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 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.

Examples of Dual Eligible in a sentence

• The MA Dual SNP shall track and pay all eligible providers the Cost-Sharing Obligations incurred on behalf of Dual Eligible Members with applicable Medicaid eligibility categories covered under this Agreement.

• Section 3.01Plan Offer to Dual Eligible Individuals Residing in CMS-approved Service Areas.

• Cost Sharing Obligations mean those financial payment obligations incurred by HHSC in satisfaction of the Deductibles, Coinsurance, and Co-payments for the Medicare Part A and Part B programs with respect to Dual Eligible Members.

• Pursuant to the Texas State Plan, HHSC is financially responsible for the Cost Sharing Obligations attributable to Dual Eligible Members enrolled in the MA Dual SNP’s Medicare Advantage Product.

• This Agreement sets out the responsibilities of the Parties for Dual Eligible Members enrolled in the MA Dual SNP Health Plan Medicare Advantage.

More Definitions of Dual Eligible

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.

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 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

Dual Eligible means an individual eligible for Medicare and Medicaid benefits.

Dual Eligible. As used in this Contract, a Medicare enrollee who is also eligible for TennCare and for whom TennCare has a responsibility for payment of Medicare Cost Sharing Obligations under the State Plan. For purposes of this Contract, Dual Eligibles are limited to the following categories of recipients: QMB Only, QMB Plus, SLMB Plus, and Other Full Benefit Dual Eligible (“FBDE”).