Dual Eligible

This brief highlights key facts about Medicare beneficiaries living in rural areas, including their demographic and health characteristics, access to care, and satisfaction with care.

The interactive maps illustrate how many people are enrolled in Medicare and Medicaid in each congressional district, including the number of people receiving full Medicaid and partial Medicaid benefits.

The recently passed House budget resolution targets cuts to Medicaid of up to $880 billion or more over a decade to help pay for tax cuts. Major cuts to Medicaid may impact coverage for the almost 1 in 5 Medicare beneficiaries (12.2 million) who are also enrolled in Medicaid.

This analysis examines who was eligible for Medicare and/or Medicaid between 2002 and 2022 because they received disability benefits from one of the country’s Social Security disability programs, Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI). Many who receive SSDI and SSI qualify for both Medicare and Medicaid, known as dual-eligible individuals.

This issue brief merged beneficiary-level Medicare and Medicaid data from 2021 to document sources of coverage for dual-eligible individuals nationwide and by state.

This brief examines current Medicaid eligibility policies and enrollment patterns using data from KFF’s 2024 50-state survey of states’ eligibility and enrollment policies for seniors and people with disabilities, and 2021 Medicare and Medicaid claims data from the Centers for Medicare and Medicaid Services (CMS).

In 2023, 5.2 million dual-eligible individuals were enrolled in a Medicare Advantage plan designed specifically for dual-eligible individuals, known as Dual-Eligible Special Needs Plans (D-SNPs). This brief highlights 10 things to know about D-SNPs, including national and state enrollment trends, plan availability, insurer participation, benefits, and prior authorization rates and denials

This issue brief describes the share of dual-eligible individuals with full Medicaid benefits who use wraparound services, including institutional LTSS, home- and community-based services (HCBS), vision services, dental care, and non-emergency medical transportation (NEMT); and how use of these services varies by state and select demographic characteristics of enrollees.

On September 21, 2023, the Centers for Medicare and Medicaid Services (CMS) finalized a rule that is intended to help low-income Medicare beneficiaries gain access to Medicaid coverage of Medicare premiums and often, cost sharing, through the Medicare Savings Programs.