"Dual eligibles" make up about 15 percent of Medicaid enrollment but consume 39 percent of program spending
July 01, 2012
SOURCE: Kaiser Family Foundation, "Medicare's Role for Dual Eligible Beneficiaries" and "Medicaid's Role for Dual Eligible Beneficiaries." All figures are for federal fiscal year 2008 and are rounded.
A "dual eligible" is a person who receives insurance benefits from both Medicare and Medicaid — he or she is both poor and low income. The graphic above describes the different characteristics of the Medicare and Medicaid programs and their intersection in the dual eligible population.
Dual eligibles tend to be older and sicker than the average Medicare or Medicaid beneficiary. Although dual eligibles represent only 15 percent of the Medicaid population, they account for almost 40 percent of program spending. Similarly, they represent about 20 percent of the Medicare population, but about 30 percent of program spending.
Dual eligibles require a complex set of health care services. But because Medicare and Medicaid pay for different kinds of health benefits, care for dual eligibles is often uncoordinated. In 2008, spending on the 9 million dual eligible beneficiaries totaled $261 billion, or roughly $29,000 per person.
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