Preventing and Addressing Unnecessary Medicaid Eligibility Churn Among Dually Eligible Individuals: Opportunities for States
Supporting States in Improving Care for Dually Eligible Individuals through the Integrated Care Resource Center
U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services, Medicare - Medicaid Coordination Office
People who are dually eligible for Medicare and Medicaid benefits often have multiple chronic physical and behavioral health conditions, and many use long-term services and supports (LTSS). Unfortunately, a relatively high proportion of dually eligible individuals cycle in and out of Medicaid eligibility, often due to lack of response to state Medicaid renewal notices. This creates disruptions in coverage and care, which can result in adverse health outcomes and increased costs for individuals and states. This Integrated Care Resource Center technical assistance brief summarizes steps that states can take in partnership with Dual Eligible Special Needs Plans (D-SNPs) to: (1) prevent unnecessary Medicaid eligibility loss among dually eligible populations; and (2) mitigate the impact of temporary Medicaid eligibility losses among D-SNP enrollees when such losses occur.