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Medicare Advantage

What's the Advantage If You've Got Medicaid, Too?

By Mary A. Ashkar, Vicki Gottlich & Patricia Nemore

Since 2003, enrollment of so-called dual eligibles—individuals eligible for both Medicare and Medicaid—in Medicare Advantage plans has burgeoned to one million. Little formal study has been done regarding whether dual eligibles benefit from using Medicare Advantage plans. However, the failure of Medicare Advantage to coordinate with Medicaid in providing benefits, cost sharing, and appeals processes calls into question whether dual eligibles actually derive benefit from Medicare Advantage plans. For some dual eligibles, enrollment in an MA plan may result in increased out-of-pocket costs and decreased access to health care. Medicare Advantage plans for Special Need Populations in particular may not be all that advantageous.

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