Wednesday, 12 September 2012

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Medicare And Medicaid Dual Eligibility


By Alex Turner


Both Medicare and Medicaid are used as a way to allow families as well as individuals access to health care by providing them with financial assistance to cover costs. The main goal of the centers of Medicare and Medicaid is to provide health services to all of those who need it and this is accomplished by using a number of different programs. American's across the nation take advantage of a number of different programs offered by CMS, and in some cases they may take advantage of more than one program.

While there are a variety of ways an individual can qualify for Medicare services as well as Medicaid assistance, the term dual eligible is used to describe all beneficiaries who receive service or assistance from more than one program. Individuals and families who have dual eligibility must first meet a number of financial and income related requirements. Each program offered by the centers of Medicare and Medicaid services has a number of set guidelines when it comes to being eligible to become a beneficiary. In order to be a dual eligible individual or family, one has to meet all of the requirements of each program.

The cost of those who are dual eligible is considerable higher than those who are only receiving assistance from one CMS program. In fact, individuals who are dual eligible cost Medicare around 60 percent more than those enrolled in one program. These individuals have the costs of their acute care paid for by Medicare and in addition are using a Medicaid program to help pay for any extra co-payments, monthly premium payments or annual deductibles.

Those who are enrolled in these programs are commonly of a lower income, often close or even below the poverty line. These individuals also commonly report lower overall health status than other individuals utilizing Medicare programs. In addition statistics have reported that those who are dual eligible more commonly take advantage of long-term care facilities than those who are not dual eligible. The goal of the program is to allow these individuals easy access to health care. Dual eligible have reported that their access to care is easy and the quality of care is high. Medicare beneficiaries who are not dual eligible have reported access to care easier in some areas and worse in others when compared to dual eligible individuals and families.

For More information go to Altegra Health.




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