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Author(s)
Teal W. Benevides, Anne M. Roux, Samuelle Voltaire, Mary P. Sowers, Lindsay L. Shea
Published Online: February 2026
Topics
Health Care
Type
In-depth Report
Data Source
Medicaid and Medicare claims data (MMLEADS 2012 + linked 2019 Medicaid and Medicare data)
# Pages
23
Autistic dual eligibles were unique compared to the general population of dual-eligible people.
Most dual-eligible adults in the U.S. are 65 years and older and are chronically ill. They typically qualify for Medicare first when they turn 65 and later qualify for Medicaid based on income. Autistic dual eligibles do not follow this pattern.
Autistic dual eligibles are generally young (age 45 and under), male, and white. They most often enter Medicaid first by qualifying for disability based on intellectual disability (ID), autism, or psychiatric conditions. They then enter Medicare later also based on disability. These differences have major policy implications, as dually-eligible autistic adults will likely need lifelong health and developmental services.
This report highlights a critical but overlooked group: autistic adults who are dual eligible for both Medicaid and Medicare.
About 2.2% of U.S. adults—around 5.5 million people—are on the autism spectrum. The number of autistic adults is growing quickly, with rates increasing nearly 300% since 2000. Many autistic people also have other physical and mental health conditions, which means they often need specialized health care and community support throughout their lives.
Like other adults with intellectual and developmental disabilities (I/DD), autistic adults often rely on public health insurance. Most use Medicaid or Medicare, and some qualify for both programs. Individuals who qualify for both are called “dual eligibles” or “duals.”
As autism prevalence rises, public systems like Medicaid and Medicare are struggling to meet the needs of the growing population of autistic adults. Autistic adults frequently use Medicaid to meet their health and service needs, but integrated use of both Medicaid and Medicare among dual eligibles is underdeveloped.
Understanding pathways and reasons for dual eligibility within this population is essential to guide policy and improve care systems. This report presents new findings about dual eligibility among autistic people.
Benevides, Teal W.; Roux, Anne M.; Voltaire, S.; Sowers, Mary P.; and Shea, Lindsay L. National Autism Indicators Report: Use of Dual Medicaid and Medicare Coverage among Autistic People. Philadelphia, PA: Policy and Analytics Center, A.J. Drexel Autism Institute, Drexel University, January 2026.
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