DC Medicaid for a Grandchild With a Relative Caregiver

How DC Counts Income for a Child's Medicaid

When a relative caregiver applies for Medicaid on behalf of a child in DC, the child is not automatically evaluated as a one-person household. DHCF determines household size and countable income under MAGI tax-filer and non-filer rules. Under non-filer rules, the caregiver is not included just because the child lives with them, though a parent or siblings may be included under the applicable household rules.

This differs from child-only TANF, and the child's household composition and income need to be reviewed before estimating eligibility.

DC Healthy Families Income Limits

DC Medicaid covers children ages 0-18 up to 319% FPL plus a 5% income disregard (effectively 324%) and ages 19-20 up to 216% plus the 5% disregard (221%). Eligibility is based on the applicable household size and income.

Coverage includes primary care, dental, prescriptions, mental and behavioral health services, and specialist referrals through managed care organizations.

How to Enroll

Apply through District Direct at districtdirect.dc.gov. DC Health Link directs Medicaid applicants to District Direct. When applying as a non-parent relative caregiver, you sign the health application as a caretaker — you do not need a court custody order to enroll the child.

The application asks for the child's identity documents (birth certificate or passport), Social Security number, proof of DC residency, and documentation of your caregiving arrangement (school records, medical records, or a professional letter confirming you as primary caretaker).

Continuous Eligibility and Renewal

Once enrolled, children receive 12 months of continuous eligibility regardless of income changes during that period. At renewal time, the Department of Health Care Finance (DHCF) attempts a passive (ex parte) redetermination first, cross-checking automated databases. If passive renewal cannot confirm eligibility, you receive a renewal packet.

If you miss the renewal deadline, DC allows up to 90 days after the certification end date to return the renewal form. If you remain eligible, coverage is reinstated retroactively to the certification end date; after 90 days, you must submit a new application.

Health Coverage for the Caregiver

If you need health coverage for yourself, adult Medicaid eligibility thresholds changed in January 2026. Parent and caretaker-relative Medicaid uses a 133% FPL threshold plus a 5% disregard (effective cutoff 138%). Eligible adults ages 21-64 with income from 138% to 200% FPL may qualify for the Healthy DC Plan, a Basic Health Program under ACA Section 1331.

Medicaid and Other DC Benefits

Medicaid can be received alongside child-only TANF, GCP/CRCP subsidies, SNAP, WIC, and the OSSE childcare subsidy, subject to each program's eligibility rules. CFSA's permanent guardianship subsidy policy includes medical coverage through DC Medicaid; for an out-of-state guardian, it describes Title XIX Medicaid in the state of residence, subject to provider acceptance.

For the complete guide to enrolling, renewing, and stacking all DC benefits as a relative caregiver, see the DC Kinship Financial Help Guide.

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