Low-income people who are eligible for both Medicare and Medicaid are known as Dual Eligibles (or duals).
Access to Medicaid is critical for these individuals (who tend to be very low income and have high health needs) because it provides essential coverage for services that Medicare doesn’t cover, including long-term care at home or in a nursing facility, oral health, vision, hearing, and transportation. Medicaid also helps older adults afford Medicare by paying for Medicare premiums and other Medicare out-of-pocket costs.
Navigating the two programs together is like managing two different insurance companies that don’t communicate with each other. Additionally, many states require people to regularly fill out complicated forms to continually “prove” their eligibility, and, as a result, many eligible people lose coverage over paperwork errors. Losing Medicaid, even temporarily, can cause life-threatening disruptions in care.
Justice in Aging’s advocacy focuses on making the two programs work better together, ensuring people dually eligible are not improperly billed for covered services, improving care coordination, and helping dually enrolled people access the financial assistance for Medicare they are entitled to.
In 2024, Justice in Aging also launched a two-year project to improve the integration of Medicare and Medicaid, including improving Dual Eligible Special Needs Plans (D-SNPs), a type of aggressively marketed private plan that promises a lot, but doesn’t always lead to better health outcomes
