A person eligible for Categorical Needy (CN) or Medically Needy (MN) and the Qualified Medicare Beneficiary (QMB) program or Special Low-Income Medicare Beneficiaries (SLMB) programs. See: Medicare
A Medicare beneficiary who qualifies for some assistance from Medicaid. A dual eligible may qualify either for full Medicaid benefits, or only for Medicaid coverage of Medicare cost-sharing amounts.
A person enrolled in Medicare and Medicaid.
A Medicare beneficiary who also receives the full range of Medicaid benefits offered in his or her state. Medicare usually pays the charges for inpatient while Medicaid will pay the co-pay for inpatient care in hospitals. Medicare will be considered the primary insurer for inpatient care for the Care/Caid patient.
This term refers to a Medicare beneficiary who also receives (or is eligible for) Medicaid benefits. A “part dual eligible” is a Medicare beneficiary who is eligible to have some or all of their Medicare premiums covered by Medicaid.
a person who gets both Medicare and Medicaid
Persons who are entitled to more than one source of third party reimbursement. For example, a client covered by both Medicare and Medicaid is dual eligible.
means you are enrolled in Medicaid and entitled to Medicare Part A and/or B benefits.
Medicaid beneficiaries who are also eligible for health benefits under Medicare or other public-sponsored health programs.
A person who has both Medicare and Medicaid.
An individual who is eligible for both Medicare and Medicaid coverage.
A beneficiary who is eligible for both Medicare and Medicaid.
Consumers who receive both Medicare and Medicaid.
A person who is eligible for both Medicare and Medicaid. CMS will automatically enroll dual eligibles in low-premium PDPs. If they choose to stay in a low-premium PDP, dual eligiblesâ€™ only cost for drugs will be a $1 co-pay for generic drugs and a $3 co-pay for brand-name drugs. Exception The first phase of the appeals process; a formal decision by a Medicare prescription drug plan to cover a medication not on its formulary, or to reduce a co-payment for a drug not on the PDPâ€™s preferred list. If the plan does not approve the exception, the appeals process can continue.