Medicaid/SCHIP: Medicare/Medicaid Dual Enrollees

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Medicaid/Medicare Dual Enrollees

Resources on Dual Eligibles and Issues Related to Their Transition to the New Medicare Drug Benefit
A collection of information and publications on dual eligibles, their current drug coverage, and issues related to their transition to the new Medicare drug benefit.

Medicaid Enrollment and Spending for Medicare Beneficiaries in 2003
This report provides the latest national and state data on Medicaid enrollment and spending for individuals enrolled in both Medicaid and Medicare. Nationally, there are 7.5 million dual eligibles and while they comprise 14% of the Medicaid population, they account for 40% of Medicaid spending.

Recent Documents: (117 results)

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Perspectives on Medicare Part D and Dual Eligibles: Key Informants’ Views From Three States -- May 2007

In 2006, low-income individuals receiving health coverage through both the Medicaid and Medicare programs, “dual eligibles,” experienced a change in their prescription drug benefit when their Medicaid prescription coverage was replaced by the Medicare prescription drug program known as Medicare Part D. This study provides information on the ongoing successes and challenges that dual eligibles faced in the first eight months of Part D and how different state approaches (Connecticut, Washington and Florida) may affect dual eligibles’ ability to access prescription medications.

The Impact of Part D on Dual Eligibles Who Spend-Down to Medicaid -- May 2007

This paper explores the inter-relationship of Medicare prescription drug coverage and Medicaid spend-down for the medically needy. It describes Part D impacts for spend-down individuals and the resulting effects on their eligibility both for Medicaid and the Medicare Low-Income Subsidy assistance.

Medicare: A Primer -- March 2007
This primer provides an overview of the Medicare program, how it is structured, who it serves, and how it works.

KaiserEDU.org Issue Module: Financing Long-Term Care -- March 2007
This KaiserEDU.org issue module discusses long-term care costs, Medicaid and Medicare's role in paying for care and role of private long-term care insurance.

Medicaid and Long-Term Care: Recent Publications Illuminate Key Policy Issues -- December 2006

With recent policy debates about the future of Medicaid, the Foundation's Kaiser Commission on Medicaid and the Uninsured has created a resource page of recent publications that address key policy issues when examining Medicaid's role for high cost populations and in long-term care.

Voices of Beneficiaries: Medicare Part D Insights and Observations One Year Later -- December 2006
This December 2006 report describes the views and experiences of 35 Medicare beneficiaries under the new drug benefit in advance of the 2007 open enrollment period. It is based on one-on-one structured interviews with a diverse group of Medicare beneficiaries conducted in four cities.

Profiles of Medicaid's High Cost Populations -- December 2006

This paper examines the role that Medicaid plays in addressing six populations with serious health needs resulting in high costs. For each population profiled, the report describes the condition and the need for services and supports, as well as the role of Medicaid in meeting those needs. Profiles of real people with these conditions are also included with descriptions of model programs or cutting edge practices designed to meet the needs of these individuals.

Benefit Design and Formularies of Medicare Drug Plans: A Comparison of 2006 and 2007 Offerings -- November 2006
This analysis provides a profile of the 2007 Medicare stand-alone drug plans that are being offered to the program’s 43 million beneficiaries for 2007 and highlights some of the changes in plans between 2006 and 2007. It looks at premiums, covered drugs, the amount enrollees pay to fill a prescription, and other key features that would affect out-of-pocket costs and access to drugs for people with Medicare.

Observations on the Initial Implementation of the Medicare Prescription Drug Program: Perspectives of State Medicaid Directors Through a Focus Group Discussion -- May 2006

This report summarizes the observations of Medicaid directors at a March 2006 focus group on the new Medicare drug benefit and its interactions with state Medicaid programs as dual enrollees are transition from a Medicaid drug benefit to the Medicare benefit.

Transitions 2006 -- May 2006

This 2006 video produced by the Foundation reports on the experiences of three dual enrollees as they transition from a Medicaid prescription drug benefit to the new Medicare drug benefit.

This primer provides an overview of the Medicare program, how it is structured, who it serves, and how it works.

This KaiserEDU.org issue module discusses long-term care costs, Medicaid and Medicare's role in paying for care and role of private long-term care insurance.

This December 2006 report describes the views and experiences of 35 Medicare beneficiaries under the new drug benefit in advance of the 2007 open enrollment period. It is based on one-on-one structured interviews with a diverse group of Medicare beneficiaries conducted in four cities.

This analysis provides a profile of the 2007 Medicare stand-alone drug plans that are being offered to the program’s 43 million beneficiaries for 2007 and highlights some of the changes in plans between 2006 and 2007. It looks at premiums, covered drugs, the amount enrollees pay to fill a prescription, and other key features that would affect out-of-pocket costs and access to drugs for people with Medicare.

This 2006 video produced by the Foundation reports on the experiences of three dual enrollees as they transition from a Medicaid prescription drug benefit to the new Medicare drug benefit.

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Medicaid/Medicare Dual Enrollees

Over 7 million of Medicaid’s 50 million beneficiaries are “dual enrollees”, low-income elderly and individuals with disabilities who are enrolled in both Medicaid and Medicare. While Medicare covers basic health services, including physician and hospital care, dual enrollees rely on Medicaid to pay Medicare premiums and cost-sharing and for services that Medicare does not cover, such as prescription drugs and long-term care. Because dual enrollees have significant health needs and few resources to obtain the range of services they require, Medicaid’s assistance is crucial.