KFF January 31, 2024
In 2021, 12.9 million people received health coverage through both the Medicare and Medicaid programs. For those “dual-eligible individuals,” Medicare is the primary payer and covers medical acute and post-acute care, including skilled nursing facility services and home health care. Medicaid wraps around Medicare coverage by paying Medicare premiums and in most cases, cost sharing. Most dual-eligible individuals (9.5 million people in 2021) are also eligible for Medicaid benefits that are not otherwise covered by Medicare, including long-term services and supports (LTSS), vision, and dental care (referred to here as Medicaid “wraparound services” for dual-eligible individuals).
Dual-eligible individuals tend to have low incomes, high rates of long-term disabilities, and multiple chronic conditions. Without coverage of wraparound services under Medicaid, some...
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