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Dual-eligible beneficiaries (Medicare dual eligibles or "duals") refers to those qualifying for both Medicare and Medicaid benefits. In the United States, approximately 9.2 million people are eligible for "dual" status. [1] [2] Dual-eligibles make up 14% of Medicaid enrollment, yet they are responsible for approximately 36% of Medicaid ...
Medicare is the federal health insurance program in the United States for people ages 65 and older. Medicaid is a joint federal and state program to help people with limited resources or income ...
Medicare and Medicaid: Dual eligibility A person may be eligible for both Medicare and Medicaid, which makes them dually eligible. This article looks at the rules, qualifying criteria, and more.
Medicare and Medicaid are different government-funded healthcare programs. To be eligible for both, a person will need to qualify for either partial-dual or full-dual coverage.
In the United States, Medicaid is a government program that provides health insurance for adults and children with limited income and resources. The program is partially funded and primarily managed by state governments, which also have wide latitude in determining eligibility and benefits, but the federal government sets baseline standards for state Medicaid programs and provides a ...
2.6 million were in the "coverage gap" due to the 19 states that chose not to expand the Medicaid program under the ACA/Obamacare, meaning their income was above the Medicaid eligibility limit but below the threshold for subsidies on the ACA exchanges (~44% to 100% of the federal poverty level or FPL); 5.4 million were undocumented immigrants;
In addition, a growing number of people are signing up for Medicare Advantage plans created specifically for those who are dual-eligible. According to KFF, 5.2 million dual-eligible individuals ...
The Centers for Medicare & Medicaid Services (CMS) is a federal agency within the United States Department of Health and Human Services (HHS) that administers the Medicare program and works in partnership with state governments to administer Medicaid, the Children's Health Insurance Program (CHIP), and health insurance portability standards.