New York, NY—Millions of people rely on both Medicare and Medicaid to access affordable health care, but when the two programs fail to work together, beneficiaries can face costly delays, denied care, and overwhelming confusion. A new case study series from the Medicare Rights Center highlights how gaps in Medicare-Medicaid coordination affect real people and offers policy solutions aimed at improving care for more than 12.5 million dually eligible beneficiaries nationwide.

Making Medicare and Medicaid Work Better Together draws on eight examples from the Medicare Rights Center’s national helpline, where callers sought help navigating problems with their Medicare-Medicaid coverage. The series documents recurring failures in coordination that leave beneficiaries caught between two complex systems, often at moments of serious illness or vulnerability. 

“These case studies are intended to do more than document individual hardship. They are meant to inform policy decisions,” said Fred Riccardi, President of the Medicare Rights Center. “By showing how current rules and systems fail dually eligible beneficiaries in practice, we hope to support meaningful improvements in how Medicare and Medicaid work together.” 

The series includes four case study briefs examining common challenges in Medicare–Medicaid coordination, such as inefficient appeals processes, coverage gaps and service disruptions, and shortcomings in integrated special needs plans. Each brief pairs real-world examples with targeted policy recommendations for federal and state leaders. 

To complement the written briefs, the series also features two short videos and an infographic that explain forms of dual coverage, such as integrated Dual-eligible Special Needs Plans, and important cost-saving benefits, like the Medicare Savings Program. These resources provide clear, accessible context for beneficiaries while reinforcing the policy implications of how coverage design and administration affect access to care. 

The full case study series is available online at medicarerights.org/policy-series/making-medicare-and-medicaid-work-better-together.