Medicaid Renewal and Work Requirements

The new work requirements do not apply to the following groups of people:

• Children 18 or younger
• Any adult 65 or older
• Adults enrolled in waiver programs like the Elderly and Persons With Physical Disabilities Waiver, Services My Way, Individuals with Developmental Disabilities Waiver, or the Individual and Family Support Waiver
• Adults who are disabled or have a health condition qualifying them for Medicaid (non-MAGI)
• Adults in long-term institutional care, like nursing facilities and intermediate care facilities
• Adults in the Program of All-Inclusive Care for the Elderly (PACE)
• Adults in the Qualified Medicare Beneficiary (QMB) and QMB+ programs
  

Many Medicaid populations are not subject to Medicaid work requirements through exemptions in statute. If exempted, the individuals won't be subject to work requirements (no need to fill out or submit information related to work requirements, and no "look back" period).

Exempted individuals include:

• Individuals who are pregnant or postpartum
• Individuals who are already compliant with SNAP/TANF work requirements
• Parent/caretaker relatives of a disabled child or a child 13 years or younger
• Individuals enrolled in or entitled to Medicare Part A benefits, or enrolled in Medicare Part B
• Individuals enrolled or eligible for Medicaid as a current or former foster care youth
• Native Americans and Alaska Natives who are eligible to receive services via the Indian Health Service 
• Veterans with a disability rated as total under Section 1155 of Title 38 of the U.S. Code
• Individuals who are medically frail in a way that significantly impacts their ability to meet Medicaid work requirements, including anyone:
  • Who is blind or disabled (as defined in Section 1614) 
  • With a substance use disorder 
  • With a disabling mental disorder 
  • With a physical, intellectual, or developmental disability that significantly impairs their ability to perform one or more activities of daily living
  • With a serious or complex medical condition

Some other exceptions include those in rehabilitation, those who received inpatient hospital services, and those traveling for medical reasons.

• Visit District Direct or download the District Direct mobile app, available in the Google Play or Apple App Store.
• On the main page, click Log In and then click Create Account.
• On the next page, enter the information required to create your account, such as your username and password.
• Once complete, click Create Account. Then connect your account by clicking Connect Your Account on the homepage and entering the required information.
• Once your account is active, return to the homepage, where your information will appear.

• If you have an account, you can access your account at District Direct or through the District Direct mobile app, available in the Google Play or Apple App Store.
• Next, you must enter your username and password. If you applied for benefits online, you created your username and password when you applied.
• If you don’t remember your username or password, you can reset it by clicking the Forgot Password or Forgot Username link or calling the Public Benefits Call Center at 202-727-5355.

After receiving your renewal letter in the mail from DHCF, complete your renewal immediately to help avoid a gap in your health coverage. You may complete and return your renewal using one of the following methods:

• Online. Visit District Direct or download the District Direct mobile app, available in the Google Play or Apple App Store.
• By fax or mail. Fax a completed application from DC Health Link to 202-671-4400 or mail it to:
  • Department of Human Services
    Economic Security Administration
    Case Record Management Unit
    P.O. Box 91560
    Washington, DC 20090
• In person. Visit a Service Center with all of your documentation. Service Centers are open 7:30 a.m. to 4:45 p.m., Monday through Friday. Find a Service Center.

The District will require that currently enrolled individuals subject to work requirements meet the following requirements for any one month during the individual’s most recent eligibility determination and redetermination of eligibility (i.e., their last renewal):

• Work at least 80 hours in any month since their last renewal in 2026.
• Complete at least 80 hours of community service in any one month since their last renewal in 2026.
• Participate in a work program for at least 80 hours in any one month since their last renewal in 2026.
• Is enrolled in an educational program (school) at least half-time in any one month since their last renewal in 2026.
• Engages in any combination of the above for a total of at least 80 hours in any one month since their last renewal in 2026.
• Has a monthly income that is not less than the applicable minimum wage requirement of Section 6 of the Fair Labor Standards Act of 1938, multiplied by 80 hours.
  • For a household of one, someone earning near the District living wage could work approximately 33 hours a month and meet this income requirement.
  • This amount is equal to roughly 44% of the federal poverty level (FPL) for a household of one.
• Has had an average monthly income over the preceding six months that is not less than the applicable minimum wage requirement under Section 6 of the Fair Labor Standards Act of 1938 multiplied by 80 hours and is a seasonal worker.

The first renewal group subject to the new Medicaid work requirements will be those with March 2027 recertification dates. The look back period for this group will go back to April 1, 2026, which would have been the first day after their most recent eligibility determination/redetermination of eligibility. This approach to the look back period will apply to all Medicaid renewal groups in each month forward from March 2027.

New Medicaid applicants in 2027 must demonstrate compliance with the Medicaid work requirements by meeting one or more of the following criteria during the one-month look back period or one month prior to their application.

• Work at least 80 hours in any month since their last renewal in 2026.
• Complete at least 80 hours of community service in any one month since their last renewal in 2026.
• Participate in a work program for at least 80 hours in any one month since their last renewal in 2026.
• Is enrolled in an educational program (school) at least half-time in any one month since their last renewal in 2026.
• Engages in any combination of the above for a total of at least 80 hours in any one month since their last renewal in 2026.
• Has a monthly income that is not less than the applicable minimum wage requirement of Section 6 of the Fair Labor Standards Act of 1938, multiplied by 80 hours.
  • For a household of one, someone earning near the District living wage could work approximately 33 hours a month and meet this income requirement.
  • This amount is equal to roughly 44% of the federal poverty level (FPL) for a household of one.
• Has had an average monthly income over the preceding six months that is not less than the applicable minimum wage requirement under Section 6 of the Fair Labor Standards Act of 1938 multiplied by 80 hours and is a seasonal worker.

For example, someone applying for Medicaid in April 2027 must demonstrate that they have met the new Medicaid work requirements in the month of March or that they have a qualifying exemption.

Approved activities may include:

• Working
• Job training
• Education
• Volunteering
• A mix of these activities

Most enrollees will not need to send in extra paperwork to prove requirements. DC Medicaid will check information the state already has. This includes information such as your employment and Social Security records.

If DC Medicaid is unable to determine you met the residency, income, and/or workforce requirements (if applicable) using available data sources, then you will need to submit proof that shows you meet the requirement or that you have an exemption.

Most enrollees will not need to send in extra paperwork to prove requirements. DC Medicaid will check information the state already has. This includes information such as your employment and Social Security records.

If DC Medicaid is unable to determine you met the residency, income, and/or workforce requirements (if applicable) using available data sources, then you will need to submit proof that shows you meet the requirement or that you have an exemption.

All important notices and any required documentation will be sent to you by mail.