How does dual eligibility work for individuals qualified for both Medicare and Medicaid?

Dual eligibility refers to individuals who qualify for both Medicare and Medicaid. In this scenario, these individuals benefit from both programs, which provides a more comprehensive coverage model. Medicare serves as the primary insurance for various health services, including hospital stays, outpatient care, and some preventive services. However, it does not cover all costs; beneficiaries may still face gaps in coverage such as premiums, deductibles, and co-payments.

Medicaid acts as a secondary payer for dual eligibles, helping to cover costs that Medicare does not fully pay. This may include long-term care services, additional healthcare expenses, and assistance with out-of-pocket costs, which can significantly alleviate financial burdens for eligible individuals.

Due to the structure of dual eligibility, individuals receive a broader range of healthcare services and support, promoting improved access to health care and ease of managing costs associated with medical care. The coordination between the two programs is designed to ensure that individuals do not face overwhelming medical expenses and receive the support they need for their health.

The other options do not accurately depict how dual eligibility works, as individuals do not have to choose one program over the other or are limited to receiving benefits from only one. Additionally, while income limits are relevant in the eligibility criteria for Medicaid, the operation