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.
Medicaid Report Card
Overall State Performance Index
Based on CMS Nursing Home Compare + state Medicaid agency data
View Methodology arrow_forwardDistrict of Columbia Monthly Costs
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.
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) | |
Estate Recovery Warning
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.
Spend-Down & Asset Protection
PROTECTED ASSETS
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.
First Steps for Families
Locate your ADRC
Contact your local District of Columbia Aging and Disability Resource Center.
Gather 5 years of records
Bank statements, deeds, asset transfers for the Medicaid look-back period.
Financial assessment
Consult a Medicaid planner if assets exceed $4,000.
Resource Contact
Department of Health Care Finance (DHCF)
How to Apply for District of Columbia Long-Term Care Medicaid
Assess Level of Care
Obtain medical certification demonstrating a nursing home level of care is needed.
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.
Submit Application
Apply online via District Direct, by phone at (202) 727-5355, or mail a paper application to the Department of Human Services.
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.
Interviews
Attend required caseworker evaluations to determine eligibility and care needs.
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)
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.