The Landscape of Medicare and Medicaid Coverage Arrangements for Dual-Eligible Individuals Across States

(By Maria T. Peña, Maiss Mohamed, Jeannie Fuglesten Biniek, Alice Burns, Juliette Cubanski, and Tricia Neuman for The Kaiser Family Foundation Published: Jul 30, 2024)

Policymakers, researchers, and others have long called for reforms to improve the coordination of Medicare and Medicaid benefits for the people who receive health insurance coverage through both programs. People in this group, also known as dual-eligible individuals, have lower incomes, are more racially and ethnically diverse, and often face greater mental and physical health challenges than the general Medicare population. Dual-eligible individuals with full Medicaid benefits, who comprise most dual-eligible individuals, usually have Medicare benefits covered under traditional Medicare or Medicare Advantage and, separately, Medicaid benefits covered through Medicaid fee-for-service or Medicaid managed care (referred to here as Medicaid delivery systems). A small percentage of dual-eligible individuals have most of their Medicare and Medicaid benefits covered through a single plan or program. Continue reading here…

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