More than 12.5 million Americans are currently jointly enrolled in both Medicare and Medicaid, the two largest health care programs in the United States.
These Americans, known as “dual-eligible individuals,” rely on both programs to complete their health care needs. Medicare typically covers preventive and acute services, and Medicaid “wraps around” the Medicare coverage to provide coverage of Medicare cost sharing, long-term services and supports (LTSS), and additional behavioral health services.
Dual-eligible individuals are often facing socioeconomic vulnerability and complex health challenges. They are more likely to be in poor health and experience multiple chronic conditions, functional impairments or behavioral health conditions.
Justice in Aging, a Modern Medicaid Alliance partner, advocates on behalf of the dual-eligible population to ensure they can access the health services they need from the two programs.
Supporting Dual-Eligible Individuals During the Redeterminations Process
At the onset of the COVID-19 pandemic, Congress implemented important measures to ensure that the millions of Americans relying on Medicaid coverage, including older adults, would not lose their health coverage during the public health emergency (PHE).
Now that the coverage protections have ended, states are conducting the Medicaid redeterminations process to determine whether each American enrolled in Medicaid is still eligible for the program.
To provide advocates with the proper tools and resources they need to support older adults during the transition back to normal operations, Justice in Aging created a guide on Common Medicaid Unwinding Issues Impacting Older Adults: Advocacy Opportunities & Practice Tips.
The guide is intended to help disability and aging advocates recognize and resolve common issues that may impact dual-eligible individuals during the redeterminations process, such as unclear requirements for Medicaid renewal, improper termination from certain programs, and lack of clarity or awareness around transitioning to Medicare or applying for new coverage.
For each issue area, the guide presents an explanation of the issue, advocacy opportunities that encourage advocates to work with states to resolve an issue, and practice tips that serve as tangible actions advocates or individuals can take to mitigate an issue. The guide is a living document that is being updated as new issues arise and the needs of older adults and their advocates evolve.
This guide is a part of a larger resource library developed by Justice in Aging that has important and relevant information, announcements, and tips on the Medicaid unwinding.
Additional resources featured in the library about Medicaid redeterminations and the unwinding of Medicaid continuous coverage protections include:
- Alert: Four Important Things to Know about Redeterminations
- Fact Sheet: Unwinding Medicaid Continuous Coverage Protections: Implications and Advocacy for Individuals Dually Eligible for Medicare and Medicaid
- Webinar: Unwinding of COVID Medicaid Continuous Coverage Requirements—What Advocates for Older Adults Need to Know
Justice in Aging’s commitment to supporting advocates for older adults by equipping them with important resources is a critical example of how Modern Medicaid Alliance partners are ensuring Medicaid enrollees and their families can properly navigate the redeterminations process.
For more information on how Modern Medicaid Alliance partners are supporting Americans during the Medicaid redeterminations process, check out our recent partner roundup.