Resources on Dual Eligibles and Issues Related to Their Transition to the New Medicare Drug Benefit
With the new Medicare prescription drug benefit available as of January 1, 2006, over 6 million low-income seniors and people with disabilities who are enrolled in both Medicaid and Medicare—also known as dual eligibles—have been transitioned from Medicaid drug coverage to new Medicare drug plans. While there are many policy issues related to the overall establishment of the new drug benefit, the mandatory transition of dual eligibles has created a special set of challenges for the federal government, states, and beneficiaries.
If the characteristics of dual eligibles are examined, it becomes evident that they will need special attention when being enrolled in the new Medicare benefit:
- Nearly three-quarters (73%) have $10,000 or less in income
- 61 percent have less than a high school education
- More than one-third (37%) are disabled
- More than one-third (34%) have a mental impairment
- More than one-quarter (27%) have diabetes
- Nearly one-fifth (19%) reside in a long-term care facility
A collection of information and publications on dual eligibles, their current drug coverage, and issues related to their transition to the new Medicare benefit follows:
Who are the Dual Eligibles?
The Transition to Part D
Podcast: Insights on Transitioning From Medicaid to the New Medicare Prescription Drug Benefit: Audio Briefing (Downloadable Audio File)
Speakers include: Barbara Lyons, Deputy Director, Kaiser Commission on Medicaid and the Uninsured, Linda Elam, Senior Associate, KCMU; Vern Smith, Principal, Health Management Associates; Michael Perry, Partner, Lake Research Partners; and Michael McMullan, Deputy Director for Beneficiary Services, Center for Beneficiary Choices, Centers for Medicare & Medicaid Services.
Prescription Drug Coverage under Medicaid
Overview of the Many Steps that CMS has taken to Make Sure All Dual Eligibles have Medicare Prescription Drug Coverage January 1, 2006
.pdf on CMS Website
Medicare: Contingency Plans to Address Potential Problems with the Transition of Dual-Eligible Beneficiaries from Medicaid to Medicare Drug Coverage
.pdf on GAO Website
also of interest
- Financial Alignment Demonstrations for Dual Eligible Beneficiaries: A Look at CMS’s Evaluation Plan
- State Demonstration Proposals to Integrate Care and Align Financing and/or Administration for Dual Eligible Beneficiaries
- Financial and Administrative Alignment Demonstrations for Dual Eligible Beneficiaries Compared: States with Memoranda of Understanding Approved by CMS
- Medicare at a Glance