Dual eligible

What is a dual eligible?

A dual eligible beneficiary is an individual who is eligible for benefits under both Medicare and Medicaid insurance programs. They are sometimes referred to as dual eligibles or duals.

Most dual eligibles qualify for full Medicaid benefits including nursing home services, and Medicaid pays their Medicare premiums and cost sharing.

Dual eligible beneficiaries have complex and often costly health care needs, and have been the focus of many recent initiatives and proposals to improve the coordination of their care aimed at both raising the quality of their care while reducing its costs.