How does medicare's Part D payment structure differ for dual eligibles compared with that for medicare beneficiaries who do not qualify for dual eligibility?

Answer 1

Medicare's Part D payment structure for dual eligibles differs significantly from that of beneficiaries who do not qualify for dual eligibility. Dual eligibles, who are eligible for both Medicare and Medicaid, typically have their Part D premiums, deductibles, and cost-sharing covered by Medicaid, resulting in lower out-of-pocket costs. In contrast, non-dual beneficiaries are responsible for their Part D premiums and may face higher cost-sharing depending on their specific plan and income level. This means that dual eligibles generally experience greater financial assistance and reduced medication costs compared to their non-dual counterparts.