Dual Eligibles

NSCLC champions consumer protection for those who have both Medicare and Medicaid (dual eligibles) as several states finalize and implement demonstration plans to move many duals eligible individuals into private managed care plans.

Dual eligibles as a group have higher health needs and lower incomes than other Medicare beneficiaries. They are also more likely to need long term services and supports. Historically, there has been a lack of coordinated care for dual eligibles and the health reform law encouraged state demonstrations to address the problem.

A separate NSCLC website provides aging and disability advocates the information and tools they need to ensure that models for delivering health and long term services and supports to dual eligibles include strong consumer protections. The site houses NSCLC reports, summaries, and comments on state proposals and plans as well as state profiles and federal guidance.

Recent NSCLC activity is highlighted below. Also, NSCLC is educating California advocates in 2013 on that state’s Memorandum of Understanding with the Centers for Medicare and Medicaid Services. Check Events often for related webinars throughout the year.

• WEBINAR: Dual Eligible Demonstrations – An Update for Advocates
  Free Webinar Wednesday, December 3, 2014  3 - 4 PM EDT Over the past year, hundreds of thousands of beneficiaries in several states received passive enrollment notices as part of the Financial Alignment Initiative. On January 1, 2015, another large ...



• WEBINAR: The California Coordinated Care Initiative: Advanced Training Consumer Protections and Benefit Package Summary
  Free Webinar Series When: Tuesday, October 21, 2014 10:00 – 11:00 AM PST California is moving forward with the Coordinated Care Initiative (CCI), including the federally-approved dual eligible demonstration known as Cal MediConnect. The CCI starte...



• How Advocates Can Protect Clients from Balance Billing in California
  In this September 2014 Fact Sheet,  NSCLC shares guidance on protecting clients when providers in California balance bill dual eligibles illegally.



• “Fix List” for California Duals Program Released
  A “Fix List” for tracking problems in the roll out of California’s Coordinated Care Initiative (CCI) was shared with the state’s Department of Health Care Services and CMS in June. It calls on the state to fix problems encountered by beneficiar...



• WEBINAR: The California Coordinated Care Initiative: What Advocates Need to Know – Basics
  Free Webinar Series When: Monday, July 14, 2014 2:00 - 3:00 PM PDT/ 5:00 - 6:00 PM EDT The state of California has started implementation of the Coordinated Care Initiative (CCI), including the federally-approved dual eligible demonstration project k...



• Health Network Alert – New Version of Advocate’s Guide to Coordinated Care Initiative Now Available
  (06/27/2014)  Implementation of the Coordinated Care Initiative (CCI) – California’s dual eligible demonstration program -- is now underway in Los Angeles, Riverside, San Diego, San Bernardino, and San Mateo counties. Because there have been si...



• Health Network Alert: New NSCLC Resource for States Preparing Dual Eligible Demonstration Consumer Enrollment Notices
  (06/26/2014)  With support from The Commonwealth Fund, NSCLC prepared a new resource, You’ve Got Mail: Designing Enrollment Notices for a Dual Eligible Demonstration Rollout. The resource is designed to assist consumer advocates and state officials ...



• WEBINAR: The California Coordinated Care Initiative: Advanced Training Consumer Protections and Benefit Package Summary
  Free Webinar Series When: Wednesday, June 25, 2014 1:00 - 2:00 PM PST California is moving forward with the Coordinated Care Initiative (CCI), including the federally-approved dual eligible demonstration known as Cal MediConnect. The CCI started on A...



• WEBINAR: The California Coordinated Care Initiative- Advanced Training Enrollment Timelines and Notices
  May 13, 2014 California is moving forward with the Coordinated Care Initiative (CCI), including the federally-approved dual eligible demonstration known as Cal MediConnect. The CCI started on April 1, 2014, in certain counties, and will continue to...



• WEBINAR: Consumer Outreach in the Dual Eligible Demonstrations
  April 8, 2014 Explaining the dual eligible demonstrations to consumers is no easy task! How do you give consumers enough information so that they can make informed choices without drowning them in details? How do you reach the many hard-to-reach sub g...