Summary
CareFirst is launching the Healthy DC Plan on January 1, 2026, for Washington D.C. residents with incomes between 138-200% of federal poverty level. The plan offers $0 premiums, copays, and deductibles, with a temporary waiver of prior authorization requirements during the initial implementation period.
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What to do
immediately · 5 steps
01Billing team must verify network participation using CareFirst's Find a Doctor tool for 'CareFirst Healthy DC' network.
02Update eligibility verification processes to check Healthy DC Plan benefits through CareFirst Provider Portal.
03Train staff that prior authorization is temporarily waived for Healthy DC members until further notice.
04Front desk staff should verify member eligibility and benefits for all D.C.
05residents who may qualify for this new plan.
Original notice
Healthy DC Plan Update
provider.carefirst.com · Always check the source before changing claims.