Dual Special Needs Plan: For People with Medicare & Medicaid

Published by: Medicare Made Clear

Some people are eligible to have both Medicare and Medicaid. These people are considered “dual eligible,” and they also qualify to enroll in a special kind of Medicare Advantage plan known as a Dual Special Needs Plan (D-SNP).

 

 

What Is A Dual Special Needs Plan?

 

A Dual Special Needs Plan is a special kind of Medicare Advantage coordinated-care plan. It is an all-in-one plan that combines your Medicare Part A and Part B benefits, your Medicare Part D prescription drug coverage, your Medicaid benefits and additional health benefits such as vision, dental or fitness.

 

 

Who Can Get A Dual Special Needs Plan?

 

You can get a Dual Special Needs Plan if you meet the following qualifications:

 

1.    You are eligible Medicare and Medicaid and have both.

2.    You have Medicare Part A and Part B.

3.    You live in the plan’s area.

 

 

What Does A Dual Special Needs Plan Cover?

 

Just like any other Medicare Advantage plan, a Dual Special Needs Plan will include coverage for Medicare Part A and Part B. It will also include Part D prescription drug coverage and extra benefits not provided by either Medicare or Medicaid.

 

Examples of extra benefits a Dual Special Needs Plan may provide include:

 

  • Credits to buy health products
  • Transportation assistance
  • Care coordination via a personal care coordinator
  • Personal emergency response system (PERS)
  • Tele-health options such as virtual medical visits with your doctor
  • Worldwide emergency coverage

 

The extra benefits offered will vary by plan, provider and location.

Learn More About Dual Eligible Plans

 

Understand if you're eligible for a dual plan, and find the plan that may be a good fit for your needs.

A Special Note About Enrolling in D-SNP Plans

 

If you qualify for Medicaid and are enrolled in Medicare, you may be able to enroll in a Dual Special Needs Plan during the first nine months of the year in a Special Enrollment Period, rather than the Medicare Annual Enrollment Period (AEP) in the fall.

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