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  • Writer's pictureVicki Jessup

Remember the Partial Duals During PHE Unwind

Updated: Jan 25, 2023

With the COVID-19 public health emergency potentially coming to a close there has been a lot of well-grounded discussion about how to prevent Medicaid recipients from losing their benefits. During the COVID-19 public health emergency (PHE), as a condition of enhanced federal funding, states can’t disenroll anyone from Medicaid – with limited exceptions for voluntary disenrollment, out of state moves, or death. This continuous coverage requirement has allowed millions of people to maintain uninterrupted coverage through the pandemic.

If the PHE ends in mid-July (which is the growing consensus expectation), the continuous coverage requirement will end July 31, 2022. When the requirement ends, states will begin the process of “unwinding” and reviewing Medicaid eligibility for all enrollees. States are starting to share their plans for the unwinding process, and most are enlisting support from managed Medicaid plans to conduct member outreach regarding the importance of updating contact information and completing renewal paperwork.

However, there is one significant group that is in danger of being under-informed. Medicaid recipients who are “partial duals” receive limited benefits to offset their Medicare expenses. According to the most recent published numbers, this group is estimated to include 4.5 million Medicare Advantage members! Their coverage through the Medicare Savings Programs includes payment of their Medicare Part B premium -- $170 per month in 2022.

“Partial duals” are not enrolled in Medicaid managed care because they don’t receive the full scope of Medicaid covered benefits. However, many are enrolled in Medicare Advantage plans. These members will need to complete a renewal during the PHE unwinding to retain their Medicaid coverage. Medicare Advantage plans are in an excellent position to play an important role in helping to keep their “partial duals” covered.

We at BeneLynk encourage states to partner with Medicare Advantage plans in the same manner that they are partnering with managed Medicaid plans – to coordinate wide-scale outreach about the need to keep the important partial dual Medicaid benefits. In these busy times we encourage state Medicaid administrations to not forget about their “partial duals” during the unwinding planning process!


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