Benefits of dual eligible

Being dual eligible, means you qualify for both Medicare and Medicaid, comes with several benefits. Here are some key advantages:

​

1. Comprehensive Coverage: Dual eligibles receive full Medicare benefits, which include hospital and medical insurance, as well as prescription drug coverage. Additionally, they receive Medicaid benefits, which can cover services not included in Medicare, such as long-term care and support in home and community-based settings.

2. Financial Assistance: Medicaid helps cover Medicare premiums, deductibles, and copayments, significantly reducing out-of-pocket costs for dual eligibles. This financial assistance can make healthcare more affordable and accessible.

3. Extra Help with Prescription Drugs: Dual eligibles often qualify for Medicare's Extra Help program, which provides additional assistance with prescription drug costs. This means lower copayments and premiums for medications.

4. Access to Special Programs: Dual eligibles may have access to special programs like the Program of All-Inclusive Care for the Elderly (PACE) and Dual-Eligible Special Needs Plans (D-SNPs). These programs coordinate Medicare and Medicaid benefits to provide comprehensive and integrated care.

​

Overall, being dual eligible can provide a more comprehensive and cost-effective healthcare solution for individuals who qualify for both Medicare and Medicaid.