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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. [ 1][ 2] Dual-eligibles make up 14% of Medicaid enrollment, yet they are responsible for approximately 36% of Medicaid ...
It is an organization that provides or arranges managed care for health insurance, self-funded health care benefit plans, individuals, and other entities, acting as a liaison with health care providers (hospitals, doctors, etc.) on a prepaid basis. The US Health Maintenance Organization Act of 1973 required employers with 25 or more employees ...
The community health center ( CHC) in the United States is the dominant model for providing integrated primary care and public health services for the low-income and uninsured, and represents one use of federal grant funding as part of the country's health care safety net. The health care safety net can be defined as a group of health centers ...
Long-term care. Long-term care ( LTC) is a variety of services which help meet both the medical and non-medical needs of people with a chronic illness or disability who cannot care for themselves for long periods. Long-term care is focused on individualized and coordinated services that promote independence, maximize patients' quality of life ...
Medicaid is the largest source of funding for medical and health-related services for people with low income in the United States, providing free health insurance to 85 million low-income and disabled people as of 2022; [ 3] in 2019, the program paid for half of all U.S. births. [ 4]
A Katie Beckett waiver or TEFRA waiver is a Medicaid waiver concerning the income eligibility for home-based Medicaid services for children under the age of nineteen. Prior to the Katie Beckett waiver, if a child with significant medical needs received treatment at home, the child's income would be deemed to include the parents' entire ...
Most states — 38 and Washington, D.C. — have the same income limit of $2,523 per month for a single person for most types of Medicaid services. For a married couple, the limit increases to ...
As initially passed, the ACA was designed to provide universal health care in the U.S.: those with employer-sponsored health insurance would keep their plans, those with middle-income and lacking employer-sponsored health insurance could purchase subsidized insurance via newly established health insurance marketplaces, and those with low-income would be covered by the expansion of Medicaid.