Integrated Care for Dual-Eligible Beneficiaries
How Does Centene Help People Who Have Medicare and Medicaid?
Some people qualify for both Medicare and Medicaid, meaning they are “dually eligible.” Many of these people need extra help because they are older and may also have limited income, a disability, or long-term health needs.
Centene helps make care easier to get and easier to understand. Here are a few ways we help:
- We bring Medicare and Medicaid benefits together so care feels less confusing.
- We have deep experience serving people who have low income and complex needs, including Medicaid Aged, Blind, Disabled (ABD), long-term services and supports (LTSS), and Medicare Advantage Dual-Eligible Special Needs Plans (D‑SNPs)
- We look at the whole person. We connect medical care, mental healthcare, social needs and LTSS to support people managing multiple chronic conditions.
- We work with doctors and community groups to help members get the right care at the right time.
Centene started as a Medicaid company with a focus on lower-income and medically complex populations more than 40 years ago. Today, we also support many Medicare members. This helps us understand what people need when they have both Medicare and Medicaid. As of June 2026, Centene serves approximately 13 million Medicaid members, includin nearly 750,000 people who are eligible for both Medicaid and Medicare, as well as approximately 1 million Medicare members.
For dual‑eligible members enrolled in our integrated D‑SNPs, we built an integrated care model that brings members caregivers and providers together in a more coordinated way.
Centene’s Duals Operating Model: One Team, One Plan
Centene supports dual-eligible members through our ABD, LTSS and Medicare Advantage D‑SNPs programs. We built this experience into our Duals Operating Model, which is a unified Medicare‑Medicaid solution.
How Centene Helps Dual-Eligible Members
Watch a member testimonial to learn how a Fidelis Care New York member received personalized support and improved access to healthcare and social services.
Who Is Eligible for Both Medicare and Medicaid?
Dual‑eligible people can get both Medicare and Medicaid. This may happen because of age or disability, along with low income and limited financial resources. Today, more than 12 million people in the United States are dually eligible. Many have long-term and complex health needs requiring them to seek care more often.
Getting care can be hard when Medicare and Medicaid work like two different systems. People may have to talk to more than one plan to get the help they need. This can lead to problems like:
- Disconnected provider networks across Medicare and Medicaid plans
- Duplicative administrative processes
- Limited coordination across providers and care teams
These issues can make it harder to get good care and manage ongoing health needs every day.
Some people also face daily life problems that can affect their health. They may not always have healthy food, steady housing, or help from family or friends. They may also have trouble paying for basic needs like heat or electricity.
That is why dual care needs a team approach that goes beyond traditional clinical coordination. It should connect medical care, mental healthcare, social needs and financial support. People also need clear help finding answers – like how to apply for dual Medicare and Medicaid.
Many states now ask health plans to better connect Medicare and Medicaid benefits. The goal is to improve access, care continuity and outcomes for dual-eligible beneficiaries.
Where Centene Serves Dual-Eligible Members
Centene serves many dual-eligible members through Medicare Advantage D-SNP plans, including integrated D-SNP products across 20 markets. Of these, 11 states offer applicable integrated plans (AIPs). Through our AIP models, members benefit from one insurance card, one care manager, and coordinated Medicare and Medicaid benefits and services. Members don’t have to guess which program covers a service or who to call. We help manage appointments, prescriptions, referrals and messages between providers. This helps members get the right care at the right time.
As the dual-eligible population grows due to our country's aging population, Centene is committed to helping these members get better outcomes, an easier experience and lower costs.
*Highlighted states reflect where Centene offers D-SNP plans in 2027.
Resources for Dual‑Eligible Beneficiaries
Want to learn more about enrolling, covered services and how dual eligibility works? These resources can help:
- What Is a Dual Special Needs Plan (D-SNP)? (Wellcare.com)
- Dual Eligibility (Wellcarenow.com)
Related News
Wellcare is expanding Medicare Advantage and prescription drug coverage to improve access, affordability and coordinated care for members nationwide.
Meridian Health Plan is expanding coordinated coverage for dual-eligible members in Illinois, strengthening access to integrated care across Medicare and Medicaid.
Centene’s policy recommendation to expand access to nutritious food as a supplemental benefit in Medicare Advantage, enabling earlier, prevention-focused interventions for members with chronic conditions.
Wellcare CEO Michael Carson on Centene’s strategy to expand Dual-Eligible Special Needs Plans (D-SNPs) and deliver sustainable, coordinated care for members with complex needs.
Wellcare’s CEO on improving Medicare Advantage performance, including perspectives on quality ratings and opportunities to strengthen outcomes for members.