.png)
In an article published today (09/12/25) in the Health Forum of the Journal of the American Medical Association, Eric T. Roberts, PhD, and José F. Figueroa, MD, MPH, wrote of the ongoing challenge of loss of Medicaid among members dually enrolled in both Medicare and Medicaid.
Citing a range of studies, the article notes that “…8% of dual-eligible beneficiaries lost Medicaid for at least 1 month per year. Another [study] estimated that, among those who were newly dual-eligible, 30% lost full-benefit Medicaid for at least 1 month and 24% lost Medicaid for more than 3 months. Some individuals experience a cycle of losing and regaining Medicaid, commonly referred to as churn.”
The rate of loss of Medicaid among newly enrolled dual recipients is noteworthy, as it points to a particular challenge in navigating the renewal process and ties into the driver of the failure to renew. As the authors indicate, much of this churn is not attributable to a change in circumstances that renders the dually enrolled member ineligible for Medicaid, but rather to failure to comply with the administrative requirements for annual Medicaid renewal:
“These requirements are particularly burdensome for older adults and individuals with disabilities who may have cognitive impairments, functional limitations, or insufficient social support to navigate these bureaucratic processes. Delays or mistakes in the renewal process can lead to procedural disenrollment, when Medicaid coverage is terminated for reasons such as incorrect paperwork. Evidence indicates that a substantial proportion of individuals who lose Medicaid regain it within a year, suggesting that procedural disenrollment, rather than improved financial status, is a major driver of churn.” As I wrote earlier this year, these administrative burdens, sometimes referred to as “sludge,” are increasing as a result of H.R.1 and related state initiatives to reduce Medicaid enrollment.
In response to these challenges, Roberts and Figueroa note that, among a range of possible steps, “…states can require managed care plans serving dual-eligible individuals to help enrollees with Medicaid renewals.” At BeneLynk, we are fortunate to work on behalf of forward-thinking managed care plans serving dual members. Every year, our clients task us with helping millions of dual-enrolled members navigate the Medicaid renewal process. Our government relations team, led by one of the nation’s foremost experts in Medicaid eligibility, Vicki Jessup, works relentlessly to track the changing landscape of Medicaid renewals. They ensure our Lynk360 system and professional advocates have the information needed to help the people we serve maintain their benefits. To put this knowledge into action, we conduct multi-channel outreach centered on human-to-human advocacy, making sure we reach as many members as possible and provide the support they need.
As this article states, dual-enrolled Medicare and Medicaid recipients face a particularly challenging environment for maintaining Medicaid benefits. If you want to make sure your members keep the benefits they deserve, please contact us today. We help your dual-enrolled members keep their Medicaid benefits. Start a conversation today by emailing us at sales@BeneLynk.com.
About the Author: Sean Libby is the CEO of BeneLynk, the nation’s leading social care company serving members of government-sponsored health plans, and has been an advocate for older Americans, people with disabilities, veterans, and individuals with low income for over 22 years. At BeneLynk, we are committed to helping managed care plans deliver superior social care solutions to their members.