Factors Affecting Enrollment in Dual Health Beneficiaries

Running head: SOCIOLOGY
Topic: SOCIOLOGY
Name of the Student:
Name of the University:
Author Note:

1SOCIOLOGY
Medicare is the health insurance for people more than 65 years of age or certain
people under the age group and many patients suffering from end stage renal diseases. People
can receive their coverage through the original Medicare program and a Medicare advantage
plan. Similarly, Medicaid is another insurance program funded by the state as well as federal
government which pays for families with low incomes or limited resources (Cms.gov, 2019).
From the article, it can be seen that nearly 400,000 beneficiaries which are dually eligible
have been enrolled in financial alignment demonstrations. Furthermore, only 7% of dual
beneficiaries have been enrolled in Virginia (The Henry J. Kaiser Family Foundation, 2019).
Thus the essay would deal with the reasons people do not get enrolled in dual health
beneficiaries in spite of qualifying for both of them.
Controlling cost is one of the factors for not being enrolled in beneficiaries. The
expenses eventually reach higher rate during economic downturns due to loss of jobs and
health benefits of older people. Often control costs are reduced by cutting the payment rates
which ultimately reduces the benefits of the beneficiaries given to older people. Most of the
employees receive care through private managed care companies which often deal with the
issues of quality improvement and control costs. According to verdicts of Supreme Court in
2012, states have the independence of deciding to participate in the health laws which most of
the countries have refused. Thus most of the people have not received health insurance. Most
of the older people do not have sufficient earnings for qualifying for federal subsidiaries for
coverage on the health expenses even though a huge percentage of the people qualify for the
programs. According to studies, people not getting the facilities for dual beneficiaries’ often
do not receive specialists and dentists along with the care they should receive (Galewitz,
2019). Lack of knowledge is another factor affecting people in spite of being eligible. Most
of the people are not aware of the various advantages and coverage of the dual beneficiaries,
thus being dubious about their benefits. Moreover, cultural and social barriers are some of the