A Medicare Advantage Dual Eligible Special Needs Plan is a type of Medicare Advantage plan designed to serve people who are eligible for both Medicaid and Medicare. The plan covers the same benefits as Original Medicare (Part A and Part B), but also provides extra benefits that Original Medicare doesn’t cover, like prescription drugs, vision, dental care, and wellness programs.
Medicare Advantage Dual Eligible Special Needs Plans are designed to help people who are eligible for both Medicare and Medicaid. If you’re eligible for both, these plans can provide additional benefits and help lower your out-of-pocket costs.
A Medicare Advantage Dual Eligible Special Needs Plan will cover all the same things as Original Medicare (Part A and Part B) plus additional benefits like vision, dental, hearing, and prescriptions.
If you choose a plan that includes prescription drug coverage, you’ll have a maximum out-of-pocket amount of $6,700 per year. Once you meet this amount, your plan will pay 100% of your covered out-of-pocket expenses for the rest of the year.
Medicare Advantage Dual Eligible Special Needs Plans also include catastrophic coverage, which provides extra protection against high drug costs in certain situations.
Dual-eligibles typically have low incomes and may also have disabilities, chronic illnesses, or other special needs. These plans are available at no extra cost to beneficiaries, and they may include prescription drug coverage, as well as other benefits not normally covered by Medicare or Medicaid.
This type of plan is only available to people who are eligible for both Medicaid and Medicare. For example, you could be eligible if you have full Medicaid benefits and Medicare Part A and Part B.
D-SNPs can provide additional benefits that Original Medicare doesn’t cover. These benefits may include coverage for dental care, vision care, and hearing aids. They may also offer programs to help manage your health conditions.
To join a D-SNP, you must already have both Medicare and Medicaid coverage. If you aren’t sure if you’re eligible for both, call the phone number on your Medicare card or contact your local Medicaid office for assistance.
Medicare Advantage Dual Eligible Special Needs Plan (D-SNP) is a type of Medicare Advantage Plan that includes prescription drug coverage. D-SNP is for people who have Medicare and Medicaid and who have certain chronic conditions or other special needs.
Medicare Advantage Plans can be HMOs, PPOs, Private Fee-for-Service Plans (PFFS), Special Needs Plans (SNPs), or Medical Savings Account (MSA) Plans. Some plans may also offer extra coverage, such as vision, hearing, dental and/or health and wellness programs. Most include Medicare prescription drug coverage (Part D).
If you have both Medicare and Medicaid, you are considered a “dual eligible” beneficiary. This means that you qualify for both Medicare and Medicaid. You can make an informed decision about whether to enroll in a Dual Eligible Special Needs Plan (D-SNP).
Dual Eligible Special Needs Plans are like other Medicare Advantage plans but they limit enrollment to people who have special needs. They must coordinate both your Medicare and Medicaid benefits so that they work together to meet all of your needs, including long term care services.
This type of plan offers all the benefits of Original Medicare, may include prescription drug coverage and may offer extra coverage, like vision, hearing, dental and/or health and wellness programs. With a Medicare Advantage SNP you get all your Medicare-covered health care through that plan.