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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?

Dual Eligibles: Medicaid’s Role for Low-Income Medicare Beneficiaries

icon_reports_studies.gifProfiles of Medicare Beneficiaries With Medicaid Drug Coverage Prior to the Medicare Drug Benefit (.pdf)

icon_reports_studies.gifDual Eligibles: Medicaid Enrollment and Spending for Medicare Beneficiaries in 2003

icon_reports_studies.gifThe Stability of Medicaid Coverage for Low-Income Dually Eligible Medicare Beneficiaries

The Transition to Part D

icon_reports_studies.gifThe Transition of Dual Eligibles to Medicare Part D Prescription Drug Coverage: State Actions During Implementation

icon_reports_studies.gifDual Eligibles and Medicare Part D: An Implementation Update

icon_charts_data.gifMedicare Beneficiaries with Prescription Drug Coverage by Type, as of January 13, 2006

icon_charts_data.gifDistribution of Medicare Beneficiaries with Prescription Drug Coverage by Type, as of January 13, 2006

icon_reports_studies.gifAn Implementation Perspective on Part D, the Medicare Prescription Drug Program

podcasticon.gif 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.

icon_reports_studies.gifMedicare Prescription Drug Coverage for Residents of Nursing Homes and Assisted Living Facilities: Special Problems and Concerns

Prescription Drug Coverage under Medicaid

icon_reports_studies.gifState Medicaid Outpatient Prescription Drug Policies: Findings from a National Survey, 2005 Update

icon_reports_studies.gifMedicaid and Outpatient Prescription Drugs

The Clawback

icon_reports_studies.gifAn Update on the Clawback: Revised Health Spending Data Change State Financial Obligations for the New Medicare Drug Benefit

icon_reports_studies.gifThe “Clawback”: State Financing of Medicare Drug Coverage

Other Resources

icon_reports_studies.gif 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

icon_reports_studies.gif Medicare: Contingency Plans to Address Potential Problems with the Transition of Dual-Eligible Beneficiaries from Medicaid to Medicare Drug Coverage
.pdf on GAO Website