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What Are Dual-Eligible Special Needs Plans?

dual-eligible special needs plan

If you’re entitled to both state and federal health plans, you may be able to enroll in a Dual-Eligible Special Needs Plan. Call our licensed insurance agents today at (800) 950-0608 to learn more about eligibility for a D-SNP.

Just the Essentials:

  • Individuals who are dually eligible for Medicare and Medicaid may be able to enroll in a specific Special Needs Plan.

  • These “dually eligible” individuals may qualify for a Dual-Eligible Special Needs Plan (D-SNP).

  • Your Dual-Eligible Special Needs Plan will provide benefits tailored to your specific medical circumstances, like any other Special Needs Plan.

  • These special Medicare Advantage plans allow you to access more coverage than you’d have with Original Medicare or traditional Medicare Advantage plans.

Engaged in Medicare Planning? Include a Special Needs Plan in your Search

The Special Needs Plan (SNP) is one of the best-kept secrets in the world of Medicare. Very few people know that these special Medicare Advantage plans, which provide more coverage than a typical Medicare plan, exist.

We’re here to change that.

Whether you need specialized coverage for a chronic condition, or you need help covering medical expenses that come with institutional care, there’s an SNP for you. Today, we’re going to focus on the Medicare Advantage Dual Eligible Special Needs Plan.

What is the Dual-Eligible Special Needs Plan (D-SNP), and what will it cover? Let’s find out.

A Dual-Eligible Special Needs Plan Helps Coordinate Medicare and Medicaid Benefits

Are you eligible for both Medicare and Medicaid coverage? Are you enrolled in both Medicare and Medicaid? If you can answer “yes” to either question, you’re eligible for a Special Needs Plan known as a Dual-Eligible Special Needs Plan, or D-SNP.

These types of plans are very important to include in any type of Medicare planning or research, especially if you’re considered dually eligible. This means that you’re eligible for both Medicare and Medicaid. Why are these plans so important for Medicare planning while researching Medicare Advantage options, you might ask? The answer is a simple one.

D-SNPs are designed to help you consolidate your Medicare and Medicaid benefits into one super-helpful plan. This makes it much easier:

  • For your provider to make referrals to specialists.
  • To receive a specialized treatment plan from your provider.
  • To receive coverage for physical and behavioral health care.
  • To find a qualified provider.

If you’re worried about whether or not you’ll receive equal or better coverage with a D-SNP, put those worries to rest. Like any Medicare Advantage plan, a Medicare Advantage Dual-Eligible Special Needs Plan must provide the same coverage as an Original Medicare plan. However, like any other Special Needs Plan, you’ll receive coverage that’s more in-depth and specialized than you would with Original Medicare or traditional Medicare Advantage plans.

How Will I Know if I’m Eligible to Enroll in a D-SNP?

Whether or not you’re eligible to enroll in a Dual-Eligible Special Needs Plan relies primarily on one factor and one factor alone. In order to enroll, you must be dually eligible to enroll in both Medicare and Medicaid*. If you aren’t considered dually eligible, then you won’t be eligible for a D-SNP.

There are other factors that play into eligibility as well. For instance, you’ll need to live in an area that has D-SNP coverage. So, if you’re dually eligible and live in an area where D-SNP coverage is readily available, you’re good to go!

I’m Not Considered Dually Eligible - What Options Do I Have?

It’s true that a D-SNP offers very comprehensive coverage for those who are eligible. However, if you aren’t eligible for a Dual-Eligible Special Needs Plan, you still have wonderful coverage options that can help you get the care you need.

When you’re in the phase of Medicare planning, be sure to consider as many options as you can. Keeping your options open is a great way to expand the field of coverage types that are available to you. For instance, you may find another Special Needs Plan, such as a Chronic Condition SNP or an Institutional SNP, that will cover the types of care you need. You may also find great coverage with a Medicare Advantage plan in your area.

Are you currently searching for Medicare plans in your area? If so, our free plan finder makes it easier than ever to find options in your area that can work for you. Just enter your zip code into the free plan finder tool below to get started. If you have any questions about the plans you find, give our licensed insurance agents a call at (800) 950-0608. They’ll be happy to help you find the answers you’re looking for!

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