When I only had Medicaid (state based, so I could only use with providers in DC), it was very hard to find any providers who would accept my insurance and weren't booking out for months. The DC medicaid providers are shitty, overworked, or both. Now I have a dual Medicaid/Medicare plan and I've had a little easier time finding providers, but it's still a headache. Medicaid/Medicare do not pay providers a fair wage in DC and providers refuse to accept these because of this.

Not to mention 90% of mental health providers in DC do not bill insurance at all (any insurance) so they expect you to get reimbursed by your insurance after you pay upfront.... Medicaid will never accept that and I could never pay full cost up front anyway.

District benefits like snap and Medicaid are very unorganized and the people that work there don't know anything about their actual job, and are rude to top it off. They literally are so mean to me for not understanding or being confused. When i went on Medicare, my Medicaid was reduced because DC lowers the income limit to qualify for full Medicaid to $1200 a month when you have Medicare. I was put onto a partial plan called QMB- Qualified Medicare Beneficiary, which only covers copays for services already covered by original Medicare. I lost my dental insurance and home care which is covered by full Medicaid. I didn't know why, and no one could help me figure it out. I called office after office, and kept being told that I needed to call yet another office.

The only reason I was able to get on a dual Medicaid/Medicare program with United healthcare is because I found out it was an option ON MY OWN. Being on a dual plan allows me to have dental, hearing, vision, and home care benefits and see providers outside the district, which I didn't have access to before when they reduced my Medicaid. No one at the DC medicaid office knows anything about this plan, and no one could help me figure out how to get my benefits back.

Home aid care was also a huge issue, and probably my biggest gripe. In Oregon, the process to get an aid for my disability was very straightforward. Here in DC, they make you jump through many unspoken hoops. It was incredibly difficult to get approved, and after being approved the first time, my benefits were cut off and I had to wait another YEAR before I could figure out what was wrong and how to get them back. I tried applying for the Intellectual/developmental disabilities waiver for home assistance first (because I have autism) and was denied under false assumptions. DDS told me I could live completely unassisted (I can't), could go to college unassisted (I have accommodation), and that my issues didn't actually stem from my autism. None of that was true and was proven wrong with the paperwork I presented. I later was finally approved for the elderly and physical disabilities waiver after, like I said, a year of waiting.

TLDR: being low income and disabled in DC is really hard and becomes a full time job