Enrollment and Spending for Dual-Eligible Individuals

This data collection draws on Medicare and Medicaid administrative data to present national and state-level information on people who are covered by both Medicare and Medicaid, referred to as dual-eligible individuals (also known as dually-enrolled beneficiaries). Dual-eligible individuals qualify for Medicare coverage on the basis of age (65 and older) or disability. To qualify for Medicaid benefits, Medicare beneficiaries must meet eligibility criteria based on financial (related to income and wealth) and non-financial (generally, age or disability) requirements. For “partial-benefit” enrollees, Medicaid pays Medicare premiums and, in many cases, also pays Medicare’s deductibles and cost-sharing on behalf of dual-eligible individuals. Dual-eligible individuals who also receive the full range of Medicaid benefits that are not covered by Medicare are generally referred to as “full-benefit” enrollees. This data collection includes the number of dual-eligible individuals and Medicare and Medicaid spending on these enrollees.

This work was supported in part by Arnold Ventures. KFF maintains full editorial control over all of its policy analysis, polling, and journalism activities.