Medicare enrollees who are in the Qualified Medicare Beneficiary (QMB) program—a Medicaid program that pays for Medicare costs—should not be billed for health care costs, with a few exceptions. Unfortunately, QMB enrollees often face medical bills that are issued to them improperly. Recently, the Centers for Medicare & Medicaid Services (CMS) and the Consumer Financial […]
This year, Justice in Aging launched a new project to build the capacity of national and state advocates to inform policies affecting how people dually eligible for Medicare and Medicaid receive their care. As part of this project, we are developing educational resources and trainings for advocates across the country on Dual Eligible Special Needs […]
Introduction In April 2024, the Centers for Medicare and Medicaid Services (CMS) issued a final rule for 2025 Medicare Advantage Plans and Prescription Drug Plans (“Part C/D Rule” or “Final Rule”).[1] This rule makes multiple changes relevant to individuals dually eligible for Medicare and Medicaid (“dually eligible individuals”), including: These changes will take place over […]
In April, the Centers for Medicare and Medicaid Services (CMS) finalized a rule that will affect how dually eligible individuals access Medicare Advantage plans and Medicare benefits. The rule changes: In addition, the rule improves how Special Supplemental Benefits for the Chronically Ill (SSBCI) are administered, limits D-SNP “look-alike plans” that are not subject to […]
This brief provides advocates with basic information about Dual Eligible Special Needs Plans (D-SNPs) and how they can improve service coordination for dual-eligible populations.
Since 2020, enrollment in Dual Eligible Special Needs Plans (D-SNPs) has doubled. Today, over five million individuals eligible for both Medicare and Medicaid are enrolled in these Medicare Advantage plans, and enrollment is expected to continue rising. An increasing number of states are focusing on D-SNPs as a primary vehicle for integrating care and improving […]
More than 12 million people are eligible for both federal programs, and policy change is needed to enable these programs to work most effectively Washington, D.C.—A diverse group of national stakeholders launched the Medicare-Medicaid Integration Alliance (MMIA) and announced cornerstone principles as a framework for federal and state policies that better support people dually eligible […]
We all know that handling one health insurance company can be a headache. Now, imagine juggling two at the same time. This is the reality for nearly 13 million older adults and people with disabilities who are enrolled in both Medicare and Medicaid. Insufficient coordination of Medicare and Medicaid benefits contributes to confusion and roadblocks […]
