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STATE PROFILE • Last updated: April 24, 2026

District of Columbia Medicaid & Elder Care

The District of Columbia offers comprehensive senior Medicaid through the EPD Waiver, providing home and community-based services with generous asset limits despite high local care costs.

leaderboard RANKED #2 NATIONALLY

Medicaid Report Card

Overall State Performance Index

A Grade
ELIGIBILITY ACCESSIBILITY STRONG
WAIVER AVAILABILITY STRONG
QUALITY OF CARE MODERATE

Based on CMS Nursing Home Compare + state Medicaid agency data

View Methodology arrow_forward

District of Columbia Monthly Costs

NURSING HOME (SEMI-PRIVATE) $11,952 State Avg / Month
ASSISTED LIVING $6,978 State Avg / Month
ADULT DAY HEALTH CARE $2,530 State Avg / Month

Washington DC's long-term care costs are significantly higher than the national average, with nursing home care projected at approximately $14,000 per month in 2026.

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Waiver Programs

Elderly and Persons with Physical Disabilities (EPD) Waiver

Also called: HCBS Waiver, Services My Way

The District of Columbia's EPD Waiver is a Medicaid program for seniors aged 65 and older, or physically disabled adults aged 18-64, who require a nursing home level of care. It provides a range of home and community-based services to support independent living and prevent premature institutionalization. The waiver includes a self-direction option, 'Services My Way,' allowing participants to choose and hire their caregivers, including family members (excluding spouses).

  • check_circle Adult Day Health
  • check_circle Case Management
  • check_circle Homemaker Services
  • check_circle Personal Care Aide Services
  • check_circle Respite Care
  • check_circle Assisted Living Services
  • check_circle Environmental Accessibility and Adaptation Services
  • check_circle Participant-Directed Community Support Services

insights Program Snapshot

Functional criterion
Nursing Home Level of Care
Administered by
Department of Health Care Finance (DHCF) Long Term Care Administration
Self-direction
Yes, through 'Services My Way' (family members, excluding spouses, can be hired)
Recertification
Annual

2026 Eligibility Requirements

Criteria Individual Limit Married (Both Applying)
Monthly Income $2,982 $5,964
Asset Limit $4,000 $6,000
Home Equity Limit $1,130,000
Level of Care Nursing Home Level of Care (NHLOC)
The District of Columbia is a Medically Needy state, allowing individuals with high medical expenses to 'spend down' their income to qualify for Medicaid.
home_work

Estate Recovery Warning

District of Columbia MERP: Aggressive
info The District of Columbia is required by law to seek reimbursement for long-term care costs after the death of Medicaid recipients through its Estate Recovery Program (MERP).
info The state has not expanded the definition of 'estate' beyond the probate estate.
info No hardship provision is explicitly mentioned in its estate recovery plan.

The District of Columbia's Medicaid Estate Recovery Program is mandated to recover long-term care costs from a deceased recipient's probate estate. The program does not explicitly detail hardship exemptions or expand beyond the probate estate.

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Spend-Down & Asset Protection

Medically Needy Pathway Income Cap State Miller Trust Required

PROTECTED ASSETS

Primary home up to $1,130,000 equity One vehicle (any value) Personal belongings Household goods Burial plots (for applicant and spouse)

COMMON PITFALLS

  • warning Look-back Period: Gifts or transfers for less than fair market value during the 60-month look-back period may result in a penalty period.
  • warning Excess Income: Failing to utilize the Medically Needy pathway if income exceeds the limit but medical expenses are high.
  • warning Joint Accounts: The full balance of joint accounts is often counted as the applicant's asset, potentially impacting eligibility.
Community Spouse Resource Allowance (CSRA): $162,660

First Steps for Families

1

Locate your ADRC

Contact your local District of Columbia Aging and Disability Resource Center.

2

Gather 5 years of records

Bank statements, deeds, asset transfers for the Medicaid look-back period.

3

Financial assessment

Consult a Medicaid planner if assets exceed $4,000.

View Full Application Process ↓
District of Columbia state capitol

Resource Contact

Department of Health Care Finance (DHCF)

call (202) 727-5355
Official site open_in_new

How to Apply for District of Columbia Long-Term Care Medicaid

1
Assess Level of Care

Obtain medical certification demonstrating a nursing home level of care is needed.

2
Gather Records

Collect proof of residency, income for the past 30 days, assets, health insurance cards, medical expenses, and documents of any asset transfers in the last five years.

3
Submit Application

Apply online via District Direct, by phone at (202) 727-5355, or mail a paper application to the Department of Human Services.

4
Contact ADRC for EPD Waiver

For EPD Waiver services, contact the DC Office of Aging's Aging and Disabilities Resource Center (ADRC) at (202) 724-5626.

5
Interviews

Attend required caseworker evaluations to determine eligibility and care needs.

6
Approval & Care

Receive an eligibility decision within 45 days, or 90 days if a disability review is required.

Documents You'll Need

Financial Verification

  • 5 years of bank statements
  • Stock/bond certificates
  • Retirement account information
  • Life insurance policies

Income Verification

  • Social Security award letters
  • Pension stubs
  • VA benefit statements
  • Proof of income for the past 30 days

Medical/Identity

  • Social Security card
  • Medicare card
  • Doctor's clinical assessments
  • Health Insurance Cards

Property/Residency

  • Home deed
  • Vehicle registration
  • Proof of District of Columbia residency (e.g., mortgage/rent statement, utility bill)
timer Federal Deadline: 45 Days
update Typical District of Columbia Processing: 90 Days

Frequently Asked Questions About District of Columbia Medicaid

Does District of Columbia Medicaid pay for assisted living?

Yes, the Elderly and Persons with Physical Disabilities (EPD) Waiver in the District of Columbia covers services provided in assisted living residences. However, it is important to note that the waiver does not cover the cost of room and board within these facilities. This program aims to help eligible seniors and disabled individuals receive necessary care outside of a nursing home setting.

What is the District of Columbia Medicaid income limit for seniors in 2026?

For a single senior applying for Nursing Home Medicaid or Home and Community-Based Services (HCBS) Waivers in the District of Columbia in 2026, the monthly income limit is $2,982. For married couples with both spouses applying, the combined income limit is $5,964 per month. The District also offers a Medically Needy pathway for individuals with higher incomes but substantial medical expenses.

How long is the HCBS waiver waitlist in District of Columbia?

The District of Columbia's Home and Community-Based Services (HCBS) Waivers, such as the EPD Waiver, are not entitlement programs and operate with a limited number of participant slots. Consequently, waiting lists may exist for these programs. However, specific, up-to-date figures on the number of individuals on the waitlist or the average wait time are not consistently published by authoritative sources.

Will Medicaid take my parent's house in District of Columbia?

Medicaid will not take a parent's house while they are alive and using it as their primary residence, especially if a spouse or dependent child resides there. However, after the Medicaid recipient's death, the District of Columbia's Estate Recovery Program is legally mandated to seek reimbursement for long-term care costs from the deceased's probate estate.

Can I be paid to care for my parent through District of Columbia Medicaid?

Yes, the District of Columbia's Elderly and Persons with Physical Disabilities (EPD) Waiver includes a self-direction option called 'Services My Way.' This program allows eligible participants to hire and pay family members, including adult children, to provide personal care and supportive services. Spouses, however, are generally not eligible to be paid caregivers under this program.

Medicaid vs Medicare for long-term care in District of Columbia?

Medicare is a federal health insurance program primarily for individuals aged 65 and older, typically covering short-term skilled nursing care or rehabilitation. It does not cover long-term custodial care. In contrast, District of Columbia Medicaid, administered by the Department of Health Care Finance (DHCF), is a needs-based program that provides extensive coverage for long-term care services, including nursing home care, assisted living services, and in-home care for eligible seniors.

TOPICAL GUIDES — HOW MEDICAID WORKS

EXPLORE DISTRICT OF COLUMBIA

Last updated: April 24, 2026. Sources: Department of Health Care Finance (DHCF), CMS Nursing Home Compare, Genworth 2024 Cost of Care Survey. Eligibility rules are set by each state Medicaid agency and update annually. We cite the agency name, statute, or CMS data source for every figure on this page; see our methodology and editor.