The District of Columbia (DC) Insurance Exchange (Marketplace) is called DC Health Link. DC Health Link is administered by the District.
General information about DC Health Link can be found at: https://www.dchealthlink.com/ Learn more:Background
PATIENTS
DC Health Link is essentially a marketplace for individuals and small businesses with up to 100 employees to shop for health insurance if they do not already have insurance coverage from another source. If they have insurance from another source (such as employment, retirement benefits, or spousal benefits), they do not need to obtain it from the Marketplace.
HIV PROVIDERS
Providers must contract with each of the plans in the marketplace individually in order to fully participate in the DC Health Link.
This process is similar to enrolling in insurance or managed care organization provider networks. See below for a list of insurers participating in the state marketplace, and information on contacting them.
As an HIV provider, you may qualify for the designation, of an “Essential Community Provider (ECP).” The Qualified Health Plans participating in the Insurance Exchange (Marketplace) are required to contract with a minimum number of ECPs and Specialists to ensure network adequacy.
Visit our Provider Resources Section for more specific instructions to assist you in contacting health plans.
REPORTING PROBLEMS
The state office of insurance is primarily responsible for examining and addressing issues with the plans offered within the state Exchange (Marketplace), and the companies that offer them. If you are experiencing problems as a medical provider with the plans or companies in the state exchange, or if your patients are experiencing problems with the plans or companies in the state exchange, including trouble with access to medications, access to preferred providers, navigating the appeals process, excessive costs, or possible discriminatory policies, or any other problems related to the Affordable Care Act, please report these problems to the state office of insurance:
District of Columbia Department of Insurance
810 First Street, NE, Suite 701
Washington, DC 20002
(202) 727-8000
Additionally, if you are experiencing these or other problems, please report these problems to AAHIVM, so that we may track issues affecting our members, and seek additional policies remedies.
QUALIFIED HEALH PLANS PARTICIPATING IN THE EXCHANGE
Below is a list of the Qualified Health Plans that have publicly announced that they will offer plans in the DC Health Link.
This list is being routinely updated, and may change as insurers join or leave the Exchange. Please check back for updates.
Aetna
Plan Website: http://www.aetna.com/
Provider Enrollment: http://www.aetna.com/healthcare-professionals/join-aetna-network/join-provider-network.html
Plan types offered: Individual, SHOP
CareFirst BlueCross BlueShield
Plan Website: https://member.carefirst.com/individuals/home.page
Provider Enrollment: https://provider.carefirst.com/wcmwps/wcm/connect/151c2000456e3acea7b8afed9a4bbc9e/DCUniformCredRecredApp.pdf?MOD=AJPERES&CACHEID=151c2000456e3acea7b8afed9a4bbc9e
Plan types offered: Individual, SHOP
Kaiser Permanente
Plan Website: https://healthy.kaiserpermanente.org/html/kaiser/index.shtml?region=MID
Provider Enrollment: http://www.kaiserpermanentejobs.org/default.aspx
Plan types offered: Individual, SHOP
United HealthCare
Plan Website: http://www.uhccommunityplan.com/plan/state/DC/index
Provider Enrollment: http://www.uhccommunityplan.com/physicians-network
Plan types offered: Individual, SHOP