Dual Eligible definition

Dual Eligible means a Medicare managed care recipient who is also eligible for Medicaid, and for whom HHSC has a responsibility for payment of Cost Sharing Obligations under the Texas State Plan. For purposes of this Agreement, Dual Eligible individuals are limited to the following categories of recipients: QMB Only, QMB Plus, and SLMB Plus.

Dual Eligible refers to an individual who meets the requirements to receive benefits from both the Federal Medicare Program and the Wisconsin Medicaid Program. “Dual eligibility” does not guarantee “dual coverage.”

Dual Eligible means a Medicare managed care recipient who is also eligible for Medicaid, and for whom EOHHS has a responsibility for payment of Cost Sharing Obligations under the State Plan. MA Health Plan may enroll only those categories of Dual Eligible individuals identified in Appendix A.

Examples of Dual Eligible in a sentence

• As outlined in section 3.02, the Department agrees to provide the D-SNP or its subcontractors with real- time access to the state’s eligibility system (ForwardHealth) only to verify an applicant’s Dual Eligible status or a Dual-Eligible member’s current Medicaid status.

• Pursuant to the Texas State Plan, HHSC is financially responsible for the Cost Sharing Obligations attributable to Dual Eligible Members enrolled in the MA Agreement.

• The Contractor and the Department enter this contract to outline each party’s obligations to provide or arrange benefits for Dual Eligible members enrolled in the Contractor’s D-SNP.

• The Contractor identified above has entered a contract with the Centers for Medicare & Medicaid Services (“CMS”) to provide a Dual Eligible Special Needs Plan (“D-SNP”).

• On behalf of currently enrolled SSI HMO categorically eligible members who receive full medical assistance benefits, and who become newly Medicare eligible either by age or disability, and provided that such Medicare eligibility results in Full Benefit Dual Eligible status for such members, the D-SNP shall perform the default enrollment process as provided by 42 CFR§§ 422.66 and 422.68.

More Definitions of Dual Eligible

Dual Eligible means a person eligible for Medicare who is also eligible for Medicaid (dual eligible) is in a medical institution that is funded by Medicaid for a full calendar month, the dual eligible person is not required to pay co-payments for their Medicare covered prescription medications for the remainder of the calendar year.

Dual Eligible means an individual who is entitled to Medicare Part A and/or Medicare Part B and is eligible for some form of Medicaid. The MA Health Plan may enroll only those categories of Dual Eligible individuals identified in Appendix A.

Dual Eligible means a MA Member who is eligible for both Medicare and Medicaid benefits.

Dual Eligible means a Medicare recipient who is also eligible for Medicaid, and for whom the State has a responsibility for payment of Cost Sharing Obligations under the Georgia State Plan. For purposes of this Agreement, Dual Eligibles are limited to the following categories of recipients: Full Benefit Dual Eligibles, QMB Only, SLMB, and SLMB Plus.

Dual Eligible means an MA Member who is eligible for both Medicare and Medicaid benefits.

Dual Eligible. An individual who has established eligibility for Medicare as their primary coverage and Medicaid as their secondary coverage.

Dual Eligible means a Medicare managed care recipient who is also eligible for Medicaid, and for whom the State has a responsibility for payment of Cost Sharing Obligations under the Washington State Plan. For purposes of this Agreement, Dual Eligibles are limited to the following categories of recipients: QMB Plus, SLMB Plus