In the District, Medicaid long-term care is administered by the Department of Health Care Finance, known as DHCF. Coverage can look very different depending on the setting: it pays for care in a nursing facility, and separately, it funds services delivered at home or in the community through Home and Community Based Services waivers. Before either path opens up, DHCF checks four things — that you live in the District, that your citizenship or immigration status qualifies, that you meet the financial rules, and that you have a documented medical need for the level of care you're requesting.
Financially, DHCF actually gives applicants three ways in. If you already receive or qualify for SSI, you're automatically Medicaid-eligible. If your income runs higher than the SSI cutoff, you may still qualify under the Special Income Standard — set at 300% of the SSI federal benefit rate, which works out to $2,982 per month in 2026. On the resource side, DHCF's long-term-care framework allows $4,000 in countable resources for a single applicant and $6,000 for a married couple, and it doesn't count the value of your home, one vehicle, or ordinary household and personal belongings against that limit.
None of this replaces an individualized eligibility review — DHCF's published overview is a starting point for understanding the shape of the program, not a substitute for having your specific numbers checked against current rules.