Medicaid/CHIP: Medicare/Medicaid Dual Enrollees

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Medicaid/Medicare Dual Enrollees

Where Does The Burden Lie?: Medicaid and Medicare Spending for Dual Eligible Beneficiaries
This issue brief analyzes the demographic and health characteristics of people who are simultaneously eligible for Medicaid and Medicare, as well as their patterns of service utilization and spending under both programs.

Reports Analyze Cost and Coverage of People Eligible for Both Medicaid and Medicare and Options for Reforming Financing of Their Care
Two reports examine coverage of the nearly 9 million “dual eligible” beneficiaries and explore the national and state impacts of shifting the financing of selected services for this population from Medicaid to Medicare.

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Key Questions about Changes for Medicaid and Low-Income Individuals: HR 3200 America’s Affordable Health Choices Act of 2009 -- August 2009
This brief highlights some key questions about provisions related to Medicaid, the Children’s Health Insurance Program, and provisions that affect low-income individuals included in HR 3200, the America’s Affordable Health Choices Act 2009 (the House Tri-Committee Bill).

Health Reform Opportunities: Improving Policy for Dual Eligibles -- August 2009
This brief provides an overview of opportunities under health reform to realign federal and state policy for the dual eligibles to promote a more rational, cost-efficient system for 9 million of the poorest, sickest and highest-cost people covered by both Medicaid and Medicare.

Money Follows the Person: An Early Implementation Snapshot -- June 2009

This issue brief examines the early successes and challenges of the Money Follows the Person Demonstration, 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.

Medicare Prescription Drug Plans in 2009 and Key Changes Since 2006: Summary of Findings -- June 2009
This report summarizes findings from a series of Medicare Part D 2009 Data Spotlights documenting changes in drug coverage and costs since 2006 and finds, in many ways, beneficiaries over time are paying more for less generous benefits.

Medicare Part D 2009 Data Spotlight: Specialty Tiers -- June 2009
This Data Spotlight examines use of the specialty tier in Medicare Part D drug plans, including the numbers and kinds of drugs included on specialty tiers and what beneficiaries pay for those drugs.

The Social Security COLA and Medicare Part B Premium: Questions, Answers, and Issues -- May 2009
This brief explains how the lack of a cost-of-living increase for Social Security recipients in 2010, and no or low increases through 2012, will affect beneficiaries' monthly premiums for Medicare Part B, as well as the implications for the Medicare and Medicaid programs.

Where Does the Burden Lie?: Medicaid and Medicare Spending for Dual Eligible Beneficiaries -- April 2009

This issue brief analyzes the demographic and health characteristics of people who are simultaneously eligible for Medicaid and Medicare, as well as their patterns of service utilization and spending under both programs.

Rethinking Medicaid's Financing Role for Medicare Enrollees -- February 2009

This report examines coverage of the nearly 9 million "dual eligible" beneficiaries and explores the national and state impacts of shifting the financing of selected services for this population from Medicaid to Medicare.

Dual Eligibles: Medicaid Enrollment and Spending for Medicare Beneficiaries in 2005 -- February 2009

This report provides the latest national and state data on Medicaid enrollment and spending for individuals enrolled in both Medicaid and Medicare, also knows as dual eligibles. Nationally, there are about 8.8 million dual eligibles. Although they comprise 18 percent of the Medicaid population, they account for 46 percent of Medicaid spending.

Dual Eligibles: Medicaid's Role for Low-Income Medicare Beneficiaries -- February 2009

This updated fact sheet describes the nearly 8.8 million "dual eligibles," the low-income elderly and persons with disabilities who are enrolled in both Medicare and Medicaid, why this population needs Medicaid, what services they receive from Medicaid, and the current policy challenges related to dual eligibles, including the financing of their care.

This brief highlights some key questions about provisions related to Medicaid, the Children’s Health Insurance Program, and provisions that affect low-income individuals included in HR 3200, the America’s Affordable Health Choices Act 2009 (the House Tri-Committee Bill).

This brief provides an overview of opportunities under health reform to realign federal and state policy for the dual eligibles to promote a more rational, cost-efficient system for 9 million of the poorest, sickest and highest-cost people covered by both Medicaid and Medicare.

This report summarizes findings from a series of Medicare Part D 2009 Data Spotlights documenting changes in drug coverage and costs since 2006 and finds, in many ways, beneficiaries over time are paying more for less generous benefits.

This Data Spotlight examines use of the specialty tier in Medicare Part D drug plans, including the numbers and kinds of drugs included on specialty tiers and what beneficiaries pay for those drugs.

This brief explains how the lack of a cost-of-living increase for Social Security recipients in 2010, and no or low increases through 2012, will affect beneficiaries' monthly premiums for Medicare Part B, as well as the implications for the Medicare and Medicaid programs.

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Medicaid/Medicare Dual Enrollees

Over 7 million of Medicaid’s 50 million beneficiaries are “dual enrollees”, low-income elderly and individuals with disabilities who are enrolled in both Medicaid and Medicare. While Medicare covers basic health services, including physician and hospital care, dual enrollees rely on Medicaid to pay Medicare premiums and cost-sharing and for services that Medicare does not cover, such as prescription drugs and long-term care. Because dual enrollees have significant health needs and few resources to obtain the range of services they require, Medicaid’s assistance is crucial.