Nice Healthcare

To be eligible for Nice, you must be enrolled in a District medical plan. However, your eligible dependents do not need to be enrolled in a District medical plan to use Nice. 

• Nice can treat anyone over eight weeks old.
• To be eligible for Nice’s mental health services, you must be 18 or older.
• Nice physical therapy services are available to those 12 and older, and children under the age of
• 16 must be accompanied by a parent for their first physical therapy visit.

Medicare-Eligible Employees (Age 65+)

For employees enrolled in the District medical plan, Employees age 65+ do have access to Nice Healthcare services regardless of Medicare enrollment status (Parts B, C, or D). They can access:

• Virtual and in-person visits
• Included labs (35 labs)
• Medications on the Nice included list (550+ formulary)
• Important limitations:
  • Nice cannot prescribe medications or order labs or imaging outside of the Nice included list
  • Nice cannot provide services that would need to be billed through Medicare 
  • Members cannot self-pay for non-included services through Nice

Medicaid

Medicaid members have additional restrictions. They can access:

• Virtual and in-person visits
• Included labs
• Medications: Not eligible to receive medications through Nice; Exception: If the member has secondary insurance, Nice may prescribe medications on the Nice included list only
• Limitations - As with Medicare:
  • Nice cannot provide services that would be billed through Medicaid
  • Members cannot self-pay for non-included services

Please note that for all benefits-eligible dependents who are Medicare- or Medicaid-eligible, the same conditions listed above would apply.