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翻訳と辞書　辞書検索 [ 開発暫定版 ] スポンサード リンク Medicare dual eligible ： ウィキペディア英語版 Medicare dual eligible Dual-eligible beneficiaries (Medicare dual eligibles or "duals") refers to those qualifying for both Medicare and Medicaid benefits. In the United States, approximately 9.2 million people are eligible for "dual" status spending an estimated $319.5 billion in 2011 alone. Dual-eligibles make up 14% of Medicaid enrollment, yet spend approximately 36% of Medicaid expenditures. Similarly, duals total 20% of Medicare enrollment, and spend 31% of Medicare dollars. Dual-eligibles are often in poorer health and require more care compared with other Medicare and Medicaid beneficiaries.〔Medicare Payment Advisory Commission and Medicaid and CHIP Payment Access Commission, Data Book: Beneficiaries Dually Eligible for Medicare and Medicaid (Washington, D.C.: December 2013), 26.〕 The reason that the cost for dual-eligible long-term care is high is that duals are a complex population with a complex set of needs. As a result, a one-size-fits-all approach for duals is not possible. == Medicare and Medicaid Coverage for Dual-Eligibles == Medicare is the primary payer for most services, but Medicaid covers benefits not offered by Medicare. Medicare coverage for dual-eligibles includes hospitalizations, physician services, prescription drugs, skilled nursing facility care, home health visits, and hospice care. Under Medicaid, states are required to cover certain items and services for dual-eligibles, including long-term nursing facility services and home health services. Although states are required to cover certain populations and services, they have the option to expand coverage beyond these mandatory levels (i.e., offer home and community-based services), and accordingly state Medicaid programs vary in scope. Dual-eligibles may be categorized as full-benefit or partial-benefit. Those with full benefits may receive the entire range of Medicaid benefits; those with partial-benefits do not receive Medicaid-covered services, but Medicaid covers their Medicare premiums or cost-sharing, or both. Partial benefit dual-eligible beneficiaries have limited income and assets, but their income and assets are not low enough to qualify them for full Medicaid benefits in their state.〔 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Medicare dual eligible」の詳細全文を読む スポンサード リンク 翻訳と辞書 : 翻訳のためのインターネットリソース Copyright(C) kotoba.ne.jp 1997-2016. All Rights Reserved.