This issue brief examines coverage of the nearly 9 million “dual eligible” beneficiaries, the low-income elderly and persons with disabilities who are enrolled in both Medicare and Medicaid. It explores the national and state impacts of shifting the financing of selected services for dual eligibles from Medicaid to Medicare, including…
Featured Dual Eligible Resources
Health Plan Enrollment in the Capitated Financial Alignment Demonstrations for Dual Eligible Beneficiaries
This chart and a related fact sheet provide a snapshot of enrollment in the capitated financial alignment demonstrations by state for beneficiaries who are dually eligible for Medicare and Medicaid as of June, 2015.
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Related Dual Eligible Resources
- Financial and Administrative Alignment Demonstrations for Dual Eligible Beneficiaries Compared: States with Memoranda of Understanding Approved by CMS
- Early Insights From Ohio’s Demonstration to Integrate Care and Align Financing for Dual Eligible Beneficiaries
- Early Insights from One Care: Massachusetts’ Demonstration to Integrate Care and Align Financing for Dual Eligible Beneficiaries
- Early Insights from Commonwealth Coordinated Care: Virginia’s Demonstration to Integrate Care and Align Financing for Dual Eligible Beneficiaries
- Dual Eligible Demonstrations: The Beneficiary Perspective
- Affordable Care Act Provisions Relating to the Care of Dually Eligible Medicare and Medicaid Beneficiaries
- Nearly 355,000 Dual Eligible Beneficiaries Are Enrolled in Capitated Financial Alignment Demonstrations in 9 States, as of June 2015
This slide shows how many people are covered by both Medicare and Medicaid.
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This issue brief examines the early successes and challenges of the Money Follows the Person Demonstration (MFP), a Medicaid initiative enacted into law in 2006 that gives states enhanced federal support to balance their Medicaid long-term care programs by providing more services in the community and fewer in institutional settings.…
This issue paper provides state-level estimates on spending on dual eligibles and illustrates the fiscal effects of scenarios where the federal government assumes the cost of prescription drugs, Medicare premiums, acute care, and long-term care for this population.Issue Paper (.pdf)
People with disabilities are at risk in the health-care system because of their wide-ranging health-care needs, their relatively heavy use of prescription drugs, health-care and support services, and typically low incomes. A new survey of people with permanent mental and/or physical disabilities explores their health-care experiences and challenges in accessing…
Dual Eligibles: Medicaid's Role in Filling Medicare's Gaps – Issue BriefThis paper presents a profile of dual eligible beneficiaries (those qualifying for both Medicare and Medicaid), describes their health care expenditures, and analyzes the distribution of spending on the population.Issue Paper (.pdf)
Consumer Protection Issues Raised by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003
This paper identifies and examines consumer protection issues that arise from the Medicare Prescription Drug, Improvement, and Modernization Act of 2003. Key issue areas include: beneficiary information, marketing, enrollment and disenrollment, the drug benefit package and cost-sharing, the appeals process, concerns for low-income beneficiaries, challenges for nursing home issues, and…
This fact sheet, Medicare’s Role for Older Women, discusses the characteristics of female Medicare beneficiaries, their health care needs, the structure of Medicare including cost-sharing requirements, and anticipated changes due to health reform.
Medicare Health Plans and Dually Eligible Beneficiaries: Industry Perspectives on the Current and Future Market
As federal and state governments advance efforts to better coordinate care and reduce costs for people dually eligible for both Medicare and Medicaid benefits, this brief examines how insurers now serving these markets view the opportunities and challenges, including a look at Medicare Advantage Special Needs Plans.
This issue brief details the various eligibility pathways by which individuals with disabilities and the elderly can qualify for Medicaid coverage. The program, which serves as a safety net for many of the nation’s poorest and sickest individuals, provides health coverage to nearly 60 million Americans, including 8.5 million with…