 months to prove that you are still eligible to receive benefits. ESA will send you that form in the mail.
My doctor is not listed with any of the health plans. Can I still see them?
Maybe. First, check the spelling of your doctor’s name to make sure you typed the correct name in the search field on the “Find a Doctor” page on this website. If their name isn’t listed, then call your doctor to ask if they participate in the DC Healthy Families program. If they say yes, then call Customer Service Center at (800) 620-7802 to choose this doctor.
When can I go to a doctor?
You can go to a doctor as soon as your enrollment takes effect.
I already see a doctor I like. Can I stay with this doctor?
Yes, if your doctor works with one of the health plans that is part of the DC Healthy Families program. Many doctors work with the program. You can ask your doctor if they participate in the program or you can search for your doctor on the “Find a Doctor” page.
What are the DC Healthy Families and Alliance Programs?
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DC Healthy Families: DC Healthy Families is a program that provides free health insurance. If you live in Washington, D.C., have children under the age of 19 or are pregnant, and meet certain income guidelines, you may be eligible for free coverage. The DC Healthy Families program covers doctor visits, vision and dental care, prescription medicines, hospital stays, after-hours care, and transportation for appointments.
DC Healthy Families also offers special programs for newborn babies, children with disabilities or special health care needs, and people with HIV and AIDS.
DC HealthCare Alliance: The DC HealthCare Alliance program offers medical assistance to District residents who don’t qualify for DC Healthy Families, don’t have other types of health insurance, and meet certain income guidelines.
The Alliance program does not require you to be a U.S. citizen or alien resident to receive benefits. The Alliance program covers doctor visits, prescription medicines, dental care, wellness programs, and hospital stays.
If you do not qualify for the DC Healthy Families program, you may qualify for the DC HealthCare Alliance program.
How can I change my address or other contact information?
You must contact Economic Security Administration - ESA (formerly known as IMA) to change your address or other contact information to officially make this change in the system. To contact ESA Change Center, call (202) 727-5355 or go to your ESA Service Center (Anacostia, Congress Heights, Fort Davis, H Street, or Taylor Street). If you do not update your information with ESA, then we may be unable to contact you, and your documents/benefit information may be mailed to the wrong location.