If you are an individual who qualifies for both Medicare and Medicaid, you may be eligible to enroll in a Dual Eligible Special Needs plan (D-SNP). These plans may offer additional benefits with no extra cost. Here is what you need to know about joining a D-SNP.
Do Medicare and Medicaid Work Together?
If you are eligible for both programs, it is possible to enroll in both Medicaid and Medicare. Dual plans work with an individual’s Medicaid coverage to cover doctor visits, hospitals care, and medication. The rules to qualify for a dual plan vary from state to state, but a Medicare professional can help you determine if you are eligible.
How Do Dual Special Needs Plans Function?
Like any Advantage plan, a D-SNP covers all of your Original Medicare needs, in addition to some supplemental benefits that are specific to the D-SNP. In fact, many dual special needs plans offer valuable extra benefits like dental care, eye exams, hearing exams, and transportation to health care visits and pharmacy.
How To Get Dual Special Needs Plans?
There are nearly 11 million individuals who are dually-eligible for Medicare and Medicaid, and a large portion of them rely on D-SNPs to coordinate their health care benefits. To be eligible, you may need to meet the following requirements:
- Be eligible for and enrolled in both Medicare and Medicaid
- Fit into a vulnerable group of Medicare beneficiaries
Eligibility categories differ from state to state, visit the Medicaid website for more specifics.
The type of plan you choose will dictate some measure of how your benefits function, therefore you should choose wisely with the help of a trusted advisor. There are several types of D-SNP types available currently. They are as follows:
- All Dual
- Zero Cost Sharing D-SNP
- Dual Eligible Subset D-SNP
- Fully Integrated Dual Eligible Special Needs Plans