In Medicaid, what does the term 'dual eligible' refer to?

The term 'dual eligible' specifically refers to individuals who qualify for both Medicaid and Medicare. This designation is important because it indicates that these individuals can access a broad range of healthcare services and benefits provided by both programs.

Medicare is primarily designed for older adults aged 65 or older, as well as some younger individuals with disabilities, while Medicaid is a program that assists individuals with limited income and resources, which includes many who are elderly or disabled. Dual eligible beneficiaries can take advantage of the comprehensive services available through both programs, including hospital visits, long-term care, and preventive services, which may help improve their overall health outcomes and reduce out-of-pocket costs.

The other options describe groups that do not capture the dual eligibility status. For instance, individuals qualifying for Medicare only do not have the benefits provided under Medicaid. Similarly, individuals with disabilities may or may not be dual eligible, as some may only qualify for Medicaid. Lastly, individuals enrolled in private insurance plans might have different eligibility criteria that do not intersect with the public programs of Medicaid and Medicare. Thus, only those who qualify for both programs are classified as dual eligible.