Dual Eligibles
Dual eligibles are people enrolled in both Medicare and Medicaid, a population of more than 12 million Americans who are disproportionately low-income, chronically ill, and heavy users of home-based care. For home health agencies, duals are a core patient segment: Medicare pays first for the skilled episode while Medicaid wraps around with cost-sharing protection and long-term services and supports.
Definition
Dual eligibles are people enrolled in both Medicare and Medicaid, a population of more than 12 million Americans who are disproportionately low-income, chronically ill, and heavy users of home-based care. For home health agencies, duals are a core patient segment: Medicare pays first for the skilled episode while Medicaid wraps around with cost-sharing protection and long-term services and supports.
Why it matters
Dual Eligibles is part of the Payers & Programs vocabulary used across home health operations, documentation, and revenue cycle. Understanding it helps clinicians, QA leads, and administrators stay aligned on care quality and compliance.
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