Dual SNP

About Dual-snps

A Dual Special Needs Plan (or D-SNP) is a type of Medicare Advantage plan specifically designed for people who qualify for both Medicare and Medicaid—often called “dual-eligible” individuals. These plans combine the benefits of Medicare and Medicaid into one coordinated plan, with extra support tailored to people who may have limited income, chronic conditions, or complex healthcare needs.

How it Works

Medicare + Medicaid Coverage, Combined

D-SNPs include all the standard Medicare Part A and B benefits (hospital and medical insurance), and they typically also include Part D prescription drug coverage. What makes D-SNPs different is that they work alongside your Medicaid benefits to reduce or even eliminate out-of-pocket costs like premiums, deductibles, and copays. In many cases, there may be $0 cost for medical visits, hospital stays, and prescriptions, depending on your level of Medicaid eligibility.

Extra Benefits and Care Coordination

Since D-SNPs are built for people who may need extra help, these plans often include added benefits you wouldn’t get with Original Medicare alone, such as:

• Allowances for Health Groceries
• Over-the-counter (OTC) benefit cards
• Dental, vision, and hearing coverage
• Transportation to Medical Appointments
• Personal care coordination

Care coordination is a big part of a D-SNP. Many plans assign a care manager or service coordinator to help you manage medications, make appointments, and stay on top of chronic health conditions.

 Eligibility Requirements

To enroll in a D-SNP, you must:

1. Be enrolled in Medicare Part A and Part B
2. Be eligible for some level of Medicaid in your state (which could include full Medicaid or a Medicare Savings Program)

You must also live in the plan’s service area.

In short, D-SNPs are ideal for people who qualify for both Medicare and Medicaid and want enhanced support, more benefits, and less out-of-pocket cost, all through a single, streamlined Medicare Advantage plan.

Do I Lose My Medicaid?

The benefits are a no brainer but is there anything I should be cautious of? That’s a great question – and one we get a lot. Usually, the biggest concern for someone on Medicare and Medicaid is the worry of losing their Medicaid benefits. You should ALWAYS check with a licensed agent before enrolling into one of these plans. In about 98% of cases it has no impact on your Medicaid benefits – meaning that you still have all of your Medicaid benefits and it’s still secondary to your Medicare Advantage plan (just like it was with Original Medicare). However, for individuals who are receiving an institutionalized level of care, either at a facility or at home, it may conflict with your Medicaid depending on the extent of those benefits. Therefore, it’s always best to check with a licensed agent first making any changes. Contact Us now in order to determine if a Dual-SNP is right for you.