What does Dual Eligibility refer to?

Dual Eligibility refers to the status of an individual who qualifies for both Medicare and Medicaid. This situation typically occurs with individuals who are aged 65 or older, as well as some younger individuals who have disabilities or specific medical conditions.

Medicare provides health coverage to those 65 and older and certain younger people with disabilities, covering major medical expenses. On the other hand, Medicaid is a state and federal program that assists with medical costs for individuals and families with limited income and resources.

When someone is dual eligible, they can benefit from both programs, which helps cover a wider range of health care costs, allowing for more comprehensive coverage. This can include hospital stays, doctor visits, long-term care, and certain prescription drugs. Each program fills gaps in coverage offered by the other, making it incredibly beneficial for low-income seniors or disabled individuals who may struggle with medical expenses.

The other options focus exclusively on one program, either Medicare or Medicaid, or restrict eligibility based on age, which does not encompass the complete picture of individuals who may qualify for assistance through both programs.