MedicaidAdministrativeMedium impact
Healthy DC Plan Update
CareFirst BlueCross BlueShield·DC·Provider News
Effective date
Jan 1, 2026
We identified it
Jun 20, 2026
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.
Action Required
Immediately: Billing team must verify network participation using CareFirst's Find a Doctor tool for 'CareFirst Healthy DC' network. Update eligibility verification processes to check Healthy DC Plan benefits through CareFirst Provider Portal. Train staff that prior authorization is temporarily waived for Healthy DC members until further notice. Front desk staff should verify member eligibility and benefits for all D.C. residents who may qualify for this new plan.