If you have both Medicare and Medicaid, a Dual Special Needs Plan can unify your coverage and add valuable benefits. Here is how it works.
What is a Dual Special Needs Plan?
A Dual Special Needs Plan (D-SNP) is a type of Medicare Advantage plan available only to people who are dual eligible, meaning they have both Medicare and Medicaid. The plan coordinates your Medicare and Medicaid benefits under one roof, often with a single care manager who helps manage appointments, medications, and Medicaid services. Because Medicaid covers your Medicare cost-sharing, most D-SNP members pay little to nothing out of pocket. D-SNPs include Part D drug coverage and typically layer on extra benefits standard Medicare does not provide. For dual eligibles, a D-SNP is usually the most complete option. Call 1-800-MEDIGAP to compare plans near you.
Benefits and costs of a D-SNP
D-SNPs commonly offer a $0 monthly premium, $0 or low copays, and extra benefits such as dental, vision, hearing aids, transportation to medical appointments, fitness memberships, and monthly over-the-counter or grocery allowances. Because you are dual eligible, Medicaid generally covers Medicare deductibles and coinsurance, keeping your costs minimal. Benefit packages vary by plan and county, so the same carrier may offer different perks depending on where you live. These extras can add real value, but they differ widely. Comparing several D-SNPs side by side is the best way to maximize what you receive. 1-800-MEDIGAP does this comparison for free.
How to enroll in a D-SNP
To join a D-SNP you must have both Medicare and active Medicaid (or a qualifying Medicare Savings Program) in your state. Dual eligibles enjoy a Special Enrollment Period that lets them change plans once per quarter during the first three quarters of the year, far more flexibility than other beneficiaries. You apply through the plan or a licensed agent, and the plan verifies your dual status. If your Medicaid eligibility changes, your D-SNP enrollment can be affected, so keeping your Medicaid current is important. Call 1-800-MEDIGAP for free help confirming eligibility and enrolling in the right D-SNP.