Low-income seniors and people with disabilities who receive Medicare and Medicaid (known as dual eligibles) are a diverse group who share the underlying feature of poverty. This is a population at great risk of experiencing life-threatening gaps in health care. Dual eligibles on average have higher health needs than other Medicare beneficiaries. They are more likely to be women and people of color than other Medicare beneficiaries. They are also more likely to experience disparities in access to health care due to sexual orientation, disability, or language barriers. Their need for long-term services and supports is also greater. Dual eligible beneficiaries often are wrongly billed by medical providers for charges that they do not owe, a practice known as “balance billing.” They experience barriers to using their Medicare and Medicaid benefits together in certain instances such as when trying to access durable medical equipment (DME) or when using non-emergency medical transportation (NEMT).

Under a provision of the Affordable Care Act, many states have implemented demonstrations that integrate care for duals via managed care plans. These demonstrations offer the promise of improved care for millions of poor seniors, but also introduce the possibility of service cuts that put beneficiaries’ health at risk.

Justice in Aging has a website dedicated to providing aging and disability advocates the information and tools they need to advocate for strong consumer protections in new dual eligible demonstrations. On this site, you’ll find reports, summaries, and comments on state proposals and plans, as well as state profiles and federal guidance. Below, we also have a national duals toolkit on design and implementation and a compilation of California-specific resources.

Dual eligibles should be able to access the health care and long term services and supports they need. Through advocate trainings and administrative advocacy at the state and federal level, Justice in Aging works to remove barriers that exacerbate the disparities this group faces. As national experts on issues of dual eligibles, we’re an information hub for advocates and a feedback loop to policymakers implementing new programs. Advocates across the country rely on our resources and trainings to help them counsel the clients they serve directly. Last year alone we trained over 13,000 advocates and direct service providers on issues impacting dual eligibles. We meet regularly with health plan administrators and government agencies to share on-the-ground stories gathered from the advocates we train, and push for needed fixes to the program. We seek to ensure that new programs actually work as they should and also to fix longstanding dysfunctions in older continuing programs that keep dual eligibles from getting the services they need.