New York, NY – The Medicare Rights Center (Medicare Rights) is proud to announce the release of an essential new resource aimed at guiding policymakers in making informed decisions to enhance benefits access and coordination for individuals eligible for both Medicare and Medicaid, often referred to as dually-eligible individuals or “duals.”  

Every year, Medicare Rights answers thousands of questions on its national helpline. This collection of case studies sheds light on the real-world challenges and successes faced by Medicare Rights’ dually eligible clients and their counselors, offering valuable insights into how improved collaboration between Medicare and Medicaid can make a significant difference in accessing affordable health care. 

“Our newly released case study series is designed to help policymakers understand the complexities and opportunities inherent in the coordination between Medicare and Medicaid,” said Fred Riccardi, president of the Medicare Rights Center. “By following the experiences of our clients and counselors, the case studies highlight how even simple changes can lead to substantial improvements in accessing benefits and care.”  

The case studies highlight the following real-life scenarios and form the basis of Medicare Rights’ policy recommendations, which aim to make Medicare, Medicaid, and Medicare Savings Programs (MSPs) more accessible, user-friendly, and sustainable for all beneficiaries. 

• Medicare Savings Program Enrollment: This case study focuses on how automatic enrollment in Medicare Savings Programs can remove many individuals’ barriers when enrolling. Simplifying the enrollment process is essential to increasing participation and ensuring that more people can benefit from these vital programs. 

• Medicare Savings Program Recertification: Medicare Savings Program recertification varies widely nationwide. This case study compares two experiences—one with automatic recertification and one with a more complex process—to illustrate the need for nationwide Medicare Savings Program recertification improvements. 

• Medicaid Renewal: Renewing Aged, Blind, and Disabled Medicaid is necessary to maintain benefits. This case study contrasts a complicated renewal process with one eased by COVID-19 public health emergency flexibilities, arguing for lasting reforms in Medicaid renewal procedures. 

• Medicare-Medicaid Integration: Coordinating benefits and services for dually eligible individuals is often complex and disjointed. This case study examines the challenges of poorly integrated care and offers recommendations for improving integration at both state and federal levels. 

The case study series also includes an explainer video that serves as a primer, providing context and explaining the terminology, systems, and challenges associated with Medicare, Medicaid, and Medicare Savings Programs. It is an ideal starting point for those looking to understand the broader issues in the case studies.

An interactive case study also immerses viewers in a client’s experience with MSP enrollment, allowing them to see the challenges through the client’s eyes. This digital tool emphasizes simplifying the MSP enrollment process for all eligible Americans. 

“We invite policymakers, individuals with Medicare, and advocates to explore these resources and join the effort to improve benefits access and coordination for dually eligible individuals. By making informed decisions based on the insights provided in these case studies, we can work together to create a more equitable and efficient system for all,” said Mr. Riccardi. 

Access the case study series here. 

Visit www.medicarerights.org/policy for more policy resources.