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This variable is contained in the following files: TAF Demographic and Eligibility File
SAS Name
DUAL_ELGBL_CD_01

Indicates coverage for beneficiaries entitled to Medicare (Part A and/or B benefits) and eligible for some category of Medicaid benefits in the month (i.e., dually eligible). There are separate variables for each of the 12 months during the year.

Comments

Dual eligibles are often divided into “full duals” and “partial duals” based on the level of Medicaid benefits they receive. CMS generally considers beneficiaries to be full duals if they have values of 02, 04, or 08, and to be partial duals if they have values of 01, 03, 05, or 06. Partial duals are sometimes divided into the QMB-only population (01) and all other partial duals (03, 05, or 06). There are different ways to classify dually eligible beneficiaries.

SOURCE: T-MSIS Annual Demographic and Eligibility TAF

CodeCode value
00
Eligible is not a Medicare beneficiary
01
Eligible is entitled to Medicare- Qualified Medicare Beneficiary (QMB) only
02
Eligible is entitled to Medicare-QMB and Medicaid coverage including prescription drugs
03
Eligible is entitled to Medicare- Specified Low-Income Medicare Beneficiary (SLMB) only
04
Eligible is entitled to Medicare-SLMB and Medicaid coverage including prescription drugs
05
Eligible is entitled to Medicare- Qualified Disabled Working Individual (QDWI)
06
Eligible is entitled to Medicare-Qualifying Individuals (QI)
08
Eligible is entitled to Medicare-Other Dual Eligibles (Non QMB, SLMB, QDWI or QI) including prescription drugs
09
Eligible is entitled to Medicare – but without Medicaid coverage (This code is to be used only with specific CMS approval).
10
Separate CHIP Eligible is entitled to Medicare
Null/missing
source value is missing or unknown