Medicaid and Other Payers

Medicaid interacts with other payers when Medicaid beneficiaries have other sources that are legally liable for payment of their medical costs. These may include private insurance, Medicare, other public programs such as the Ryan White program, workers’ compensation, and amounts received for injuries in liability cases. The program also interacts with CHIP when states provide Medicaid coverage to beneficiaries using CHIP funds.

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Featured publications

Financial Alignment Initiative for Beneficiaries Dually Eligible for Medicaid and Medicare

July 2016 |

Medicaid and Medicare together provide health coverage for approximately 10 million low-income seniors and people with disabilities who are dually eligible for both programs. The Centers for Medicare & Medicaid Services’ Federal Coordinated Health Care Office has implemented the Financial Alignment Initiative to improve care and reduce program costs for these beneficiaries, as well as […]
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Medicaid and Medicare Plan Enrollment for Dually Eligible Beneficiaries

July 2016 |

Medicaid and Medicare together provide coverage of medical care and long-term services and supports (LTSS) for approximately 10 million low-income seniors and people with disabilities who are dually eligible for both programs. Policymakers have long had concerns around the lack of coordination between Medicaid and Medicare, and how this can result in fragmented care, high […]
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Update on Pregnancy-Related Medicaid and Minimum Essential Coverage

June 2016 |

In its March 2014 report, the Commission looked in depth at the challenges resulting from overlapping Medicaid and exchange eligibility for pregnant women, in part related to variation across states in Medicaid-covered benefits.  The Commission made two recommendations focused on reducing inequities for pregnant women in Medicaid-covered benefits as well as mitigating the impact of […]
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