Using MSIS Data to Analyze Medicaid Eligibility and Managed Care Enrollment Patterns in 1999. Tables 12A-12D: Managed Care Enrollment for Persons in Aged and Disabled Eligibility Groups by Dual Eligible Status by Plan Type in December 1999

02/01/2003

Tables 12A and 12B show the number of aged and disabled persons, respectively, who were dually eligible for Medicaid and Medicare and enrolled in managed care plans in December 1999. The counts in these tables are duplicated, since an individual could have been enrolled in more than one type of plan, in which case he or she would have been counted twice. Tables 12C and 12D convert the data in Tables 12A and 12B to a percent distribution; the percentages reflect duplicated counts in Tables 12A and 12B.

Managed care programs for dual eligibles are complicated because Medicare is the first payor, and state Medicaid programs are generally responsible for Medicare copayments, deductibles and premiums. In addition, Medicaid programs have total responsibility for some services, such as prescription drugs and long-term care, which are not covered by Medicare.

Findings

  • Just under 88 percent of aged Medicaid enrollees were dually eligible for Medicaid and Medicare in December 1999 (Table 12A). This is believed to be an undercount, since not all states were able to fully identify their dual eligible population. For the most part, the only Medicaid beneficiaries over age 65 who would not qualify for some Medicare coverage are some groups of noncitizen immigrants.

  • About 37 percent of disabled Medicaid enrollees were dually eligible for Medicaid and Medicare in December 1999 (Table 12B). The majority of disabled persons on Medicaid do not qualify for Medicare, either because they have not worked enough quarters with contributions to Social Security to have qualified for Social Security benefits, or because they are in the two-year waiting period between the commencement of Social Security benefits and eligibility for Medicare. Generally, disabled children are not able to qualify for Medicare benefits, since they have not worked and contributed to Social Security.

  • Aged and disabled dual eligibles were less likely to be enrolled in some type of managed care plan than aged and disabled persons not identified as dual eligibles. About 24 percent of aged dual eligibles were enrolled in some type of managed care, versus 35 percent for aged persons who were not identified as dual eligibles (Table 12C). About 31 percent of disabled dual eligibles were enrolled in some type of managed care, versus 50 percent of disabled persons who were not dual eligibles (Table 12D).

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