Medicaid and Medicare dual eligibility

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Some individuals, such as low-income seniors, are eligible for both Medicare and Medicaid; these individuals are known as dual-eligible beneficiaries. For those enrolled in Medicare who are eligible, enrolling in Medicaid may provide some benefits not covered by Medicare, such as stays longer than 100 days at nursing facilities, prescription drugs, eyeglasses, and hearing aids. Medicaid may also be used to help pay for Medicare premiums. According to the Henry J. Kaiser Family Foundation, in 2011 there were about 9,972,300 dual eligibles in the United States, or 15 percent of Medicaid enrollees. While average Medicaid spending per enrollee was $5,790, spending per dual eligible was $16,904.^{[1][2][3][4][5]}

In Maine, 28 percent of Medicaid enrollees were also enrolled in Medicare, the lagest percentage in the country. Utah had the smallest percentage at 19 percent. Meanwhile, Medicaid spending per dual eligible was highest in New York, $30,697. Alabama had the lowest spending at $8,576.

The chart below includes statistics identifying the percentage of Medicaid enrollees within a state that were also eligible for Medicare, as well as the amount spent through Medicaid per dual eligible.

Spending in detail[edit]

The table below displays data on Medicaid spending on dual eligibles in detail, as well as dual eligible spending as a share of total Medicaid spending for each state. Medicaid spending on dual eligibles in North Dakota amounted to 56 percent of total Medicaid spending, the largest percentage in the country. Vermont had the smallest percentage at 21 percent.^[6][7]

Medicaid spending in the 50 states[edit]

Click on a state below to read more about Medicaid spending in that state.

See also[edit]

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  Healthcare policy in the United States

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  Medicaid

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  Effect of the Affordable Care Act in the United States

Footnotes[edit]