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06/11/2021

What is a full benefit dual eligible?

What is a full benefit dual eligible?

The term “full dual eligible” refers to individuals who are enrolled in Medicare and receive full Medicaid benefits. Individuals who receive assistance from Medicaid to pay for Medicare premiums or cost sharing* are known as “partial dual eligible.”

What is MMA filing?

The file that states submit is called the MMA File (after the Medicare Prescription Drug Improvement and Modernization Act of 2003) or State Phasedown File. The MMA File Exchange is the state data exchange that provides current information on updated full- and partial-benefit dual-eligible beneficiary status.

What came out of the Medicare Prescription Drug Improvement and Modernization Act?

On December 8, 2003, President George W. Bush (R) signed the Medicare Prescription Drug, Improvement, and Modernization Act (P.L. 108–173), which authorizes Medicare coverage of outpatient prescription drugs as well as a host of other changes to the program.

What year did the Medicare Prescription Drug Improvement and Modernization Act added new prescription benefits for the elderly?

The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 was enacted in November 2003 and became effective on January 1, 2006.

How was Medicare Part D funded?

Part D is financed by general revenues (71 percent), beneficiary premiums (17 percent), and state payments for beneficiaries dually eligible for Medicare and Medicaid (12 percent). Higher-income enrollees pay a larger share of the cost of Part D coverage, as they do for Part B.

How does one become eligible for Part D?

If you are eligible for Medicare coverage, you are also eligible for the Medicare drug benefit (Part D). You must be enrolled in Medicare Part A and/or Part B to enroll in Part D.

Can an employer force an employees to enroll in Medicare?

It’s illegal for an employer to force any actively working employee to choose Medicare instead of their group health plan. You have the option to leave the group health plan and choose Medicare as your primary insurance instead, but your employer cannot make you do so.