Dc Medicaid Provider Number Lookup


You Might Qualify For Dual Eligible Plans If

Nevada Medicaid App Overview
  • You are under age 65 and qualify on the basis of disability or other special situation OR you are at least 65 years old and receive Extra Help or assistance from your state.
  • Youre a U.S. citizen or a legal resident who has lived in the U.S. for at least five consecutive years.
  • You live in the plans service area.

How Can I Find A Top

You can use Zocdoc to find DC Medicaid Doctors who are highly rated by other patients. These ratings are based on verified reviews submitted by real patients. Every time a patient completes an appointment booked on Zocdoc, theyre invited to review their experience. Each review must comply with Zocdocs guidelines.

Department Of Health Care Finance

Office HoursConnect With UsHow to Apply for MAGI- Medicaid?

  • Call the DC Health Link Customer Service at 1-855-532-5465

Download an application from DCHealthlink.com

Mail your original, signed application to:

  • In Person: You may apply at any of the ESA Service Centers listed below:

1-855-532-5465How to Apply for Non-MAGI- Medicaid?

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Recommended Reading: Centers For Medicare And Medicaid Services Login

Find A $0 Premium Medicare Advantage Plan Today

For California residents, CA-Do Not Sell My Personal Info, .

MedicareAdvantage.com is a website owned and operated by TZ Insurance Solutions LLC. TZ Insurance Solutions LLC and TruBridge, Inc. represent Medicare Advantage Organizations and Prescription Drug Plans having Medicare contracts enrollment in any plan depends upon contract renewal.

The purpose of this communication is the solicitation of insurance. Callers will be directed to a licensed insurance agent with TZ Insurance Solutions LLC, TruBridge, Inc. and/or a third-party partner who can provide more information about Medicare Advantage Plans offered by one or several Medicare-contracted carrier. TZ Insurance Solutions LLC, TruBridge, Inc., and the licensed sales agents that may call you are not connected with or endorsed by the U.S. Government or the federal Medicare program.

Plan availability varies by region and state. For a complete list of available plans, please contact 1-800-MEDICARE , 24 hours a day/7 days a week or consult www.medicare.gov.

Medicare has neither reviewed nor endorsed this information.

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Where Can I Find A Doctor That Accepts Medicare And Medicaid

Medicaid Enrollment Form For Providers

To find a doctor that accepts Medicare payments, you may want to visit the Centers for Medicare and Medicaid Services’ Physician Compare. You can search by entering a health care professionals last name or group practice name, a medical specialty, a medical condition, a body part, or an organ system. This tool will provide you with a list of professionals or group practices in the specialty and geographic area you specify, along with detailed profiles, maps and driving directions.

Please note that Physician Compare only lists professionals that accept Medicare. Although some may also accept Medicaid, it does not have information about which professionals do accept Medicaid.

Medicaid programs vary by state and each state Medicaid agency maintains their own list of professionals that accept Medicaid. For further assistance, please contact your health plan or state Medicaid agency. For more information about Medicaid, visit the Medicaid & CHIP page on Healthcare.gov.

If you have trouble accessing the Physician Compare website, please call 1-800-MEDICARE and a representative will be able to run the search for you. They can also send you a print version of the search results.

There are other directories on MedlinePlus that will help you find health professionals, services, and facilities, some of which may serve Medicare or Medicaid payments.

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How To Apply For Medicaid Alliance Dc Healthy Families Or Retro Medicaid

There are now four ways to apply for Medical Assistance

Mail your signed application to:Department of Human Services | Economic Security AdministrationP.O. Box 91560

A Consumers’ Checkbook Privacy Policies


Consumers’ CHECKBOOK uses “cookies” to maintain your access privileges during an online session. We do evaluate site usage by analyzing user information in the aggregate, only in a way that does not identify any individual user. In light of these purposes, please note that you must accept cookies in order to use the Consumers’ CHECKBOOK website. Cookies are never used by third parties for marketing or tracking purposes.

Information logging and Storage

Consumers’ CHECKBOOK collects and stores the minimum amount of information it requires to provide a friendly user experience, improve the website’s effectiveness, and analyze utilization and resource requirements. We do not ask for or log user names or email addresses.

Also Check: Medicaid Fraud Statute Of Limitations

Who Is Eligible For Medicaid In The District Of Columbia

To receive federal Medicaid funding, the states and the District of Columbia must provide Medicaid to mandatory eligibility groups, including low-income children, pregnant women, parents of minor children, elderly people, and people with certain disabilities. States have the option of covering other eligibility groups, such as individuals receiving hospice care or certain women being treated for breast or cervical cancer.

While the mandatory and optional covered populations are consistent across the country, each state and DC set eligibility guidelines for the groups they cover. Medicaid eligibility levels in DC are among the most generous in the nation, and about one in three DC residents is covered by Medicaid.

The following are the District of Columbias Modified Adjusted Gross Income limits for some of the main groups covered by Medicaid :

  • 324% of the federal poverty level for children 0-18
  • 324% of FPL for pregnant women
  • 221% of FPL for parents with dependent children
  • 215% of FPL for other, non-elderly adults

Unitedhealthcare Dual Complete Plans


Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract and a contract with the State Medicaid Program. Enrollment in the plan depends on the plans contract renewal with Medicare. This plan is available to anyone who has both Medical Assistance from the State and Medicare. This information is not a complete description of benefits. Call TTY 711 for more information. Limitations, co-payments, and restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year.

  • Who is eligible?

    You might qualify for Dual Eligibility Plans if

  • You are under age 65, eligible for state Medicaid benefits, and qualify on the basis of disability or other special situation.
  • You are at least 65 years old and receive Extra Help or assistance from your state.
  • The Medicare Annual Enrollment Period happens once a year in the fall. If you qualify for a Dual Special Needs Plan, you may not have to wait.

    You may be able to enroll right away if you

  • Are 65 and newly eligible for Medicare or have a qualifying disability
  • Are retiring and losing your current coverage
  • Have moved out of your current Medicare plans service area
  • Have a chronic condition like diabetes or chronic heart failures
  • Receive Medicaid benefits
  • Looking for the federal governments Medicaid website? Look here at Medicaid.gov.

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    What Are You Searching For

    1100 New Jersey Ave, SE Suite 840

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    Other Coverage Programs Available In Dc

    Under its early adopted approach to Medicaid expansion, DC moved about 34,000 people who had been enrolled in DC HealthCare Alliance a District-funded program that allows low-income residents to obtain medical and dental services at no cost from participating providers to the Medicaid program. Enrollment in DC Healthcare Alliance had reached 50,000 by 2009 most of those people became eligible for Medicaid instead once Medicaid was expanded.

    So by opting to expand Medicaid early, DC was able to take advantage of federal funding to help cover a low-income population that was already being covered in a DC-based program that received no federal funding expanding Medicaid early was obviously a good financial move for DC. In addition, the benefits through DC HealthCare Alliance are more limited than Medicaid, with no funding for mental health care or medical transportation. So Medicaid provides better coverage for enrollees as well.

    For immigrant children under the age of 21, the Immigrant Childrens Program in DC provides coverage for those with income up to 200% of the poverty level, regardless of assets.

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    Become A Credentialed Provider

    If you do not have a Medicaid ID, .

    Providers interested in joining the MedStar Family Choice-DC network should complete/send the form below or contact a Provider Relations representative at .

    MedStar Family Choice-DC New Ancillary Vendor Interest FormMedStar Family Choice-DC is a member of the Council for Affordable Quality Healthcare . Please be sure to authorize MedStar Family Choice-DC as a health plan member which will allow us to access your credentialing information through CAQH. For additional assistance with CAQH, please contact a Provider Relations representative.

    Providers must hold a current, valid, unrestricted license to practice in all states where the provider provides care to MedStar Family Choice-DC enrollees. Providers must also have an active District of Columbia Medicaid Fee-for-Service provider number . In addition, primary care providers treating members under the age of 21 must also be up to date on their required HealthCheck training.

    In addition, specialists must have current unrestricted privileges at one of the following MedStar Family Choice-DC participating hospitals:

    Apply To Become A Service Provider

    CareFirst Community Health Plan District of Columbia (CHPDC)

    To become a RSA provider requires interested individuals and businesses to complete forms and undergo a rigorous review and approval process.

    Contact the Office of Contracts and Procurement

    Thank you for your interest in becoming a provider of services for the DDA Home and Community Based Services Medicaid Waiver program. Prospective providers should ensure that they meet the requirements to become enrolled as a Home and Community Based Services Medicaid Waiver Provider as outlined in General Provisions. Interested organizations and licensed clinicians must refer to the waiver service descriptions and rules for detailed requirements to become enrolled as a Home and Community Based Services Medicaid Waiver Provider. Please read the materials carefully to determine what services you or your organization may be eligible to provide.

    Department on Disabilities Services / Developmental Disabilities Administration are working to implement Person Centered Thinking philosophy throughout all enrolled HCBS providers. Person-Centered Thinking philosophy must be demonstrated by leadership and personnel that directs as much attention to the individual as to the team, requires senior leadership to be responsible for empowering people at all levels of the organization and this philosophy guides service delivery.

    Provided below is the information on the submission of the Medicaid waiver application for new and existing Home and Community Based Waiver providers.

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    Where To Apply For Health Coverage

    People in most states use HealthCare.gov to apply for and enroll in health coverage.

    If your state appears on the list below, you wont use HealthCare.gov. Youll use your states website to enroll in individual/family or small business health coverage, or both.

    Covered California is your states Marketplace. Visit Californias website.

    Is There A Medicare Advantage Phone Number

    Medicare Advantage plans are offered by private insurance companies, so you may want to call your plan provider directly with any questions about your Medicare Advantage plan. For general information about Medicare coverage, you can still call 1-800-MEDICARE, even if you are enrolled in a Medicare Advantage plan.

    Are you considering switching to a Medicare Advantage plan, changing your current Medicare Advantage plan or enrolling in Medicare Advantage for your first time? A licensed insurance agent can help answer any questions you have about Medicare Advantage plans and can help you compare plans that may be available in your local area.

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    District Of Columbia Medicaid Office

    Below is the contact information for the Medicaid office in District of Columbia. They can assist you with questions or concerns about the District of Columbia Medicaid program, including the eligibility requirements and Medicaid enrollment in District of Columbia. You can view their site online at http://doh.dc.gov. To find out if you are eligible for this program, District of Columbia Medicaid eligibility.

    The Medicaid program in District of Columbia covers basic medical care. This may include doctor services, inpatient hospital care, laboratory and x-ray services, inpatient short-term skilled nursing or rehabilitation-facility care, outpatient hospital or clinic care, short-term home healthcare, ambulance service and prescription drugs for people not covered by Medicare. We suggest contacting the Medicaid office to find out specifically what coverage is provided as it can be different in each state.

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    Civil Rights Groups File Complaint Over Dc Medicaid Dispute

    PECOS Enrollment Tutorial Initial Enrollment for an Individual Provider

    Advocates for D.C.s Medicaid recipients have filed a complaint with the U.S. Department of Health and Human Services over threatened changes to the D.C. Medicaid program.

    The groups, including the D.C. branch of the NAACP and the Health Alliance Network, a community organization devoted to health equity, have written to the HHS Office for Civil Rights, complaining that the health of the citys Medicaid recipients is imperiled by MedStar Healths dispute with the District government over its Medicaid contract.

    The groups pointed to an Aug. 20 letter penned by the D.C. Department of Health Care Finance to the D.C. Council Committee on Health, which said that MedStar Health intends to terminate its contracts with AmeriHealth Caritas DC and CareFirst Blue Cross Blue Shield, two Medicaid managed health care programs operating in the District.

    MedStar, which operates two of the citys largest hospitals, MedStar Washington Hospital Center and MedStar Georgetown University Hospital, has been in a long-standing dispute with the D.C. government over the Medicaid managed care contract of its subsidiary, MedStar Family Choice.

    The civil rights and advocacy groups speaking out against MedStars threat to end Medicaid contracts with the two insurance companies that provide Medicaid health coverage to the citys poor.

    The D.C. Department of Health Care Finance said the action would threaten access to care for as many as 230,000 District residents.

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    Generous Medicaid Program Contribute To Low Uninsured Rate

    As of 2015, the Kaiser Family Foundation estimated that there were still 42,000 uninsured residents in DC, and 48% of them were eligible for Medicaid. That said, the Districts uninsured rate is among the lowest in the nation, at 3.5% in 2019. Only Massachusetts had a lower uninsured rate at that point. DCs uninsured rate is down from 6.7% in 2013, and from more than 18% in the late 1990s. The drop in the uninsured rate is due in large part to the Districts efforts to implement the DC Healthcare Alliance, expand Medicaid and integrate the two programs.

    The COVID pandemic resulted in job losses and sharp increases in the uninsured rate across the U.S. as a whole. The District of Columbias uninsured rate was 6% as of May 2020. This was the lowest rate in the nation at that point, and a testament to the Districts commitment to providing health coverage for people with limited income. This included the fact that the normal enrollment and recertification process for DC Healthcare Alliance were relaxed during the COVID pandemic.

    Before You Call The Medicare Phone Number

    Before calling 1-800-MEDICARE, have your Medicare card ready in case the representative needs to know your Medicare number. If you are calling with a question about a claim or a bill, have the bill or the Explanation of Benefits handy for reference.

    It can also be helpful to keep a pen and paper ready to write down any important information your Medicare representative may share, such as additional phone numbers, dollar amounts, dates and more.

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    What Is Dc Healthy Families

    DC Healthy Families is a program that provides free health insurance to DC residents who meet certain income and U.S. citizenship or eligible immigration status to qualify for DC Medicaid. The DC Healthy Families program covers doctor visits, vision and dental care, prescription drugs, hospital stays, 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. To find out more about how to qualify for the DC Medicaid program

    Find More Information about DC Healthy FamiliesHere

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    How Can I Make A Same

    Methodology â Mapping the Landscape of Obesity Care

    On average, patients who use Zocdoc can search for a Primary Care Doctor who takes DC Medicaid insurance, book an appointment, and see the Primary Care Doctor within 24 hours. Same-day appointments are often available, you can search for real-time availability of Doctors who accept DC Medicaid insurance and make an appointment online.

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    District Of Columbia Has Accepted Federal Medicaid Expansion

    • 282,901 Number of DC residents covered by Medicaid/CHIP as of July 2021
    • 47,115 Increase in the number of DC residents covered by Medicaid/CHIP fall 2013 to July 2021
    • 54% Reduction in the uninsured rate from 2010 to 2019
    • 13% Increase in total Medicaid/CHIP enrollment in DC since Medicaid expansion took effect

    How To Use This Directory

    This Directory is provided as an informational guide only to help you make informed choices when selecting your health care provider.

    This information is not an endorsement of a particular physician or health care professionals suitability for your needs. While we have attempted to make the Directory as thorough as possible, under the best of circumstances, it will not be complete, may change during the plan year, and may contain errors or omissions. Provider information on the Directory is updated on at least a quarterly basis and extracted from a variety of sources including providers, plan provider directories, data aggregation partners, and other sources.

    You have the sole responsibility to:

    • Verify that the provider is in the plan network. Always call the health care provider directly to confirm that they are in the network of the plan you are considering or renewing and will continue to be during the upcoming coverage year. There may be higher costs to you if you visit a provider that is not in your plan network.
    • Verify that services are covered by your plan. Contact your plan’s customer service department to determine if the treatment requested from the in-network provider is covered. There may be higher costs to you if you receive a service that your plan does not cover.
    • Verify that the provider is accepting new patients. If you are a new patient, you should also call the provider to make sure they are accepting new patients.

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