Notes
Estimates include full-benefit dual-eligible individuals in 47 states and the District of Columbia if (1) they were in both the research-identifiable Master Beneficiary Summary File (MBSF) Base and the 2020 Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files (TAF) Research Identifiable Files (RIF) file using a Chronic Conditions Warehouse (CCW) beneficiary identifier crosswalk (2) and if individuals were a full-benefit dual-eligible individual in March (03) 2020 using the Medicare monthly DUALSTUS CD03 with values of 02,04,08 or the Medicaid monthly code (March=03) DUAL ELGBLCD 03 with values of 02,04,08 or the monthly code (March=03) RSTRCTDBNFTS CD_03 with values of 1,A,D,4,5,7. Dual-eligible individuals also had to have both Medicare Part A and B in March 2020 to be included in this analysis. The estimated total of dual-eligible individuals (7.5 million) differs from other KFF estimates due to differences in methods. Due to data suppression and rounding, subgroup estimates may not always sum to the total.
Estimates include full-benefit dual-eligible individuals in 47 states and the District of Columbia if (1) they were in both the research-identifiable Master Beneficiary Summary File (MBSF) Base and the 2021 Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files (TAF) Research Identifiable Files (RIF) file using a Chronic Conditions Warehouse (CCW) beneficiary identifier crosswalk (2) and if individuals were a full-benefit dual-eligible individual in March (03) 2021 using the Medicare monthly DUALSTUS CD03 with values of 02,04,08 or the Medicaid monthly code (March=03) DUAL ELGBLCD 03 with values of 02,04,08 or the monthly code (March=03) RSTRCTDBNFTS CD_03 with values of 1,A,D,4,5,7. Dual-eligible individuals also had to have both Medicare Part A and B in March 2021 to be included in this analysis. The estimated total of dual-eligible individuals (7.9 million) differs from other KFF estimates due to differences in methods. Due to data suppression and rounding, subgroup estimates may not always sum to the total. Data were updated on October 18, 2024 to incorporate updates to Medicare and Medicaid administrative data.
Delivery system categories are mutually exclusive. See The Landscape of Medicare and Medicaid Coverage Arrangements for Dual-Eligible Individuals Across States for details on how the delivery systems are defined and counted.
Sources
Data are from a KFF analytic file that merged the Centers for Medicare & Medicaid Services Chronic Conditions Data Warehouse 2020 research-identifiable Master Beneficiary Summary File (MBSF) Base and the 2020 Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files (TAF) Research Identifiable Files (RIF) file using a Chronic Conditions Warehouse (CCW) beneficiary identifier crosswalk.
Data are from a KFF analytic file that merged the Centers for Medicare & Medicaid Services Chronic Conditions Data Warehouse 2021 research-identifiable Master Beneficiary Summary File (MBSF) Base and the 2021 Transformed Medicaid Statistical Information System (T-MSIS) Analytic Files (TAF) Research Identifiable Files (RIF) file using a Chronic Conditions Warehouse (CCW) beneficiary identifier crosswalk.
Definitions
Full-benefit Dual-Eligible Individuals receive full Medicaid benefits and Medicaid payment of Medicare premiums and, in many cases, cost-sharing.
Medicaid Delivery System : refers to the way a state Medicaid program provides benefits to enrollees including Medicaid fee-for-service, and different Medicaid managed care plans (including limited benefit plans or carve-out plans).
NSD : not significant data (cells representing fewer than 50 enrollees).
DQ : represent data categorized as "Unusable/Unclassified" in the DQ Atlas assessment and with substantial differences in Medicaid managed care enrollment from other sources. These values are not included in the national totals.