What Does Dual Eligible Mean?

Plans often called "dual" or "dual eligible" are designed for people who qualify for both Medicare and Medicaid at the same time. These plans include all Medicare Part A (hospital stay) and Part B (doctor visit) benefits and Part D prescription drug coverage. For people with limited incomes, these plans may offer better health care coverage than Original Medicare and a separate Part D plan.

Who is it for?
Dual eligible plans are most common for Medicare eligible individuals with low incomes.

How do I qualify?
To qualify for dual eligibility, you must receive Medicare (Parts A and B) and full Medicaid benefits where Medicaid pays for all or part of your Medicare copayments, coinsurance and deductibles. To know if you qualify, you should look at the letter you received from your State Medicaid office, or call them to find out your status.

How does it work?
Medicaid benefits can help pay for Medicare costs of a dual eligible plan. Plus, dual eligible plans often cover benefits not offered by Medicare, such as routine hearing, vision and dental benefits, as well as providing coverage for transportation.

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