The District Dual Choice program is exclusively for dually eligible beneficiaries and aims to better coordinate their Medicare and Medicaid benefits. On February 1, 2022, the District expanded its existing Dual Choice program into a more comprehensive program that integrates Medicare and Medicaid benefits into a single program. That means that there is ONE set of comprehensive benefits and ONE accountable entity to coordinate the delivery of services to help coordinate the unique needs of individuals. This further simplifies health care for participants and promotes greater care coordination.
Who are Dual Eligible Beneficiaries?
Dual eligible individuals are 21 years of age or older, receive both Medicare (Parts A, B, and D), and Medicaid coverage. There are approximately 37,000 dual beneficiaries in the District.
How do I know if I am already enrolled?
If you are enrolled in the Medicare program, you may have a “red, white and blue card” that is your Medicare enrollment card; if you are enrolled in a Medicare Advantage plan, you will have a health plan card that reflects the plan with which you’re enrolled (e.g., Kaiser Permanente, Aetna, etc.). UnitedHealthcare is the private health plan that currently offers Dual Choice enrollment for District Medicaid enrollees. If you are enrolled in Dual Choice, you will receive a card from UnitedHealthcare that has both your Medicare and Medicaid IDs.
You can find more information about UnitedHealthcare’s Dual Choice plan here.
What changes will be made in the District Dual Choice Program?
On February 1, 2022, the District integrated Medicaid services into Dual Choice coverage and financing responsibilities. Previously, the Dual Choice plan only paid for Medicare services, and this may have inadvertently led to gaps in care, duplicative services paid by Medicare and Medicaid, and difficulty navigating the two programs’ coverage and services. DHCF expects that improved integration between coverage for this vulnerable population will improve the patient experience, enhance care coordination, and ultimately lead to better outcomes and satisfaction with care and coverage.