More than 12 million Americans are eligible for both Medicare and Medicaid at the same time. This group of people—known as “dually eligible individuals”—has higher rates of chronic illness, long-term care needs, and social risk factors than people who qualify for Medicare alone. They also must navigate both Medicare and Medicaid – two separate systems that were not designed to work together. The goal of Medicare-Medicaid integration is to improve the quality and experience of care for dually eligible individuals while reducing avoidable service use and costs. Explore this section of the website to learn more about the dually eligible population.
Learn More
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Working with Medicare: An Introduction to Dual Eligibility
In this webinar, ICRC staff explain the different groups of dually eligible individuals and the differences between full- and partial-benefit dual eligibility, the categories of Medicare Savings Programs and how Medicare Savings Program coverage affects one’s category of dual eligibility, and basic information about Medicare and Medicaid coverage options for full- and partial-benefit dually eligible individuals. (ICRC, June 2025)
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Dually Eligible Individuals: The Basics
In this fact sheet, ICRC provides a high-level overview of dual eligibility and key characteristics of the dually eligible population. (ICRC, April 2022)
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People Dually Eligible for Medicare and Medicaid
In this fact sheet, the Centers for Medicare & Medicaid Services (CMS) Medicare-Medicaid Coordination Office (MMCO) shares key characteristics of dually eligible individuals, such as the proportion of dually eligible individuals who receive full vs. partial benefits, the proportion of dually eligible individuals who are enrolled in Medicare Savings Programs, and the ways in which dually eligible individuals qualify for Medicare coverage. (CMS, March 2023)
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Dually Eligible Individuals – Categories
In this resource, CMS defines the different categories of dual eligibility. (CMS, September 2024)
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CMS MMCO Statistical & Analytic Reports
On this webpage, CMS provides several data reports about dually eligible individuals, including data on the number of dually eligible individuals by state and category of dual eligibility, trends in managed care enrollment and key demographic characteristics, and trends in loss of dual eligibility among full-benefit dually eligible individuals.
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Data Books: Beneficiaries Dually Eligible for Medicare and Medicaid
In these data books, the Medicare Payment Advisory Council (MedPAC) and the Medicaid Payment and Access Commission (MACPAC) summarize key characteristics of dually eligible individuals on a national level.
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In its FY2023 report to Congress, CMS MMCO summarizes key characteristics of dually eligible individuals, the number of dually eligible individuals in integrated care plans, and progress on priorities for advancing integrated care.