Dual Eligible

Over 9 million elderly Americans and younger persons with disabilities are jointly enrolled in the Medicaid and Medicare programs.  These “dual eligibles” receive coverage for most medical services from Medicare, and they also receive Medicaid assistance for Medicare premiums and cost-sharing and coverage of benefits not offered under Medicare (such…

Beginning in January, 2013, the Centers for Medicare and Medicaid Services (CMS) will implement a three year multi-state demonstration to test new service delivery and payment models for people dually eligible for Medicare and Medicaid. These demonstrations will enroll full dual eligibles in managed fee-for-service or capitated managed care plans…

This brief summarizes 15 states’ preliminary proposals to better coordinate care for people who are in both the Medicare and Medicaid programs. The design contracts, funded by the federal Center for Medicare and Medicaid Innovation (CMMI), are an outgrowth of new efforts under the health reform law to develop service…

Medicaid is a jointly financed partnership between the federal government and states. The federal-state financing and administrative structure of Medicaid provides a framework of federal core requirements along with broad state options for program design and administration. This issue brief presents an overview of the current Medicaid program framework, with…

The Kaiser Family Foundation has issued a collection of analyses related to the Part D Medicare stand-alone drug plan options available to seniors for calendar year 2010. Each of these spotlights focuses on a key aspect of the drug plans that will be available to Medicare beneficiaries in 2010 and…

As the nation considers national health reform, this brief provides an overview of opportunities to realign federal and state policy for the dual eligibles to promote a more rational, cost-efficient system for 9 million of the poorest, sickest and highest-cost people covered by both Medicaid and Medicare. Navigating two programs…

The American Bar Association Commission on Legal Problems of the Elderly explored the views of Medicare HMOs on enrolling and delivering services to Medicare beneficiaries with dementia. The Commission conducted detailed interviews with professionals at eight diverse Medicare+Choice organizations. Their report provides background information on health care decision-making law and…

The report, based on an analysis of Hewitt Associates' client database, presents new trend data on the prevalence of retiree health coverage sponsored by large employers and finds a continued erosion of retiree health benefits. The report also includes findings from a new survey assessing how large employers might change…

This study examines Medicaid pharmacy benefit use and spending among beneficiaries dually eligible for Medicare and Medicaid in 10 states by analyzing 1995 enrollment and claims data from a new 12-state database. The study finds that dual-eligibles are relatively high users of the Medicaid pharmacy benefit, with substantial variation in…

As policymakers consider a range of approaches to providing prescription drug coverage to the Medicare population in today s tight budgetary environment, one proposal that has been put forth by the Bush Administration is that of a Medicare-endorsed prescription drug discount card program. This report describes the range of existing…