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Friday, September 21, 2012

Dual Eligibility

By Alex Turner


The centers of Medicare and Medicaid provide assistance to individuals as well as families when it comes to being able to cover the high costs of health care. With the goal of allowing all who need medical attention the ability to get access to it, these programs are used to accomplish that. Millions of Americans are enrolled in a number of programs offered through CMS, and some even take advantage of more than one program. The term dual eligibility refers to individuals who are eligible to benefit from Medicare as well as Medicaid.

Dual eligibility is the term that is used to describe an individual or family who are beneficiaries from Medicare while also receiving help from Medicaid. There are many different approaches to qualify for both Medicaid assistance as well as Medicare programs. The Dual Eligible term is used to refer to anyone who utilizes two different programs. Those who are interested in becoming a beneficiary of any Medicare or Medicaid program must first meet a number of qualifying requirements in order to gain financial help. These requirements are mainly based off of individual or family income and financial obligations.

The money spent on those who are dual eligible is significantly higher than individuals who are only getting assistance from a single CMS program. In fact, dual eligible require Medicare to spend around 60 percent more than those registered in one program. These individuals have the expenses of their acute care covered by Medicare and in addition are taking advantage of a Medicaid program to assist in paying for any extra co-payments, monthly premium payments or annual deductibles.

Those who are beneficiaries in these programs are usually of a lower income, commonly close or sometimes below the poverty line. These individuals also usually report a poorer health status than other individuals using Medicare programs. Other additional statistics have stated that those who are dual eligible more often will utilize long-term care facilities than those who do not meet dual eligible requirements. The objective of the program is to permit these individuals easy admittance to health care. Dual eligible have testified that their access to care is simple and the quality of care is good. Medicare beneficiaries who are not dual eligible have reported access to care easier in some areas and worse in others when compared to dual eligible individuals and families.

For More information go to Altegra Health.




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