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CHAPTER 4 - DC HEALTHCARE ALLIANCE PROGRAM

INTRODUCTION 4.1

The DC HealthCare Alliance (Alliance) program is designed to provide medical assistance to needy District residents who are not eligible for federally-financed Medicaid benefits. This includes qualified aliens who do not meet the immigration requirements needed to be eligible for Medicaid and non-qualified aliens. Effective September 1, 2009, applicants who are enrolled in any part of Medicare or who have third party insurance are not eligible for the DC HealthCare Alliance. In addition, effective September 27, 2011, applicants must complete a face-to-face interview and may only be certified for six months. Enrollees recertifying for the Alliance must also complete a face-to-face interview. The Alliance program provides comprehensive health services, including preventative, primary, acute, and chronic care services such as clinic services, emergency care, immunizations, in-patient and out-patient hospital care, physician services and prescription drugs.

LEGAL AUTHORITY 4.2

AREA/TOPIC DISTRICT FEDERAL DC Healthcare Alliance 22 DCMR Chapter 33

DETERMINING NON-FINANCIAL ELIGIBILITY 4.3

Unless otherwise indicated, non-financial eligibility requirements for the Alliance program correspond to those of AR Medicaid (see Part IV, Non-financial Eligibility). Non-financial eligibility requirements must be verified.

Group Composition 4.3.1

The assistance unit must consist of the person requesting assistance and certain relatives and caretakers of children who live with the person, if these individuals wish to receive assistance. Relatives/caretakers who do not want to apply for benefits for themselves are never required to be included in the assistance unit, though their income and resources may be considered when determining the applicant’s eligibility. Groups that include children must follow the rules for the AR program. Groups in which no child is included (or included provisionally) must follow the rules of the SR program.

An Alliance unit may consist of any of the following:

 a single individual;  an individual and his/her spouse, including a common-law spouse;  a parent and his/her child(ren) (The children would be included provisionally for income determination purposes. If ineligible for federally-funded Medicaid, the caseworker will determine the children's eligibility for the Immigrant Children's Program); • a related or unrelated caretaker and the child and child’s siblings under his/her care (The children would be included provisionally for income determination purposes. If ineligible for federally- funded Medicaid, the caseworker will determine the children's eligibility for the Immigrant Children's Program); or  a pregnant woman and her unborn child(ren) (only if the pregnant woman is not a qualified alien).

In addition, at the group’s option, the following persons may be included in groups that include a child: