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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).
This brief examines the role of Medicaid in providing health coverage to the 9.6 million Medicare beneficiaries who are also eligible for Medicaid. The brief explains the role Medicaid plays in providing supplemental coverage to fill in the gaps in Medicare’s coverage for these dual-eligible beneficiaries.
Thirty-five percent of all California Medicare beneficiaries are enrolled in a M+C plan, far in excess of the 14 percent rate nationwide. This report seeks to identify what lessons for the nation can be drawn from the California M+C experience, as Congress debates the implications of major withdrawals from the M+C program and potential policy changes aimed at reversing this trend. The report is based largely on analysis of M+C data on plan participation, withdrawals,…
This fact sheet provides an overview of the role of Medicare and Medicaid in serving these beneficiaries, describes the health status of dual Medicare/Medicaid beneficiaries, and discusses issues of managed care and access to care.This fact sheet is a summary of a longer Background Paper (#2132), which is also available. Fact Sheet
This guide explains the critical role Medicare and Medicaid have come to play in the lives and the futures of roughly 20 million children, adults, and seniors with disabilities - and gives people with disabilities new information to help them get the most from these programs. Full PDF Report (.pdf) Section 1: Introduction HTML PDF Section 2: Medicare HTML PDF Section 3: Medicaid HTML PDF Section 4: Interaction Between Medicare and Medicaid HTML PDF
This comprehensive survey of seniors about the Medicare drug benefit finds that many seniors remain uncertain about how the new benefit will affect them and unsure about whether they will enroll. Seniors who say they understand the benefit well are more likely to report favorable views than those who do not. The survey examines in depth what seniors know and understand about the new benefit and what they think about its potential helpfulness. It was…
Medicare Part D: Issues for Dual Eligibles on the Eve of Implementation This issue brief describes how dual eligibles are treated under the Medicare drug benefit and the issues raised by their transition from Medicaid to Medicare drug coverage. The brief also explores key differences in the Medicare drug benefit compared to Medicaid drug coverage (formularies, copayments, and appeals policies) which could make the shift especially challenging for dual eligibles. Issue Brief (.pdf)
Additional Help with Prescription Drug Costs For Low-Income People on Medicare (For 2007 Benefits and Cost-Sharing) As of 2007, Medicare helps pay for outpatient prescription drugs. Medicare provides additional help with drug costs to beneficiaries who qualify based on low incomes and limited resources. The information below describes the different levels of assistance available to people who meet the eligibility requirements. People on Medicare Who Also Have Full Medicaid Benefits (Dual Eligibles) pay: No premium…
This updated resource features more than 80 charts and tables with detailed information about the Medicare program and the 42 million seniors and younger people with disabilities who rely on the program for health insurance coverage. It covers a wide range of relevant data, including state-by-state information when available. Each section can be accessed individually, or the full chartbook can be downloaded in its entirety. Complete Medicare Chartbook 2005 (.pdf) Overview (.pdf) Section 1: Medicare…
Dual Eligibles: Medicaid's Role for Low-Income Medicare Beneficiaries This fact sheet and set of tables describe the over 7 million “dual eligibles,” the low-income elderly and persons with disabilities who are enrolled in both Medicare and Medicaid. The fact sheet describes why this population needs Medicaid, what services they receive from Medicaid, and the current policy challenges related to dual eligibles, including the new Medicare prescription drug benefit. The set of tables, prepared by the…
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