Health Plan Comparison

These are the plans available in the state. If you are a program member please go to 'My Account' to see which plans are in your area. If you are a non-member, please contact your local social services officer for eligibility determination.

Available Programs:
Amerigroup District of ColumbiaAmeriHealth Caritas DCTrusted Health Plan
Details:

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Details



Details

Name of Plan Details
For More Information Details
Transportation Services Details
Dental, Oral Surgery Details
Health Education and Special Programs Details
Extra Benefits and Services Details
For Health Plan contact information Click Here Cancel, Go Back

   


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What is a health plan?
A health plan is a company that the District pays to provide health services to you and your family. A health plan is sometimes call a managed care organization (MCO). A plan offers you medical, dental, and sometimes vision services. It uses doctors, hospitals, clinics, and pharmacies that work with the health plan to provide those services.
What health plan choices do I have?
Look at your Health Plan Comparison Chart that came in your Welcome Packet. This chart shows you which plans you can choose from and what benefits and services they provide. Click here to see the Chart.

If you have questions or need help, call our Customer Service Center at (202) 639-4030 or (800) 620-7802, or visit our office.

How do I choose a health plan and a doctor?

Click here to see a video on this subject

It’s easy to choose a health plan and a primary care physician (PCP) for each of the members of your family who are in the program. Just follow these steps:

Step 1: Think about your family’s health needs.

To start, think about and write down:

  • The doctors you want to see.
    • Do you have a doctor or PCP your family already likes?
  • Which hospitals, clinics, and pharmacies you want to use.
    • Do you want them to be close to your home, your job, or your kids’ school?
  • Other services or benefits that you need.
    • Do you or your family members need to be treated for special health conditions like asthma or diabetes?

Step 2: Find out what each health plan offers.

  • Look at the Health Plan Comparison Chart to learn about the services each plan offers. The Chart is in your Welcome Packet. Click here  to see what it looks like.
  • Use the Provider Directory to find out which health plans work with the doctors, hospitals, clinics, and pharmacies you want to use. The Directory is in your Welcome Packet. Click here to see what it looks like.
  • Choose a plan that lets you go to the doctors and clinics you want, and offers you the services you need.
  • Each person in your family can have a different health plan. However, it is easier to have the same plan for everyone.
  • If you need more information, call our Customer Service Center at (202) 639-4030 or (800) 620-7802, or visit our office.

Step 3. Sign up with your plan. Signing up with a health plan is easy. There are four ways you can do it.

  • Online. This is the easiest way. Click here to get started. It will take about 10 minutes to select your health plan and doctor online.
  • By phone. Call us at (202) 639-4030 or (800) 620-7802. We can help you in the language you speak. If you have hearing loss, call the TTY/TDD line at (202) 639-4041.
  • By mail. Fill out the Health Plan Selection form and all of the other forms in your Welcome Packet. Mail them back in the enclosed envelope or fax them to (202) 289-6764.
  • Visit our office. Visit our office at 6856 Eastern Avenue NW, Suite 206, Washington DC 20012.

How do I use the Health Plan Comparison Chart?
This chart  shows the services that each plan offers. You can compare each plan and choose the one that meets your needs.
  • The top row shows the name of each health plan.
  • The left-hand column shows a list of the types of benefits and services.
  • A green P shows that the plan offers that service.
  • A red X in the column means the plan does not offer that service.
  • To see details about each plan, click on the "See Details" link under the health plan name.
  • To compare each plan's services, click on the "See Details" link next to each category name.
  • To see details for all of the plans and all of the services, click on the "See All" button.
Do I need to select a health plan and primary doctor for each member in my household?
Yes. You must select a health plan and primary care physician (PCP) for each member of your family who are in the program. Use the “How to Choose a Health Plan” guide to help you find the health plans and PCPs that meet you and your family’s needs.
Do I need to choose a health plan before I select my doctor?
You can choose a plan first or a doctor first. It’s up to you. If you pick a doctor first, we’ll tell you which health plans work with the doctor. Then you can choose one of those plans. If you pick a plan first, you can then select a doctor who works with that plan.
Can I change my health plan?
Yes. You can change your health plan within the first 90 days of enrollment. To change health plans, call our Customer Service Center at (800) 620-7802.

If you don’t change plans in 90 days, then you must stay in the health plan for at least one year, unless you can show a good reason as determined by DC Healthy Families to change.

I have health care coverage from another insurance company. Does this affect my Healthy Families membership?

Click here to see a video on this subject

If you are a member of DC Healthy Families and you have health care coverage under a different insurance provider, you must tell your ESA caseworker and health plan right away. Call your health plan by using the phone number shown on your Member ID card.

You will not qualify for the Alliance program if you have health care coverage under a different insurance provider. DC Alliance is for people who don’t have health insurance and can’t get Medicaid or Medicare.