Dual eligibles qualify for health coverage under both Medicare (Medicare Hospital Insurance (Part A) and/or Medicare Medical Insurance (Part B)) and some form of Medicaid. They must be age 65 or older or disabled, and low-income. Dual eligibles have complex medical and social service needs and account for a disproportionately large share of Medicare spending.
According to the Centers for Medicare & Medicaid Services (CMS), in 2008, there were 9.2 million dual eligibles. This represents roughly 16 percent of the total Medicaid covered population and approximately 20 percent of the Medicare covered population, as outlined in a June 2011 Medicaid and CHIP Payment Advisory Commission report to Congress. Dual eligibles accounted for 39 percent of Medicaid spending and 31 percent of spending in Original Medicare, or fee-for-service Medicare, spending in 2007, according to a Kaiser Family Foundation report.
Related FAQs
What Happens to Medicaid Under the Affordable Care Act (ACA)?
Are There Examples in the States of Novel Approaches to Managing Dual Eligibles?
What Does the Affordable Care Act Do With Regards to Dual Eligibles?
Who Is the Primary Payer for Dual Eligibiles?
How Is Medicaid Financed?
