Dual Eligible

Ohio is among the early states to launch a 3-year capitated financial alignment demonstration to integrate payments and care for beneficiaries who are dually eligible for Medicare and Medicaid. This case study describes the early implementation of the demonstration based on a diverse group of stakeholder interviews.

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…

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.

Transitions is a video that explores some of the issues and challenges “dual eligibles” may face during the transition from Medicaid drug coverage to Medicare. To download the video, right-click here and select “Save as…”

On January 1, 2006, the six million Americans who are covered by both Medicare and Medicaid saw a change in how their prescription drugs are covered. The dual eligible population was transitioned from Medicaid into the Medicare prescription drug benefit. As a group, these beneficiaries are poorer and sicker than…

This report projects the impact of the new Medicare drug benefit on out-of-pocket spending for people who enroll in 2006. This analysis from November 2004 estimates that 6.9 million beneficiaries are projected to be affected by the coverage gap (the so-called “doughnut hole”) in the standard Part D drug benefit.…

This chartpack highlights demographic data about African Americans, Hispanics and whites with Medicare to highlight potential implications for outreach efforts under the new Medicare drug benefit. The information is being used in a series of November 2005 briefings at the start of the first open-enrollment period for the new benefit.…

This brief examines the role of Medicare and Medicaid in the lives of dually eligible beneficiaries – low-income seniors and younger adults with disabilities who are eligible for both programs – through personal profiles. It includes a glossary of eligibility and service delivery system terms and state-level enrollment and expenditure data for dual eligibles.