DC Alliance Transportation Benefit: None Through Sept 2027

On October 1, 2025, the DC Department of Health Care Finance (DHCF) stopped paying for non-emergency transportation for members of the DC Health Care Alliance. That day the Alliance and the Immigrant Children’s Program became one program, moved from managed care plans to fee-for-service, and dropped several benefits. On September 10, 2026, DHCF announced that from October 1, 2026 through September 30, 2027, adults can newly apply again and several adult benefits return. Non-emergency medical transportation stays on the list of services the Alliance does not cover. Rides for DC Medicaid members go on.

What changed in 2025, and what changes on October 1, 2026

The Alliance is a locally funded program for DC residents who cannot get Medicaid and have no other health coverage, including Medicare. DHCF tied the 2025 changes to the Fiscal Year 2026 Budget Support Act of 2025, Bill 26-260, and the 2026 changes to the Fiscal Year 2027 Budget Support Act of 2026, Bill 26-661.

Item	Before October 2025	October 2025 to September 2026	October 2026 to September 2027
Program	Alliance and the Immigrant Children’s Program, run separately	One program, the Health Care Alliance	No change
How care is paid	Through a managed care plan	Fee-for-service. DHCF acts as the plan, and providers bill DHCF	Still fee-for-service
Non-emergency rides	Paid by the member’s plan	Not covered. Members find and pay for their own rides	Still not covered
Emergency ambulance rides	Covered	Covered	Covered
Income limit, age 21 and older	215% of the federal poverty level	138%	138% (133% plus a 5% disregard)
New applicants age 26 and older	Accepted	Not accepted. Children, adults 21 to 25, and pregnant women can still apply	Adults 21 and older can apply
Adult home health, podiatry, vision, hearing, and dental	Covered	Not covered	Covered
Skilled nursing facility care for adults	Covered	Not covered	Short-term stays covered

The October 2026 changes apply to adults only. DHCF’s Medicaid Director Letter MDL 26-03 says nothing changes for children in the Alliance, and hospice, organ transplants, cell and gene therapy, and long-term care stay uncovered for adults.

What did not change: DC Medicaid rides

The change is limited to the Alliance. Medicaid members still get rides, and who books them depends on the member’s coverage.

Health plan members. About 220,000 of DC’s roughly 250,000 Medicaid and CHIP enrollees are in a managed care plan, and those plans provide their members’ rides, according to DHCF’s 2026 broker contract.
Fee-for-service members. About 40,000 to 50,000 fee-for-service members a month, plus about 1,900 people in the waiver for intellectual and developmental disabilities, ride through DHCF’s broker.
The broker in late 2026. MTM Health has run fee-for-service rides since 2012. The District signed the next broker contract, CW135340, with Verida, Inc. on July 7, 2026, for a term starting October 1, 2026. MTM protested on August 5, 2026 (Contract Appeals Board case P-1231), and a stop-work order on Verida’s contract followed on August 6. On September 16, 2026, the Mayor sent the DC Council an extension of MTM’s contract from October 1 through December 31, 2026, estimated at $6,051,195. The District told the Council it did not expect a ruling on the protest for at least two months.

MTM Health’s DC booking line is 1-866-796-0601. For the plans’ ride vendors and how to join them, see our Washington, DC guide.

Who it affects

Transportation companies

No plan or broker pays for a ride for a member whose only coverage is the Alliance. Any ride you give that member is a private pay trip, billed to the rider or to whoever agrees to pay. From October 1, 2026, adults 21 and older can apply again, so more of your riders may have only Alliance coverage.

Alliance members still have covered care to get to. DHCF’s Alliance handbook, updated February 26, 2026, covers dialysis up to three times a week, and DHCF says chemotherapy and surgery remain covered. Primary care visits, hospital care, and prescriptions are covered too, and from October 1, 2026 adult podiatry, vision, hearing, and dental visits are covered again. A member who rode to dialysis through a plan before October 2025 has the same schedule and no ride benefit.

Members, clinics, and dialysis centers

DHCF told Alliance members to plan their own rides: family or friends, public transit, or low-cost options their doctor’s office knows. The 2026 handbook points to Metro’s reduced fares and paratransit and to Transport DC. Transport DC gives eligible MetroAccess customers who live in DC $5 taxi rides anywhere in the city from the 1st to the 15th of each month, and only to work and medical treatment for the rest of the month.

What DC NEMT providers should do now

Check coverage before every trip. Confirm whether a rider has Medicaid, a health plan, or only the Alliance. A broker or plan will not pay for an Alliance-only rider. DHCF also expects 700 to 900 adult noncitizens, such as refugees and asylees without a green card, to lose DC Medicaid at the end of September 2026, and their Medicaid rides with it. See eligibility verification and the immigrant eligibility change.
Set a private pay price before you quote. Decide your rate, cancellation rule, and payment terms, and take payment the way you planned. Our private pay guide covers pricing.
Talk to dialysis centers and clinics. Some serve Alliance patients who now lack rides. A center may choose to pay for rides under a written agreement. See facility contracts.
Keep your Medicaid work steady. Stay credentialed with MTM Health, which the District has asked to keep running fee-for-service rides through December 31, 2026. Watch the outcome of the protest, because a move to Verida would mean joining Verida’s network.
Do not count on one payer. When a program drops a benefit, the trips go with it. See how much revenue should come from one payer and who pays for NEMT.

Who to contact

Office	Phone	For
DC Public Benefits Call Center	(202) 727-5355, TTY 711	Alliance and Medicaid coverage, weekdays 7:30 a.m. to 4:45 p.m.
DHCF Health Care Ombudsman	(202) 724-7491 or (877) 685-6391	Help with coverage problems
DHCF main office	(202) 442-5988	Alliance program questions
MTM Health, DC Medicaid fee-for-service rides	1-866-796-0601	Booking rides at least three business days ahead, and scheduling problems
Transport DC	(202) 645-7300	$5 taxi program for eligible MetroAccess customers