How to get health care for your children

How to get health care for your children
if they live in Washington D.C.
Many parents need help paying for health care for their children. If you do not have health insurance through
your job, Washington D.C. has programs that may help you get or pay for it.
This brochure tells you ways to get help paying for health care for your children. It tells you about:
 D.C. Healthy Families (also called Medicaid).  How to get care if you or your child is not a U.S. citizen.
 Helpful phone numbers.
 Other programs to help you pay for care.
D.C. Healthy Families
D.C. Healthy Families is Washington D.C.’s health
insurance program for low income families. It is also
called Medicaid.
Most people with D.C. Healthy Families
get their medical care through a managed
care plan.
To get D.C. Healthy Families for your child:
The plans are: Chartered Health, UHC Community
Health Plan, and Health Care Services for Children
with Special Needs. D.C. 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.
 D.C. Healthy Families may also pay for medical
care that your child got in the three months
before you apply.
 Your child must live in Washington D.C.
 You must have a low income. For example:
Attention: If your income is a little higher than the numbers below,
you should still apply. Some of your income may not count.
Number of people
Your income each month
in your family
must be less than:*
4 or more
For each additional person,
add $1005to the number just above
* 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 D.C.
Healthy Families.
If your child is not a U.S. citizen, see “Health
insurance programs if you or your child is not a U.S.
citizen” on page 2 of this brochure.
Page 1
Health Care for Children in Washington D.C.
How to apply for D.C. Healthy Families:
 Call the Department of Human Services at
 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.
Other programs to help you pay for care
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
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 visit
 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 and
click on “Insurance Coverage Options.”
Health insurance programs if you or your child is not a U.S. citizen
Children who are not U.S. citizens can get health
care and health insurance in Washington D.C.
Applying will not hurt your immigration status or
your child’s. Parents’ immigration status does not
matter when applying for insurance for your child.
Page 2
Health Care for Children in Washington D.C.
The Immigrant Children’s Program is for
children who cannot get D.C. 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 D.C., and
you must have a low family income.
You apply in the same way as for D.C. Healthy
Families (see the information under “D.C.
Healthy Families” on the first page of this
Helpful phone numbers
For problems with D.C. 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
D.C. Healthy Families:
If you need to call your managed care plan:
Call the D.C. 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 D.C. Quality Trust at 202-448-1450.
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.
For information on public health insurance programs and
free or low cost health clinics, visit
Page 3
Health Care for Children in Washington D.C.