insurance

Dual-Eligible (Medicare and Medicaid)

二重受給資格者（メディケア・メディケイド） (nijū jukyū shikakusha)

Dual-eligible individuals qualify for both Medicare and Medicaid. Medicare is the primary payer; Medicaid pays for costs Medicare does not cover, such as cost-sharing, long-term care, and additional benefits. Dual eligibles include elderly and disabled low-income individuals. They may be enrolled in Dual Eligible Special Needs Plans (D-SNPs) that coordinate both programs. About 12 million Americans are dual-eligible, and they often have complex medical needs. Navigating dual eligibility can be administratively challenging and may require assistance from a benefits counselor.

Dual-eligible individuals typically have little or no out-of-pocket costs for covered services, as Medicaid fills the gaps left by Medicare.

In 9 languages

Language	Term
English	Dual-Eligible (Medicare and Medicaid)
Japanese (日本語)	二重受給資格者（メディケア・メディケイド）
Chinese (中文)	双重受益人（医疗保险和医疗补助）
Korean (한국어)	이중 자격자 (메디케어 및 메디케이드)
Portuguese	Dupla Elegibilidade (Medicare e Medicaid)
Spanish	Doble Elegibilidad (Medicare y Medicaid)
Filipino	Dual-Eligible
Thai	ผู้มีสิทธิ์สองโครงการ
Vietnamese	Đủ điều kiện kép (Medicare và Medicaid)
Romanization	nijū jukyū shikakusha

Related terms

• Medicare Part A メディケアパートA（入院保険）
• Medicaid メディケイド（低所得者医療扶助）
• Medigap (Medicare Supplement) メディギャップ（メディケア補完保険）
• Medicaid Spend-Down メディケイドスペンドダウン

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