Dual Special Needs Plan: For people with Medicare & Medicaid
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:
- You are eligible Medicare and Medicaid and have both.
- You have Medicare Part A and Part B.
- 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.
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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