Federal law protects most dually eligible individuals from getting billed for health care services and items. See Justice in Aging’s Health Care Bills and Dually Eligible Individuals. In addition to federal protections, states have protections against billing Medicaid enrollees. Advocates can use the chart below as a starting place for understanding their state’s approach to billing protections.
Some of the provisions in this chart are in each state’s Medicaid statute. Please note that there are also provisions from state insurance law, which typically govern managed care products in the state (e.g., health maintenance organizations). Often, provisions in state insurance law also apply to Medicaid and Medicare managed care programs.
If this document is missing an authority, please email us at info@justiceinaging.org.
We would like to acknowledge Pamela Reynolds, a Colin Alexander Health Law Fellow, for her work updating this chart.
