Dual Eligible Member Clause Samples
Dual Eligible Member. An individual enrolled with an AHCCCS Medicaid MCO for full Medicaid services (AHCCCS benefits) who also receives both Part A and Part B Medicare benefits. These individuals are considered to be Full Benefit Dual Eligible Members, and include Qualified Medicare Beneficiary Plus (QMB Plus), Specified Low-Income Medicare Beneficiary Plus (SLMB Plus) and Other Full Benefit Dual Eligible (Other FBDE) populations. A Full Benefit Dual Eligible Member does not include those persons enrolled in a Medicare Savings Program population: Qualified Medicare Beneficiary only (QMB only), Specified Low- Income Medicare Beneficiary only (SLMB only) or Qualified Individual-1 (QI-1).
Dual Eligible Member. An enrollee who is Dual-Eligible and is enrolled in a Plan.
Dual Eligible Member. A Medicare Advantage Member who is: (a) eligible for Medicaid; and (b) for whom the state is responsible for paying Medicare Part A and B Cost Sharing.