Medicare dual eligible
From Wikipedia, the free encyclopedia
Medicare dual eligibles, in the Medicare system of the United States, are Medicare Part A and/or B recipients who either [1] qualify for a Medicare Savings Programs (MSP) or [2] qualify for Medicaid benefits. Dual eligibles generally qualify for the QMB benefits, in which the beneficiary's non-Medicare coverage is covered by Medicaid, effectively providing full health care coverage. With the advent of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, these dual eligibles have automatically been enrolled to a random Medicare Part D plan, effective January 1 of 2006. As a result of this auto assignment, participants who were already enrolled in a Medicare Advantage HMO, may have been automatically disenrolled from their medical plan to allow for part D enrollment.
[edit] External links
- Dual eligibles entry on Medicare.gov glossary of terms page
- Medicare & You handbook (PDF) on Medicare.gov — see pages 49 (59 of 104) and 58 (68 of 104) for more complete information
- Medicare / Medicaid Dual Eligibles information from cms.hhs.gov
- Dual Eligible FAQ for claims processing by pharmacist (PDF) from cms.hhs.gov