Refer to Guidelines for Working with Dual-eligible Members

The Centers for Medicare & Medicaid Services (CMS) requires that all Medicare Advantage Organizations (MAOs) inform their network physicians and other health care providers about the Medicare and Medicaid benefits and rules for enrollees (members) eligible for both Medicare and Medicaid (i.e., dual eligibles).

An overview of the general eligibility and cost-sharing guidelines for Medicaid coverage of dual-eligible members can be found here.