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Dual eligible enrollees are Medicare enrollees that are receiving some form of assistance from their states’ Medicaid program. Dual beneficiaries may receive all or some of the following:
- Medicare Part B premium assistance
- Medicare cost sharing payment assistance
- Eligibility for full Medicaid services
Detailed descriptions of the various, specific types of dual eligibility are found on the CMS web site. The MBSF variable “Medicare-Medicaid Dual Eligibility Status” occurs monthly. The values identify:
- Qualified Medicare Beneficiaries (QMBs)
- Medicare Part B Premium and cost-sharing assistance
- With or without Medicaid benefits
- Specified Low-Income Medicare Beneficiaries (SLMBs)
- Medicare Part B Premium Assistance
- With or without Medicaid benefits
- Qualified Disabled and Working Individuals (QDWIs)
- Medicaid only pays the Medicare Part A premium
- Beneficiaries spend down assets to be eligible
- Qualifying Individuals (Qis)
- Medicaid paid Part B Premiums, effective 1/1/1998 to 12/31/2002
- Beneficiaries spend down assets to be eligible
- Medicaid Only Dual Eligibles, entitled to full Medicaid benefits but receive not cost-sharing or premium assistance
Prior to the development of the MBSF variable with the implementation of the Part D program, there was no reliable way to identify all dually eligible from Medicare enrollment files.
Statistics on the Dual Eligible Population are available from the Kaiser Family Foundation.