Medicaid appeals in District of Columbia: hearing deadline and keeping benefits
DC Medicaid (also DC Healthy Families; the DC Health Care Alliance is a local program): you have 90 days to ask for a fair hearing.
For a Medicaid eligibility decision, your Medicaid continues if you appeal before it ends or within 15 days of the date of the notice, whichever is later.
Checked against official sources: October 30, 2026.
Appeal deadlines are strict. If you are near a deadline or your care is urgent, call free help today.
Medicaid (DC Medicaid (also DC Healthy Families; the DC Health Care Alliance is a local program)) denials in the District of Columbia
- Medicaid agency
DC Department of Health Care Finance (DHCF) for coverage; DC Department of Human Services (DHS) for eligibility
- Who holds the hearing
DC Office of Administrative Hearings (OAH)
- Hearing deadline
90 days
The postmark date of the agency notice
- How to ask for a hearing
- Phone: OAH 202-442-9094 (press 3 for case filing, then 3 for public benefits)
- Form: OAH DHS Benefits Hearing Request (eligibility) or DHCF Healthcare Coverage Hearing Request (coverage); include a copy of the notice
- Online: Email the form to oah.filing@dc.gov, or use the OAH eFiling Portal (under maintenance as of October 21, 2026)
- Fax: OAH 202-442-4789
- Mail: Office of Administrative Hearings, 441 4th Street NW, Suite 450 North, Washington, DC 20001
- In person: OAH Resource Center, 441 4th Street NW, Suite 450 North, or any DHS Service Center
- Mail address
Office of Administrative Hearings, 441 4th Street NW, Suite 450 North, Washington, DC 20001
- What to include
Use the OAH hearing request form for your type of case and include a copy of the notice you received from DHS or DHCF.
- Keeping your benefits during the appeal
For a Medicaid eligibility decision, your Medicaid continues if you appeal before it ends or within 15 days of the date of the notice, whichever is later. If you appeal later but within 90 days, your appeal is still heard but coverage may not restart. DC notices of cuts or terminations must be postmarked at least 15 days before the change.
Law: D.C. Code 4-205.55; D.C. Code 4-210.09 (cited on DHCF notice)
- When the hearing is held
For eligibility appeals, you are first offered a voluntary Administrative Review Conference with a DHS hearing examiner (Office of Administrative Review and Appeals); if not resolved, an OAH administrative law judge holds the fair hearing. OAH usually first schedules a status hearing, and most hearings are by phone.
Law: D.C. Code 4-210.09 (cited on DHCF notice)
Medicaid health plan (managed care) in the District of Columbia
- Appeal to the plan first
If you are in a DC Medicaid managed care plan, appeal to the plan first under the federal managed care rules, then you can ask OAH for a fair hearing. The DC Health Care Bill of Rights external appeal does not apply to Medicaid. For questions about the Medicaid managed care appeals process, call 202-442-9094.
- Then a state hearing
120 days
The date of the plan's appeal decision notice
- If the plan is late
If the plan does not meet the federal notice or timing rules, you can ask for a fair hearing without waiting.
Law: 42 CFR 438.402, 438.408; D.C. Code 44-301.07(q)
Write my appeal: free letters
Sources
The official sources for the District of Columbia are listed on the District of Columbia page.