Weekly Checkup No. 037: The Costly Duals
Dual-eligibles (those who qualify for both Medicare and Medicaid coverage) are a costly and vulnerable population group that accounts for a disproportionate share of spending under each program. According to a report from Health Affairs, an estimated 9 million Americans fall under the dually eligible criteria, including 5.6 million low-income seniors and 3.6 million people with disabilities under age sixty-five. Medicare covers hospital, physician, and prescription drugs, as well as a variety of acute and post-acute care services. Many elderly dual-eligible beneficiaries qualify for the Medicaid program after spending down their assets paying for long-term care, which is not covered by Medicare. These beneficiaries need Medicaid to cover their long-term care provided in the home, in a community setting, or in a nursing home.