Final answer:
Dual eligibles qualify for both Medicare and Medicaid, with Medicare generally paying first and Medicaid covering the remainder. These programs work together to lower health-care costs for eligible individuals. Eligibility and benefits can vary, especially for Medicaid, which is also state-managed.
Step-by-step explanation:
Medicare and Medicaid Dual Eligibility
Individuals who are classified as dual eligibles qualify for both Medicare and Medicaid. Medicare is a federal program that provides health insurance primarily to individuals over age 65, as well as to some younger people who are disabled. Medicaid, on the other hand, is a state and federal program offering health-care coverage to eligible low-income individuals. When a service is covered by both programs, Medicare typically pays first, and Medicaid covers the remaining costs, acting as secondary insurance. This can include covering Medicare premiums, deductibles, and co-payments. Therefore, dual eligibles can benefit from the combined coverage of both programs to minimize their health-care costs.
Medicare has two main parts: Part A, which helps cover hospitalization, and Part B, an optional insurance for outpatient services. Medicaid eligibility varies by state, but the federal government requires states to include coverage for specific groups, such as the blind, disabled, and children under the Children's Health Insurance Program (CHIP). The cost of Medicare and Medicaid services is shared by the federal and state governments, though the exact percentages can differ.